bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neighborhood Disadvantage, Cognition, and Health Self-Efficacy of Older Adults in a Clinical Population
Authors: Berg Kristen , Krieger Nikolas I , Einstadter Douglas , Shamakian Lorella , Dalton Jarrod , Perzynski Adam 
Published: December 2020

Abstract
The Medicare Annual Wellness Visit (MWV) includes an assessment of health risks for older adults in the United States. Research suggests that neighborhood-level social inequality influences multiple health outcomes. We sought to examine the association between neighborhood socioeconomic position and older adults’ cognition, health management self-efficacy, and other health risks. We identified a cohort of 12,434 adults aged 65 and over from the NEOCARE Learning Health Registry who attended a routine MWV between 2011 and 2019. NEOCARE includes electronic health record and neighborhood data from 1999-2017 on over 3 million unique Northeast Ohio individuals. The study population was 60% White, 32% Black or African American, 64% female, and 90% non-Hispanic. Over 60% were ages 65-74, 29% 75-84, and 10% 85 years or older (range from 65 to 101). We used ANOVA and chi square tests to examine variation in health risks by quintile of census tract area deprivation index. Cognitive functioning differed across quintiles of area deprivation and Bonferroni-corrected tests indicated that adults in the most socioeconomically disadvantaged neighborhoods had lower average cognitive screening scores as compared to older adults in less disadvantaged areas (F=53.50, df=4, n=12,204, p&lt;.001). The proportion of adults feeling efficacious in managing their health differed according to area deprivation, with adults in more disadvantaged neighborhoods having slightly lower self-efficacy, (x2=11.01, df=8, n=11,937, p&lt;.001). Better understanding of the relationship between cognitive functioning and health self-efficacy and neighborhood environment is critical for designing programmatic and policy interventions aimed at supporting proactive aging in older adulthood.
Hearing and Cognitively Impaired Life Expectancies in the United States
Authors: West Jessica , Lynch Scott 
Published: December 2020

Abstract
As the population ages, increased prevalence of cognitive and sensory impairments may pose growing public health challenges. Among the nine modifiable risk factors for dementia, the highest percentage (9%) of dementia cases are attributed to hearing impairment. While much research has examined the relationship between hearing impairment and cognition, almost none has translated these relationships into a meaningful, life course metric: how many years of life individuals can expect to live with both impairments and how hearing impairment affects years lived with cognitive impairment. Our study fills this gap by using Bayesian multistate life table methods applied to nine waves of the Health and Retirement Study (1998-2014) to estimate years of life to be spent (1) with/without hearing and cognitive impairment, and (2) with/without cognitive impairment, conditional on having versus not having hearing impairment. Preliminary results for aim 1 reveal that at age 50, individuals will live 18.9 (18.7-19.2) years healthy, 4.3 (4.2-4.5) years hearing impaired but cognitively intact, 4.2 (4.0-4.3) years hearing unimpaired but cognitively impaired, and 2.3 (2.2-2.6) years with both impairments. Women will spend more years healthy, hearing unimpaired but cognitively impaired, or with both impairments; men will spend more years hearing impaired but cognitively intact. People with more education will spend more years hearing impaired but cognitively intact; people with less education will spend more years hearing unimpaired but cognitively impaired or with both impairments. Our study is one of the first to investigate the implications of hearing impairment for years of cognitively impaired life.
Intergenerational Communication as Non-Pharmacological Care in a Japanese Nursing Home
Authors: Hamaguchi Toshiko 
Published: December 2020

Abstract
Statistics shows that Japan now has 28.4% of population aged over 65, which marks the highest in the world. Moreover, one in four over 65 is said to have ADRD or MCI. Traditional family caregiving derived from filial piety is giving way to moving to care facilities in order to reduce a burden on children or get professional care. This suggests that everyday communication for older adults involves younger conversational partners with varying degrees of shared knowledge and experiences. Such intergenerational communication can be challenging and stressful on both sides. To date, empirical studies that observe interactional strategies of both younger caregivers and older adults is unknown. Using 21 recordings of weekly conversational activities (45-60 minutes) led by recreation workers (female, 40s) taken at a nursing home in Japan, this qualitative study demonstrates how (1) sharing of the past and present becomes a learning opportunity for both recreation workers and older participants with ADRD (aged 87-95) , (2) reference to nursing-home living establishes and reaffirms their interpersonal relationship, and (3) intergenerational conversation becomes a tool to express life satisfaction for the older participants. This evidence-based study proposes mundane conversations during recreational activities as part of non-pharmacological person-centered care which serves to improve the quality of life and life satisfaction of older adults at care facilities. It is therefore important to study communicative strategies of professional caregivers since they affect social engagement as well as emotional and psychological well-being of those at the end-of-life stage.
Factors Associated with Frailty Status in Relatively Healthy Community-Dwelling Older Adults
Authors: Ekram A R M Saifuddin , Ryan Joanne , Espinoza Sara , Murray Anne , Ernst Michael , Woods Robyn 
Published: December 2020

Abstract
Frailty is gaining importance as a predictor of disability and mortality in older people, and becoming frail poses a challenge for healthy aging. We investigated the prevalence and factors associated with pre-frail and frail status in a large study cohort of community-dwelling healthy older adults from Australia and the United States. A total of 19,114 individuals (87% Australian and 56% women) aged 65 years or older enrolled in a primary prevention clinical trial were evaluated. Frailty status was classified using the modified Fried phenotype criteria comprising of exhaustion, body mass index, grip strength, gait speed and physical activity. Prevalence and factors associated with frailty status (e.g. demographic characteristics and lifestyle factors) were reported using descriptive statistics along with a logistic regression model. At baseline, 2.3 % (95% CI, 2.1-2.5) of older trial participants were frail and 39.2% (95% CI, 38.5-39.9) were pre-frail, respectively. Women were more likely to be frail (65.1% vs 36.9%) and prefrail (58.0% vs 42.0%) than men. Lower levels of education (&lt;12 years), living alone, ethnic minorities, current smoking and past alcohol use were some of the factors which were common among frail or prefrail. Despite being a relatively healthy cohort, more than one-third of the older trial participants were pre-frail, which was more prevalent among specific subgroups of individuals. This study emphasizes the high burden of the prefrailty status even among an apparently healthy cohort of community-dwelling older people.
Obstacle negotiation in older adults: prefrontal activation interpreted through conceptual models of brain aging
Authors: Clark David , Chatterjee Sudeshna , Seidler Rachael , Skinner Jared , Rose Dorian , Lysne Paige , Woods Adam 
Published: December 2020

Abstract
Age-related decline in executive function is associated with walking deficits in older adults. The main objective of this study was to better understand the cognitive control of obstacle negotiation in older adults by identifying predictors of prefrontal recruitment during the task. The study also examined the association between prefrontal recruitment and walking performance as well as interpretation of prefrontal activity relative to cognitive models of brain aging. Prefrontal oxygenated hemoglobin concentration (O2Hb) was measured by functional near-infrared spectroscopy during typical walking (Typical) and obstacle negotiation (Obstacles) tasks in older adults. The primary outcome was change in prefrontal recruitment (∆PFR), measured as Obstacles ∆O2Hb minus Typical ∆O2Hb. Stepwise regression was used to identify potential predictors of ∆PFR. Additional analyses were conducted to further examine the relationship between ΔPFR and the identified predictors. Greater ∆PFR was predicted by lower age, worse executive function, and their interaction (R2=0.19 , p=0.02). Particularly, the effect of executive function on ∆PFR was more pronounced for “early aging” than for “late aging” older adults (p&lt;0.001). Greater ∆PFR was significantly associated with a smaller reduction in walking speed during Obstacles compared to Typical. In conclusion, age, executive function, and their interaction predict prefrontal recruitment during obstacle negotiation in older adults. These findings are generally consistent with existing cognitive models of brain aging including neural inefficiency, compensatory overactivation, and capacity-limitation with a recruitment ceiling effect.
Restricted Mean Survival Time in Action to Control Cardiovascular Risk in Diabetes (ACCORD) Blood Pressure
Authors: Shi Sandra , Wei Lee-Jen , Kim Dae 
Published: December 2020

Abstract
Background: Restricted mean survival time (RMST) provides mean time lost or gained by an intervention. This may be a more intuitive way to understand treatment effect. Objective: To determine overall and subgroup treatment effects from blood pressure targets in older adults with diabetes. Methods: We analyzed the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial data. Our outcome was cardiovascular disease free survival. We measured 5-year RMST (days) between standard and intensive blood pressure control, and compared the difference by age (≥70 or &lt;70 years old) and glycemic control (standard vs. intensive). Results: Over 5 years, those with intensive treatment lived, on average, 1716 days compared to 1714 days with standard treatment, with a RMST difference of 1.3 days (95% confidence interval, -22.1, 12.4). Among adults ≥70 years old, compared to standard treatment, intensive treatment resulted in an additional 13.6 (95% CI, -43.2, 70.3) days, where the difference was -0.5 (-20.8, 19.7) days for those aged &lt;70 years old (p-for-interaction=0.673). Compared to standard treatment, intensive treatment resulted in 28.1 (0.4, 55.9) more days for those assigned to standard glycemic control, but it appeared to result in 25.2 fewer days (-52.3, 1.9) for those assigned to intensive glycemic control (p-for-interaction=0.007). Discussion: The benefit of intensive treatment over standard treatment varies by age and glycemic control. RMST difference may allow for more intuitive and personalized weighing of benefits and risks of intensive blood pressure control.
Thalamic Volume Mediates Associations Between Cardiorespiratory Fitness and Memory in People With Parkinson’s
Authors: Petkus Andrew , Gomez Megan , Schiehser Dawn , Filoteo Vincent , Hui Jennifer , Jarrahi Behnaz , McEwen Sarah , Petzinger Giselle 
Published: December 2020

Abstract
Cognitive deficits occur in patients with Parkinson’s disease (PD), and cardiorespiratory fitness (CRF) is associated with both current and future cognitive decline in this disease. The underlying neurobiological factors explaining this relationship, however, are not well known. In this cross-sectional study we examined the associations between CRF and cognitive performance and whether such associations were mediated by grey matter volumes of basal ganglia structures. A total of 33 individuals with PD underwent structural magnetic resonance imaging (sMRI), CRF evaluation (VO2max), and neuropsychological assessment. Composite scores of episodic memory, executive functioning, attention, language, and visuospatial functioning were generated. Brain MRI morphological measurements was performed with the Freesurfer image analysis suite. Structural equation models were constructed to examine whether sMRI volume estimates of basal ganglia structures, specifically the thalamus and pallidum, mediated associations between VO2 max and cognitive performance while adjusting for age, education, PD disease duration, sex, and intracranial volume. Higher VO2max was associated with better episodic memory (Standardized β=0.390; p=0.009), executive functioning (Standardized β=0.263; p=0.021), and visuospatial performance (β=0.408; p=0.004). Higher VO2max was associated with larger thalamic (Standardized β=0.602; p&lt;0.001) and pallidum (Standardized β=0.539; p&lt;0.001) volumes. Thalamic volume significantly mediated the association between higher VO2max and better episodic memory (indirect effect=0.209) and visuospatial ability (indirect effect=0.178) performance (p&lt;.05). The pallidum did not significantly mediate associations between VO2 max and cognitive outcomes. These results suggest the thalamus plays an important role in the association between CRF episodic memory and visuospatial functioning in individuals with PD.
The Role of Attentional Control in Attention to Emotional Stimuli Among Middle-Aged and Older Adults
Authors: Ho Yuen Wan , Isaacowitz Derek 
Published: December 2020

Abstract
Prior studies have examined age differences in attention to emotional stimuli; in the current study, we considered how this might relate to dispositional measures of attentional control across age groups. Participants were 116 middle-aged (aged 35 – 64 years) and 39 older (aged 65-86 years) adults in the United States. In the study, participants filled in the Emotional Attentional Control Scale. Then participants watched fearful, happy, neutral, and disgusting videos. The gaze time for each video was measured by an eye tracker. Results did not show significant age difference in attention to happy and neutral videos. However, middle-aged adults gazed relatively more to the disgusting video and relatively less to the fearful video, t (115) =2.16, p =.03. The opposite pattern was found among older adults, t (38) =5.85, p&lt;.001. Self-reported emotional attentional control was not significantly related to attention in either age group. These findings suggest that different stimuli may yield age differences in fixation that are a less consistent pattern with the age-related positivity effect reported in previous studies, and also that self-reported emotional attentional control may not relate to gaze patterns.
Cumulative Adversity and Depressive Symptoms: Optimism as a Moderator
Authors: Dong Gabriella , Li Mengting 
Published: December 2020

Abstract
Older immigrants encountered a wide range of traumatic events across the life span, before and after immigration, in the origin and host countries. Prior studies have shown that traumatic events were associated with depression, but less is known about what are the resilience factors against depression related to traumatic events. Optimism is one of resilience assets reflecting the extent to which people hold generalized favorable expectancies for their future. This study aims to examine whether optimism could moderate the negative impact of exposure to natural disasters, traumatic personal events, and historical events on depressive symptoms. The data were drawn from the Population Study of Chinese Elderly in Chicago (PINE) in 2017-2019, with a sample size of 3,125. Traumatic life events were evaluated by natural disasters (typhoon, earthquake, and tornado), personal events (e.g. death of a loved one, physical assault) and historical events (e.g. Japanese invasion of China). Depressive symptoms were measured by PHQ-9. Optimism was assessed by Revised Life Orientation test. Linear regression with interaction terms was used. Older adults with one additional exposure to natural disaster (b=0.34, SE=0.07, p &lt;.001), personal event (b=0.32, SE=0.05, p &lt;.001), and historical event (b=0.14, SE=0.04, p &lt;.001) were associated with higher depressive symptoms. Optimism could buffer the negative impacts of natural disasters (b=-0.03, SE=0.01, p &lt;.05), personal events (b=-0.05, SE=0.01, p &lt;.001), and historical events (b=-0.02, SE=0.01, p &lt;.01) on depressive symptoms. Psychological interventions are suggested to increase optimism of older adults with exposure to lifetime traumatic events to reduce their depressive symptoms.
Racial Disparities in Cognitive Function: The Roles of Cumulative Stress Exposures Across the Life Course
Authors: Chen Ruijia , Weuve Jennifer , Kubzansky Laura , Williams David 
Published: December 2020

Abstract
Introduction: Racial disparities in cognitive function have been well-documented in the literature, but factors driving the disparities remain under explored. This study aims to quantify the extent to which cumulative stress exposures across the life course explain Black–White disparities in executive function and episodic memory. Method: Data were drawn from the 2004–2006 wave of the Midlife Development in the United States (MIDUS) and the MIDUS refresher study (N=5,967, 5,277 White, 690 Black). Cumulative stress exposures were assessed by using 10 domains of stressors (e.g., financial stress, childhood adversity). Cognitive function was assessed using the Brief Test of Adult Cognition by Telephone. Marginal structural models were conducted to quantify the proportion of the effect of race/ethnicity status on cognitive function that can be explained by cumulative stress exposures. Result: Blacks reported higher levels of cumulative stress exposures and lower average levels of executive function and episodic memory than Whites. Cumulative stress exposures explained 8.43% of the disparities in executive function and 13.21 % of the disparities in episodic memory. Cumulative stress exposures had stronger effects on racial disparities in cognitive function in the older age group (age≥ 55 years old) than in the younger age group (age &lt; 55 years old). Conclusion: Cumulative stress exposures explain modest proportions of racial disparities in levels of cognitive function. Interventions that focus on reducing stress exposures or improving coping resources among Blacks may help lessen racial disparities in cognitive function at the population level.
Evaluating the International Classification of Functioning, Health, and Disability Model as an Aging Model
Authors: Li Qiwei , Knight Becky 
Published: December 2020

Abstract
The study provides a possible theoretical framework for future aging studies focusing on a comprehensive understanding of the relationship between physical functions, social participation, and context factors including environmental and personal variables. The International Classification of Functioning, Health, and Disability (ICF) model has received considerable studies in rehabilitation counseling fields as it bridges the gap between functional limitations and overall health status for social participation. The ICF model focuses beyond physical conditions and embraces social supports and personal coping styles. This study verifies the validity of the ICF model with a data set collected from a fall prevention program. For the methods, a structural equation modeling was estimated with latent variables including body structure, body functions, activities, and personal factors. The latent variables were suggested by the ICF framework. The results showed that the estimation outcome exhibited an acceptable goodness of fit, χ2(11) = 30.401, p = .001 (due to the large sample size of 691), RMSEA= .051 [.030, .072], CFI = .968, TLI = .919, SRMR = .029. The equation level good of fit also was great with an overall R squared of .828. In conclusion, the ICF model was valid and has been tested in the aging studies with the data set collected from a fall prevention program for older adults. As the ICF model includes more variables than medical models such as personal attributions, a holistic understanding regarding aging experience among older adults from various backgrounds will become possible, which is an urgent need for diverse America.
Grandparent Resilience: Improving Self-Efficacy in Grandparents Raising Grandchildren
Authors: Fox Aimee , Riggs Nathaniel , Yancura Loriena , Fruhauf Christine 
Published: December 2020

Abstract
Grandparents often protect against childhood trauma and promote resilience through their nurturance, love, and support when raising grandchildren. Despite the beneficial role grandparents have on their grandchildren, grandparents may experience challenges of their own, including physical, mental, and emotional health issues, lack of resources, and social isolation. Few interventions exist to help grandparents successfully adapt to the challenges they face as primary parenting figures. The purpose of this study was to test preliminary efficacy of a strengths-based intervention for grandparents raising grandchildren aimed at increasing self-care behaviors, managing emotions, and connecting to community resources. Grandparents (N = 137) providing primary care to grandchildren were recruited to participate in a single-group, pre- and post-test design, 6-week intervention. Self-efficacy was assessed at baseline, post-intervention, and at a 6-month follow-up. To evaluate who the intervention might be most beneficial for, grandparents’ service knowledge, perceived support from others, and length of care provided, measured at baseline, were analyzed for moderating effects. Results of paired-samples t-tests reveal significant increases in self-efficacy (p = .013) from baseline to post-test, which were maintained at the 6-month follow-up (p = .010). Hierarchical multiple regression showed interaction effects of the hypothesized moderators were not significant, indicating improvements in self-efficacy regardless of individual variability at baseline. As demonstrated, interventions can be effective at increasing self-efficacy in grandparents raising grandchildren and strengths-based approaches have the potential to provide universal benefits to grandparents, thus improving functioning in grandfamilies and promoting the health and well-being of grandparents and their grandchildren.