bluuebunny/crossref_metadata_2025_split huggingface dataset:
MINORITY & DIVERSE POPULATIONS I UNWAVERING STRENGTH IN THE FACE OF ADVERSITY: THE STRONG BLACK WOMAN, DEPRESSION, AND BEREAVEMENT
Authors: McDuffie Danielle L , Allen Rebecca S , Black Sheila , Crowther Martha R , Whitlow Ryan , Acker Laura 
Published: November 2019

Abstract
This study sought to investigate grief outcomes among older African American (AA) women following the recent loss of a loved one. Whether or not the “strong Black woman” (SBW) schema of presenting unwavering strength despite adversity was present in recently bereaved older AA women, specifically related to depressive outcomes, also was explored. Eleven AA women aged 46 years and older (M=64.2), completed one time, in-person semi-structured interviews detailing their grief experiences. Interview transcripts were then coded by a team using an inductive qualitative approach. Four themes emerged throughout the women’s bereavement experience: 1) Acceptance of Loss and Preparation, 2) Coping as a Gradual Passing of Time, 3) Engaging in Other Activities to Cope with Loss, and 4) Helping Others Cope. About a third of the women in the sample reported being clinically depressed in accordance with the specifications for Major Depressive Disorder reported in the DSM 5. AA women in the sample were found to portray not only the stoicism consistent with the SBW schema, but also themes consistent with embodying the schema during their bereavement experience. More research and attention should be paid to AA women’s manifestations of depression, under the knowledge that AA women may have nontraditional depressive symptom presentations. Further, the tendency for the SBW schema to emerge during bereavement should be addressed with AA women in clinical practice, as lack of awareness of the use of this mechanism could lead to exacerbated, adverse adjustment.
PSYCHOSOCIAL FACTORS ASSOCIATED WITH SLEEP QUALITY AND DURATION AMONG OLDER ADULTS WITH CHRONIC PAIN
Authors: Zaidel Catherine , Musich Shirley , Karl Jaycee , Wang Shaohung , Kraemer Sandra , Yeh Charlotte 
Published: November 2019

Abstract
Sleep complaints are common among older adults with pain. Due to the risk of side effects, sleep medications are not recommended. Little is known about the association between psychosocial factors and sleep, but further awareness could support non-drug strategies for poor sleep. Our objective was to determine prevalence of self-reported poor sleep and duration among older adults with pain; and examine associations of positive psychosocial characteristics on sleep. This study analyzed surveys and claims from older adults with AARP® Medicare Supplement plans insured by UnitedHealthcare. Participants were 65+ with diagnosed back pain, osteoarthritis and/or rheumatoid arthritis; 12-months plan enrollment. All participants responded to a survey in May 2018 assessing sleep quality. Prescriptions were determined from claims. Propensity weighting was used to adjust for non-response bias. Results were weighted to generalize to those with pain. Multivariate logistic regression was used to evaluate associations. Short sleep duration was most common (39%), followed by poor quality (22%), and long duration (9%). Higher resilience and diverse social networks were associated with good quality and duration. Strongest associations with bad quality and short duration were stress, depression and sleep medications. Psychosocial factors were strongly associated with sleep quality and duration among older adults with pain. Results underscore the importance of social factors on sleep and need for non-drug sleep strategies.
ELECTRONIC USE AND SLEEP, SURPRISING BEDFELLOWS: RESTFULNESS EFFECTS OF ELECTRONICS USE PRIOR TO BEDTIME FOR THE 40-PLUS
Authors: Rainville G , Lampkin Cheryl 
Published: November 2019

Abstract
Getting restful sleep is essential to well-being but stress and poor sleep habits may make sleeping through the night challenging. This research explored life event stressors and pre-sleep activities among 2,464 randomly selected Americans age 40 and older (using Ipsos’ KnowledgeNetwork panel) to determine their joint effects on mental well-being. Respondents reported how often they engaged in twelve individual behaviors within an hour of going to sleep. These behaviors (found to be inter-correlated) were combined using EFA into four factors representing levels of engagement in each of four classes of pre-sleep activities: pre-sleep electronics use (e.g. texting/e-mail before bed), deep relaxation activities, reliance on sleep-aids, and “nightowl” behaviors (i.e., snacking). Counter to expectations, only electronics use had significant conditional effects on the path between a life events stressor index (a count of current, potentially stressful life events) and scores on the positively-framed Warwick Edinburgh well-being scale (WEMWBS). How often one sleeps through the night also had unexpected effects in a conditional path analysis. A somewhat-involved relationship emerges between each of the theoretically-relevant measures. First, the negative impact of stress is moderated by sleeping through the night. Sleeping through the night is, counter to previous studies on electronics use and sleep, mediated by the use of electronics prior to sleep. We propose that mechanisms (such as the nature of backlighting used in electronics) that hamper restfulness may be offset by relaxation effects or by setting one’s ducks in a row by texting/emailing before going to sleep.
THE ISOLATION OF OLDER ADULTS: A COMPARISON OF JAPANESE GENDERS AND HOUSEHOLDS
Authors: Katagiri Keiko 
Published: November 2019

Abstract
As the aging population increases, large changes have occurred among household structures in Japan. Half of older adults lived with their children’s families in 1980. Now around 60 percent of them live by themselves: 27% in single households and 31% as older couples alone. Older adults in single households are said to be at higher risk of social isolation. A Japanese white paper reported that they had scanty of social interactions compared to other types of households. This study examines differences in the social relationships and health statuses among household types by gender and explores the risk factors of social isolation. Nationally representative 2012 Japanese Social Survey data were used for analyses; a subsample comprised participants aged 60 to 74 years. A series of ANCOVAs were conducted. The distribution of the gender and household types were single male 105 (10.0%), married male 387 (36.8%), single female 180 (17.1%), and married female 381 (36.2%); the main effects were being female and married. An interaction effect between them (single males were less happy than married males) was observed. Neighborhood relationships were better among females and married participants. Married participants were more active in community meetings, social participation, and volunteering. However, no difference was observed in social network size. Thus, network size alone was not related to social isolation, but being active in social relationships and the quality of relationships influenced social isolation and well-being. Being married and female may facilitate higher quality relationships and may lead to activity and buffer social isolation.
AGING-FRIENDLY COMMUNITY INITIATIVES: HARNESSING NETWORKS FOR CHANGE FROM THE LOCAL TO THE GLOBAL
Authors: Greenfield Emily , Reyes Laurent 
Published: November 2019

Abstract
Aging-friendly community initiatives (AFCIs) represent multi-sectorial efforts to systematically make localities better for long lives. AFCIs typically work toward progress in multiple domains of community life, focusing both on social and built environments. Despite tremendous growth in AFCIs worldwide over the past decade, there has been little empirical research on how they develop and work toward their aspirational goals. This paper presents findings from a community-partnered study on the development of nine philanthropically supported AFCIs in northern New Jersey. Drawing on fives waves of in-depth interview data collected with leaders over three years, the paper addresses the role of the leaders’ interpersonal and interorganizational networks as they work toward aging-friendly community change. Findings on the centrality of networks across various levels of geographic scale for the development of AFCIs has implications for program theory, as well as broader issues concerning inclusion and equity within community-level responses to population aging.
PHYSICAL ACTIVITY, FALLS, AND FALL INJURIES: THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION
Authors: Ylitalo Kelly , Gabriel Kelley 
Published: November 2019

Abstract
Physical activity (PA) is positively associated with physical functioning, but relations of domain-specific PA with falls is less clear. In 2015, women (n=1,962) self-reported fall history and PA. The Kaiser Physical Activity Survey (KPAS) assessed sports, non-sports leisure, household/caregiving, and total activity. Risk ratios (RR) were generated from poisson regression. One-third (29.7%) of women (mean age=65.1 years [SD 2.7]) reported ≥1 fall and 18.3% reported ≥1 fall injury in the previous 12 months. Women in the highest quartile of sports activity had an increased risk of ≥1 fall (RR=1.19;95%CI:1.00,1.41;p=0.049). Women in the highest quartile of total activity had an increased risk of injurious falls (RR=1.31;95%CI:1.04,1.65;p=0.021), but there was no association for domain-specific indices. KPAS may identify women and activity domains, such as sports, at high risk for falls and injuries. Future work should incorporate device-based PA assessments within domains to understand fall patterns among community-dwelling older adult women.
RACIAL-ETHNIC DISPARITIES IN PHYSICAL PERFORMANCE: THE STUDY OF WOMEN’S HEALTH ACROSS THE NATION
Authors: Karvonen-Gutierrez Carrie , Colvin Alicia , Stewart Andrea , Appelhans Bradley , Cauley Jane , Dugan Sheila , Khoudary Samar El , Sternfeld Barbara 
Published: November 2019

Abstract
Racial/ethnic disparities exist in physical performance among older adults, but little is known about the factors leading to these differences. We evaluated how sociodemographic, health, behavioral, and psychosocial factors mediated the relationship between race/ethnicity and physical functioning performance among 1,855 Black, Chinese, Hispanic, Japanese and White postmenopausal women from the Study of Women’s Health Across the Nation. White women had better mean physical performance scores (decile-based score including relative performance on grip strength, timed 4-meter walk, and timed repeat chair stand tasks) as compared to Black, Hispanic and Chinese women but slightly poorer scores vs. Japanese women. In Blacks and Hispanics, 75% and 95% of that disparity, respectively, was through mediators, particularly education, financial strain, BMI, physical activity and pain. Addressing issues of poverty, racial inequality, bodily pain and obesity could reduce some racial/ethnic disparity in functional limitations as women age.
FACTOR STRUCTURE OF NEUROPSYCHIATRIC SYMPTOM FREQUENCY IN HOME-RESIDING PERSONS WITH DEMENTIA
Authors: Hodgson Nancy , Regier Natalie , Gitlin Laura 
Published: November 2019

Abstract
This study evaluated neuropsychiatric symptom clusters in a sample of home residing persons with dementia, and the impact of distinct clusters on family caregiver outcomes. The expanded Neuropsychiatric Inventory (NPI-C), including measures of frequency, was collected at baseline from 250 caregivers enrolled in Reducing Agitation in People With Dementia: the Customized Activity Trial [NCT01892579]. Principle component analyses were conducted resulting in an eight behavioral clusters, accounting for 44% of total variance: 1=agitation/aggression; 2=anxiety; 3=apathy/withdrawl; 4=impulsivity; 5=psychosis; 6=restlessness; 7=circadian disturbance; 8=depression. In multiple linear regressions caregiver burden was significantly influenced by the anxiety cluster. Caregiver depression was significantly influenced by apathy/withdrawal cluster, and quality of life was significantly associated with anxiety and circadian disturbance clusters. Dimensional representation of neuropsychiatric symptom clusters can be useful in assessing the effect of multiple co-occurring symptoms (versus discrete individual symptoms) on caregiver outcomes and for planning personalized intervention strategies for persons with dementia.
CHANGE IN DEMENTIA FAMILY CAREGIVERS’ WILLINGNESS TO PAY FOR A NONPHARMACOLOGIC INTERVENTION
Authors: Jutkowitz Eric , Scerpella Daniel , Prioli Katherine , Marx Katherine , Gitlin Laura N , Pizzi Laura , Popp Jonah 
Published: November 2019

Abstract
Family caregivers provide a majority of care for persons with dementia (PwD); however, little is known about caregiver’s willingness to pay (WTP) for an intervention to help them manage dementia symptoms. To fill this gap, caregiver/PwD dyads (n=223) were recruited to participate in a randomized trial evaluating tailored activities to minimize behavioral symptoms and functional decline. At baseline and 6-months caregivers were asked their WTP per session for the 8-session 3-month program compared to caregiver education/support only. At baseline, treatment caregivers were WTP $26.20, which was $11.50 (95%CI:-$12.70, -$10.3) less per session compared to control group caregivers WTP $37.30. At 6-months, treatment caregivers were WTP $22.90 and control caregivers $27.30. From baseline to 6-months, a change in WTP was $7.00 (95%CI:$5.80, $8.30) greater than the change in WTP for control group caregivers. Caregivers WTP slightly decreases over time in both groups but decrease is less for TAP following program participation.
SELF-REPORTED VISION IMPAIRMENT AND SUBJECTIVE WELL-BEING IN OLDER ADULTS: A LONGITUDINAL MEDIATION ANALYSIS
Authors: Ehrlich Joshua R , Xiang Xiaoling , Shah Khushali , Hu Rita X , Stagg Brian C , Freedman Vicki A 
Published: November 2019

Abstract
Vision impairment (VI) in older adults is associated with declines in well-being. However, the pathways through which poor vision leads to declines in well-being have not been well described. The purpose of this study was to determine whether activity limitations and social participation restrictions mediate the impact of self-reported VI on subjective well-being. This study used data from the National Health and Aging Trends Study (NHATS), a nationally-representative longitudinal study of Medicare beneficiaries 65 and older that includes detailed measures of the disablement process. We conceptualized a longitudinal mediation model linking self-reported VI and subjective well-being. Structural equation modeling was used to test the mediating effects of activity limitations and social participation restrictions while adjusting for covariates. The final sample included 5,431 respondents. At baseline, 8.0% of Medicare beneficiaries had self-reported VI. Subjective well-being scores were significantly lower among respondents with self-reported VI (15.7, 95% CI=15.2, 16.2) compared to those without VI (17.6, 95% CI=17.5, 17.7). Self-reported VI had a significant indirect effect on subjective well-being through limiting mobility (β=-.04, 95% CI=-.07, -.03) and household activities (β=-.05, 95% CI=-.08, -.03), but not self-care limitations (β=0.0, 95% CI=0.0, 0.0) or participation restrictions (β=0.0, 95% CI=-0.01, 0.00). Total indirect effects from all mediation paths accounted for 42% of the effect of VI on well-being. In conclusion, mobility and household activity limitations are significant mediators that explain a considerable portion of the impact of poor vision on well-being. Interventions to promote successful accommodation may result in greater well-being for visually impaired older adults.
A COMMUNITY-BASED INTERVENTION TO IMPROVE COGNITIVE FUNCTION IN RURAL APPALACHIAN OLDER ADULTS
Authors: Katz Benjamin 
Published: November 2019

Abstract
Research suggests that social isolation in Appalachian older adults may be associated with reduced cognitive function. Despite this, few interventions for these individuals incorporate both social and cognitive components in a community-based setting. The “Memory Masterclass” program was developed to address this care challenge, and implemented through an Adult Day Services Center. With 29 community-dwelling older adult participants from western Virginia, the six-week pilot program focused on strategies and practices associated with improving long-term memory or executive function. In addition to the lifestyle-focused curricula, the course included group activities focused on connecting participants to community networks of resources that might enable them to successfully implement lifestyle changes. Findings support the feasibility of implementation with a wider group of rural Appalachian older adults and suggest that individual differences in self-reported memory may be closely tied to improvements following the program.
LEARNING FROM IN-DEPTH COGNITIVE ASSESSMENTS CONDUCTED IN RURAL INDEPENDENT LIVING FACILITIES
Authors: Wiese Lisa K , Williams Christine , Galvin James E , Hain Debra , Newman David 
Published: November 2019

Abstract
Despite benefits to earlier Alzheimer’s disease interventions, efforts to increase dementia detection and treatment in high-risk rural areas are lacking. Barriers include lack of resources, including limited time for providers to conduct in-depth cognitive assessments. A pilot program tested the effectiveness of a home-based approach for increasing rates of AD detection and treatment in a rural retired farmworker community. Depression and cognitive screenings of 139 residents conducted by community health workers were followed up with in-depth geriatric-focused assessments, including the Moca-B, by experienced, culturally diverse adult gerontological nurse practitioners (AGNPs). Their findings were forwarded to primary providers. This approach was evaluated for effectiveness using correlations, regressions, and Chi-square analyses of variables on rates of ADRD screening, referrals, and ADRD diagnosis.
INTEREST GROUP SESSION—QUALITATIVE RESEARCH: INNOVATIVE QUALITATIVE AND MIXED-METHODS STUDIES OF OLDER ADULTS’ LIVED EXPERIENCES IN NETWORKS OF CARE AND CARING
Authors: Washburn Allyson M , Schwartz Abby 
Published: November 2019

Abstract
Researchers are challenged both when querying older adults about their lived experience and later when analyzing these rich interview data to characterize and preserve their truths. This symposium presents innovative strategies to meet these challenges in ways that deepen our understanding of older adults’ lives within their networks of care and caring. Participants in two interpretive phenomenological studies were family caregivers. One examined the impact of the Virtual Dementia Tour® on participants’ perceptions of their family member’s lived experience of dementia, identifying changed realities and approaches to caregiving following their experience. The second analyzed in-depth interviews of aging caregivers about future care for their adult children diagnosed with autism spectrum disorders, finding that they had difficulty identifying caregiving support for the future while feeling the need to make plans and decisions now. Two mixed methods studies explored older adults’ experience of their current environment. In the first, measures of social cognition and engagement informed the interpretation of combined phenomenological-hermeneutic and conventional content analyses of nursing home residents’ responses to questions about their relationships, finding that they valued day-to-day social interactions as connections with longtime friends were maintained. The second study combined focus groups, in-depth interviews, and web-based surveys during the psychometric testing of the Person-Place Fit Measure for Older Adults to assess older adults’ experience of aging in a particular place with people they find important. The strategies detailed in these four papers transformed more conventional approaches to deepen our understanding of older adults’ experiences of their lives with others.
REDUCING HEALTH DISPARITIES IN THE ERA OF VALUE-BASED CARE
Authors: Kumar Amit , Mahmoudi Elham , Rivera-Hernandez Maricruz 
Published: November 2019

Abstract
The US health care system is at a critical moment of transformation. The implementation of value-based models has made significant progress towards improving care quality and coordination, continuity of care and reducing cost. However, concerns have been raised regarding “cherry-picking” healthier people that may negatively impact patients with more complex needs and minority populations. Given that the US is becoming more diverse, there is a need for understanding the impact of social risk factors including ethnicity, immigration status, income and geography on health outcomes and issues of health care disparities. This panel brings together four studies that examine these phenomena in minority populations. These studies will provide novel insight regarding 1) healthcare utilization in Mexican-American Medicare beneficiaries and showing that social determinants of health are associated with a higher risk of hospitalization, emergency room admissions, and outpatient visits. 2) Mortality rates and predialysis care among Hispanics in the US, Hispanics in Puerto Rico, and Whites in the US demonstrating substantial disparities in access to recommended nephrology care for Hispanics in Puerto Rico; 3) Trends in age-adjusted mortality rates and supply of physicians in states with different nurse-practitioners regulation. 4) The impact of social risk factors on disenrollment from Fee-For-Service and enrollment in a Medicare Advantage plan in older Mexican-Americans. 5) Racial disparities in access to physician visits, prescription drugs, and healthcare spending among older adults with cognitive limitation. Studies in this panel will also discuss the effects of changes in care delivery and payment innovations in improving health equity.
RACIAL DISPARITIES IN ACCESS TO AND COST OF HEALTHCARE AMONG OLDER ADULTS WITH COGNITIVE LIMITATION: 2002 TO 2016
Authors: Mahmoudi Elham 
Published: November 2019

Abstract
Using 2002-2016 Medical Expenditure Panel Survey, we examined racial/ethnic disparities in office-visits and prescription-drugs among individuals with cognitive limitation (CL). Medicare beneficiaries (65+) with CL (N=9,369) were included. We used generalized linear models. Prevalence of CL increased overtime among all racial/ethnic groups. Our findings indicate that 96% of Whites vs. 93% of Blacks had at least one office visit (diff=0.03; 95% CI:0.01-0.04). Whites had 2 (95% CI: 1.0-0.4) and 4 (95% CI: 2.5-6.0) more office visits compared with Hispanics and Asians; and used 4 (95% CI: 1-6.9), 5 (95% CI:1.0-9.3) and 6 (95% CI: 1.0-11.5) more prescriptions than their Blacks, Hispanics, and Asians, respectively. Whites had higher annual expenditures for office-visits compared with Asians ($889; 95% CI:409-1,368) and higher expenditures for prescriptions compared with Blacks ($484; 95% CI:$151-$816) and Asians ($546; 95% CI:$28-$1064), respectively. Disparities in care among older adults with CL may put vulnerable subpopulations at a higher risk.