bluuebunny/crossref_metadata_2025_split huggingface dataset:
ACTIVITY SELECTION AND ENGAGEMENT IN OLD AGE: MOTIVATIONAL AND GOAL-BASED INFLUENCES
Authors: Hess Thomas M , Hertzog Christopher 
Published: November 2019

Abstract
Research from a variety of perspectives has emphasized the central role played by activity in supporting a variety of positive outcomes in later life. For example, participation in activities that place demands on personal resources has been shown to be beneficial in promoting brain, cognitive, and physical health. From another perspective, older adults may also engage in certain activities to promote specific outcomes (e.g., emotional) in service of psychological well-being. Such findings highlight the adaptive significance of activity selection and engagement processes. Using a variety of approaches, the presentations in this symposium focus specifically on goal-based and motivational factors that may facilitate or impede such processes. Moored and colleagues examine adaptive characteristics—including motivational ones—of individuals whose activity patterns are protective against dementia. Using longitudinal data from the Health and Retirement Study, Lothary and colleagues explore the degree to which intrinsic motivation to engage cognitive resources mediates the effect of personal resources (e.g., physical and emotional health) on participation in challenging everyday activities. Growney and colleagues present research demonstrating that subjective perceptions of difficulty affect decisions to engage in challenging activities, but that such perceptions may reflect biases associated with negative aging attitudes as opposed to actual effort expenditure. Finally, Lind and Isaacowitz examine selection associated with affective aspects of the activities, finding that both middle-aged and older adults exhibited similar biases toward positive activities in congruence with emotion-regulation goals, though age differences were observed in non-affective aspects of the activities. The discussion by Hertzog will highlight common themes.
EXAMINING WHETHER LIFESTYLE ACTIVITY PATTERNS PREDICT DEMENTIA INCIDENCE AMONG COMMUNITY-DWELLING OLDER ADULTS
Authors: Moored Kyle , Moored Kyle , Parisi Jeanine , Carlson Michelle 
Published: November 2019

Abstract
Engagement in lifestyle activities can be neuroprotective, but it remains unclear what aspects of engagement are most beneficial. Examining activity patterns may better characterize both quantitative (e.g., number) and qualitative (e.g., characteristic/motivational) differences in engagement. We used a novel, latent class analysis (LCA) to characterize subgroups with distinct activity patterns and examined whether they have differential risk of incident dementia. We compared these findings to models including standard activity frequency and variety metrics. Using the Ginkgo Evaluation of Memory Study (N=3,069), we fit Cox regressions of each activity metric on time to dementia, adjusting for intervention group and demographics. For the LCA, we derived group/class indicators for Cox regression. Variety predicted incident dementia and will be compared to LCA activity metrics in predicting risk. Activity metrics that are most protective against dementia inform intervention design. Unlike standard activity metrics, LCA may further identify subgroups with common motivations to sustain activity.
CHARACTERIZING THE PATHWAYS UNDERLYING THE ASSOCIATION BETWEEN PSYCHOLOGICAL WELL-BEING AND HEALTH
Authors: Kim Eric S , Ong Anthony 
Published: November 2019

Abstract
As populations age, identifying factors that foster the maintenance of health is crucial for improving the health and well-being of older adults. Yet, most psychological, biomedical, and public health efforts have focused on reducing harmful risk factors. While the risk management approach has contributed greatly to prevention and treatment programs, our aging society continues to grapple with the steadily rising tide of chronic conditions. Expanding the focus to include upstream, health-promoting psychosocial assets may help inform a more comprehensive response effort. Mounting research suggests that different dimensions of psychological well-being are uniquely associated with reduced risk of chronic conditions. However, the mechanisms underlying these associations remain understudied. This symposium presents 4 studies evaluating potential mechanisms. The first talk presents research evaluating how a spouse’s level of optimism may be uniquely associated with an individual’s cognitive health over time (above and beyond that own individual’s level of optimism). A second talk, draws upon a multi-burst daily diary study and focuses on affective stress response as a potentially modifiable target that could explain the health benefits of optimism. A third talk evaluates how baseline levels purpose in life might be associated with repeated measures of five key health behaviors over time. A fourth talk discusses results from a longitudinal-burst daily diary study determining the reciprocal relationships among optimism, pain interference, and goal-directed activity among older women who experience pain. Overall, these studies add to the growing research on psychological well-being and physical health by providing evidence around potential biobehavioral pathways.
COGNITIVE AND HEARING IMPAIRMENTS IN OLDER ADULTS: EVIDENCE FROM THE HEALTH AND RETIREMENT STUDY
Authors: West Jessica S , Lynch Scott 
Published: November 2019

Abstract
As the number of older adults increases, increased prevalence of cognitive and sensory impairments pose growing public health challenges. Research on the relationship between hearing impairment and cognition, however, is minimal and has yielded mixed results, with some studies finding that hearing impairment is associated with cognitive decline, and others reporting that the association is weak or non-existent. Most of this research has been conducted outside of the U.S., and the few U.S.-based longitudinal studies have relied mostly on small, non-representative samples involving short follow-up periods. Further, despite known gendered patterns in cognitive and hearing impairments, no studies to date have examined whether the relationship between the two varies by gender. Our study addresses these weaknesses in the literature by utilizing nine waves of the Health and Retirement Study (1998-2014; n=14,169), a large, nationally representative, longitudinal study that facilitates examination of long-term interrelationships between hearing and cognitive impairments. In this study, we use autoregressive latent trajectory (ALT) methods to model: 1) the relationship between hearing impairment and cognitive decline, and 2) sex differences in the relationship. ALT models enable us to determine whether hearing impairment and cognitive impairment are associated, net of their common tendency simply to co-trend with age. Results indicate that hearing and cognitive impairments are strongly interrelated processes that trend together over time. Moreover, hearing impairment has an increasing impact on cognitive impairment across age while the effect of cognitive impairment on hearing impairment levels out over time. Sex differences in these patterns are discussed.
PSYCHOLOGICAL WELL-BEING AND CHANGE OF COGNITIVE FUNCTION OVER 4 YEARS
Authors: Kong Dexia , Kong Dexia , Dong XinQi 
Published: November 2019

Abstract
This study aims to examine the relationship between psychological-wellbeing (including depressive symptoms, loneliness, anxiety, hopelessness, and stress) and cognitive function during a 4-year period among U.S. Chinese older adults. Data were from 2,300 PINE participants who completed in-home interviews at baseline, 2-year and 4-year follow-up. Cognitive function was assessed by five individual cognition tests at baseline and follow-up interviews. Mixed-effects regression models were conducted. A trend of decline in global cognition and multiple cognitive domains was observed. The study findings showed that depressive symptoms (Estimate= -0.03, p&lt;0.001), anxiety (Estimate = -0.02, p&lt;0.001), hopelessness (Estimate = -0.01, p&lt;0.01), and stress (Estimate = -0.01, p&lt;0.001) were associated with poorer global cognitive function at baseline. Baseline psychological well-being was not associated with changes in cognitive function during a 4-year period. Significant predictors of rate of change in cognitive function will be discussed. Potential explanations and implications of these findings will be presented.
PHYSICAL FUNCTION AND LONGITUDINAL CHANGES IN COGNITIVE FUNCTION
Authors: Wang Jinjiao , Wang Jinjiao , Kong Dexia , Dong XinQi 
Published: November 2019

Abstract
Among 2,038 older Chinese adults in the U.S., we examined the relationship between physical function (Short Performance Physical Battery [SPPB], [instrumental] activities of daily living [ADL/IADL] limitations) at baseline (2011-2013) and changes in cognitive function in the two-year follow-up (2013-2015). Cognitive function was measured by the East Boston Memory Test (EBMT), the Digit Span Backwards assessment (DSB), the Symbol Digit Modalities Test (SDMT), and the Mini-Mental State Examination (MMSE). During the two-year follow-up, 41.8%-50.88% of the participants decreased in cognitive function and 32.88%-44.8% increased. In linear regression that adjusted for baseline cognitive function, education, age, and other covariates, baseline SPPB and ADL/IADL limitations were significantly associated with changes in cognitive function in the two-year follow-up (SPPB: βEBMT=0.0149, p&lt;0.05; βDSB=0.0253, p&gt;0.05; βSDMT=0.2742, p&lt;0.01; βMMSE=0.1070, p&lt;0.001; ADL/IADL limitations: βEBMT= -0.0401, p&lt;0.0001; βDSB= -0.0410, p&lt;0.05; βSDMT= -0.3027, p&lt;0.01; βMMSE= -0.2566, p&lt;0.0001). This suggests that better physical function predicts positive changes in cognitive function.
BODY MASS INDEX AND COGNITIVE FUNCTION DECLINE
Authors: Hua Yingxiao , Hua Yingxiao , Kong Dexia , Dong XinQi 
Published: November 2019

Abstract
Body composition has been proposed as an important modifiable risk factor of cognitive decline in multiple epidemiological studies. However, the relationship between body mass index (BMI) and cognitive function remains controversial and conflicting in diverse populations. This study aims to investigate the association between BMI and cognitive decline in U.S. Chinese older adults. Classifications of BMI are based on Asian criteria recommended by WHO (underweight: BMI&lt;18.5, normal weight: 18.5≤BMI&lt;23, overweight: 23≤bmi&lt;27.5, obesity: bmi≥27.5). Logistic regression models were conducted. Compared with normal-weight participants, underweight participants were more likely to experience decline in episodic memory (OR=1.68, p=0.002) and work memory (OR=1.38, p=0.05). Being overweight and obesity were not associated with cognitive function decline. The findings indicate that underweight could potentially be a risk factor of cognitive function decline among U.S. Chinese older adults. Perspective studies may further investigate the association between weight loss and cognitive decline for the development of prevention strategies.
DISCERNING STATUS: SUBJECTIVE SOCIAL POSITION AND COGNITIVE HEALTH AMONG OLDER ADULTS IN RURAL SOUTH AFRICA
Authors: Kobayashi Lindsay C , Harling Guy , Farrell Meagan T , Wagner Ryan G , Berkman Lisa F 
Published: November 2019

Abstract
Rapid population aging in high absolute poverty settings, such as much of South Africa, demands new research on the social context factors that affect cognitive aging in these settings. We investigated the relationships between subjective social position within one’s village and cognitive function and impairment, with the rationale that psychosocial stress induced by low relative social position may affect cognitive aging outcomes independently of absolute socioeconomic conditions. Data were from the population-representative HAALSI study of 5,059 adults aged 40+ in rural Agincourt, South Africa. Subjective social position was assessed using the MacArthur Network social ladder, which asks respondents to indicate how high up a ladder they stand, relative to others, in their village. Cognitive function was a composite z-score of time orientation and word recall tests; scores ≤1.5 standard deviations (SD) below the mean indicated cognitive impairment. Twenty percent of those on the bottom rung had cognitive impairment, declining to 2% on the top rung. In regression models adjusted for age, sex, country of birth, education, literacy, marital status, employment, and asset-based household wealth, each ladder rung increase was associated with an 0.05 SD increase in cognitive z-score (95% CI: 0.04-0.06), and a 17% decrease in odds of cognitive impairment (OR=0.83; 95% CI: 0.79-0.88); these associations were greater in magnitude than those for years of education with these cognitive outcomes. Future work should examine if these relationships persist longitudinally, and investigate the mechanisms of these relationships, including village-level contextual factors that may contribute to subjective social position in this setting.
DEPRESSION, FUNCTIONAL DISABILITY, AND ACCESSING HEALTH CARE AMONG OLDER MEN AND WOMEN IN GHANA AND SOUTH AFRICA
Authors: Nwakasi Candidus C , Brown J Scott 
Published: November 2019

Abstract
Objectives. To inform a preventive approach to mild depression among older Ghanaians and South Africans, this study will investigate the association and possible variabilities between mild depression, functional disability, accessing health care, sociodemographic, and socioeconomic factors across genders in both countries. Methods. Cross-sectional wave 1 (2007-2010) data from WHO’s Study on Global Ageing and Adult Health (SAGE) are used, and a sample of 3871 for Ghana and 3076 for South Africa are analyzed. Binary multiple logistic regression is used to identify the association between mild depression, functional disability status, socioeconomic and sociodemographic factors, and health status. Results. The proportion of mild depression (MD) is 3.78% and 8.15% for older Ghanaian men and women, and 2.29% and 11.91% for South African older men and women, respectively. At 95% CI, increased severity (mild and high levels) of functional disability are associated with increased odds of MD in Ghanaian and South African older men and women. Apart from South African older men, older people in the study who do not receive healthcare when needed have increased odds of MD. Sociodemographic and socioeconomic factors are also associated with MD. Discussion. An untreated, persistent MD may lead to worse conditions with fatal outcomes. Since, mental health care is lacking in both countries, this study recommends policies directed towards support for formal and informal long-term care, and healthcare access to reduce the risks of depression. Thus, this study’s findings may provide relevant information for managing depression among older Ghanaians and South Africans.
PROMOTING KNOWLEDGE OF COGNITIVE DYSFUNCTION IN MINORITY COMMUNITY-DWELLING OLDER ADULTS
Authors: Alexander Koshy , Manna Ruth , Gangai Natalie , Muniz Rosario Costas , Korc-Grodzicki Beatriz 
Published: November 2019

Abstract
Minorities and older adults represent an intersection of populations that are particularly vulnerable to suboptimal care. The US population is aging and growing more diverse. Dementia afflicts minority populations more than Caucasians. Many people in the community with mild cognitive impairment (MCI) and Alzheimer’s disease do not recognize cognitive, functional or behavioral impairment as abnormal. Several barriers to treatment exist within both the older and minority populations. The Health Resources and Services Administration (HRSA), is the primary Federal agency for improving health and achieving health equity. Queens County in New York City is a multicultural, ethnically diverse urban area with 48% of its population being foreign born. Funded by a grant from HRSA, in collaboration with the South Asian Council for Social Services (SACSS), the Geriatric Resource Interprofessional Program (GRIP) at Memorial Sloan Kettering Cancer Center (MSKCC) developed and conducted educational lectures on “Memory Loss & Dementia” at 7 different community centers in Queens. Between November 2015 and January 2019 eight sessions were conducted. A total of 182 people attended. Their mean age was 68, 59% were women. 71% were born in South Asia. Consecutive interpretation of the lecture was performed; the written materials were translated beforehand. Pre and post-test questionnaires were administered to measure understanding of the topic, and qualitative comments collected. The developmental process, results of the study and challenges we faced in developing and applying the educational initiative will be presented.
RACIAL DIFFERENCES IN ELEVATED C-REACTIVE PROTEIN AMONG U.S. OLDER ADULTS
Authors: Farmer Heather R , Farmer Heather R , Wray Linda A , Xu Hanzhang , Xian Ying , Pagidipati Neha , Peterson Eric D , Dupre Matthew E 
Published: November 2019

Abstract
C-reactive protein (CRP) is a marker of inflammation linked to numerous acute and chronic conditions. Studies have not considered racial differences in elevated CRP among older adults at the national level. We investigate racial differences in elevated CRP and the socioeconomic, psychosocial, behavioral, and physiological factors that contribute to these differences overall and by gender using a nationally-representative prospective cohort of 14,700 non-Hispanic black and white participants in the Health and Retirement Study followed from 2006 to 2014. Random effects logistic regression models showed that blacks were more likely to have elevated levels of CRP than whites. In men, the racial differences in elevated CRP were attributed to a combination of socioeconomic, psychosocial, and behavioral factors. In women, the racial differences in elevated CRP were primarily attributable to physiological factors. The findings from this work have potentially important implications for clinical practice and interventions targeting vulnerable segments of the population.
FACTORS ASSOCIATED WITH MORTALITY AMONG LONG-TERM CARE RESIDENTS TRANSITIONING TO AND FROM EMERGENCY DEPARTMENTS
Authors: Tate Kaitlyn C , Reid Colin , McLane Patrick , Cummings Garnet E , Rowe Brian H , Cummings Greta G 
Published: November 2019

Abstract
Studies examining risk of death during acute care transitions have highlighted potential predictors of death during transition. However, they have not closely examined the relationships and directional effects of organizational context, care processes, resident demographics and health conditions on death during transition. By employing structural equation modeling, we aimed to 1) identify predictive factors for residents who died during transitions from long term care (LTC) to emergency departments (EDs) and back; 2) examine relationships between identified organizational, process and resident factors with resident death during these transitions; and 3) identify areas for further investigation and improvement in practice. We tracked every resident transfer from 38 participating LTC facilities to two included EDs in two Western Canadian provinces from July 2011 to July 2012. Overall, 524 residents were involved in 637 transfers of whom 63 residents (12%) died during the transition. Sustained dyspnea (in both LTC and the ED), sustained change in level of consciousness (LOC) and severity measured by triage score were direct and significant predictors of resident death during transition. The model fit the data, (x2 = 83.77, df = 64, p = 0.049) and explained 15% variance in resident death. Dyspnea and change in LOC in both LTC and ED needs to be recognized regardless of primary reason for transfer. More research is needed to determine the specific influences of LTC ownership models, family involvement in decision-making, LTC staff decision-making on resident death during transition, and interventions to prevent pre-death transfers.
READMISSION FOR HEALTHCARE-ACQUIRED INFECTIONS: DOES PATIENT DISPOSITION MATTER?
Authors: Hoffman Geoffrey J , Min Lillian , Liu Haiyin J , Mody Lona 
Published: November 2019

Abstract
Both common and preventable, healthcare-acquired infections (HAI) are nevertheless associated with high risk for hospital readmission. However, whether these infection-related readmissions are more common among older adults discharged from the hospital to a nursing facility as opposed to home is unknown. We used 2013-14 HCUP data and multivariable logistic regression models to retrospectively examine the relationship of patient disposition (home, nursing facility, home health care) with an unplanned readmission for the same HAI observed at the index admission, among older Medicare beneficiaries, controlling for patient sociodemographics, comorbidity score, and length of stay during index hospitalization. Of 8.4 million index admissions, 323,332 (3.9%) involved an index HAI, of which 15,870 (4.9%) resulted in a linked HAI readmission. HAI readmissions were more common for Clostridium difficile infections (4.0%) and urinary tract infections (UTI, 2.3%) than for ventilator-acquired pneumonia (1.4%) or surgical site infections (1.1%) (p&lt;0.001). Being discharged home or to home health care, compared to a post-acute care setting, was associated with increased odds (OR: 1.63 and 1.62, p&lt;0.001) of HAI readmission, particularly for patients with higher comorbidity scores. For home discharges, HAI readmission risk was doubled for patients with the most compared to fewest comorbidities while nursing facility discharges were equally protective across comorbidity levels. We conclude that Clostridium difficile and UTIs result in higher risk for readmission than other HAIs. Patients discharged to nursing facilities are protected from readmission. Further research into identifying modifiable mechanisms for HAI readmission, in order to improve post-hospital care of infection at home, is needed.
ISSUES IN HOME CARE AND CAREGIVING ARE MEDICAL FOSTER HOMES SERVING VETERANS WHO HAVE SIMILAR FUNCTIONAL IMPAIRMENT AS TYPICAL NURSING HOME RESIDENTS?
Authors: Levy Cari , Magid Kate , Manheim Chelsea , Thomas Kali S , Haverhals Leah M , Saliba Debra 
Published: November 2019

Abstract
The Veterans Health Administration’s (VHA’s) Medical Foster Home (MFH) program was developed as a community-based alternative to institutional care. This study compares the clinical and functional characteristics of Veterans in the VHA MFH program to residents in nursing homes to understand whether MFHs substitute for nursing home care or serve a population with different care needs. All data were derived from Minimum Data Set (MDS) 3.0 assessments. Nurses collected MDS assessments from Veterans (n=92) in 4 MFHs between April 2014-December 2015. Data for nursing home residents were from a national nursing home dataset of residents with an annual MDS assessment in 2014 (n=818,287). We found that MFH Veterans were more likely to be male, have higher functional status, and perform more activities of daily living (ADLs) independently relative to nursing home residents (p&lt;0.01 for all comparisons). Yet, a similar proportion of MFH Veterans and nursing home residents required total assistance in 9 of the 11 measured ADLs. Cognitive impairment, neurological comorbidity, and psychiatric comorbidity were similar in both cohorts; however, MFH Veterans were more likely to have traumatic brain injury (p&lt;0.01), higher Patient Health Questionnaire (PHQ)-9 depression scores (p=0.04) and less likely to have anxiety (p=0.05). Our results suggest there are two distinct MFH populations, one with lower-care needs and another with Veterans completely dependent in performing ADLs. Given these findings, MFHs may be an ideal setting for both low-care nursing home residents with less functional impairment as well as residents with higher care needs who desire community-based long-term care.