bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding Transitions in IADL and Their Consequences for Cognitive Impairment Among Older Mexican Americans
Authors: Kim Jiwon , Angel Jacqueline , Rote Sunshine 
Published: December 2020

Abstract
Mexican Americans tend to live longer lives than other ethnic groups, but it remains unclear how this trend influences the trajectory of disability and its consequences for cognitive frailty. Building on previous research, we assess transitions in IADL among the oldest old. We use data from three waves of the Hispanic Established Population of the Epidemiologic Study of the Elderly (H-EPESE) to investigate trajectories of IADL disability as individuals’ age into their 80s and 90s, a period of the life course with much higher rates of morbidity and decreasing socioeconomic resources. The H-EPESE is a benchmark longitudinal cohort study based on an original sample of 3,050 Mexican-Americans aged 65 and older in the Southwestern United States. Our modeling approach estimates transitions in patterns of IADL employing the Latent Transition Analysis (LTA). Results revealed three heterogeneous latent classes: high IADLs, difficulty in transportation and mobility, and low IADLs. Those with high IADLs tended to remain in the same class over time. Individuals having difficulty in transportation and mobility tended to stay in the same class or transfer to high IADLs, whereas those with overall low IADLs transferred to either the same class or to difficulty in transportation and mobility. Additional analysis revealed that cognitive impairment was a significant predictor of instrumental disability over time. Furthermore, females were more likely than males to belong to difficulty in transportation or mobility class than to the low IADL class. Our results highlight the long term consequences of cognitive decline on IADL limitations.
Work and Self-Rated Memory Among Native Hawaiian and Other Pacific Islander Older Adults
Authors: Lee Yeonjung (Jane) , Terada Tyran 
Published: December 2020

Abstract
According to the productive aging framework, productive activities can function as protective factors of cognitive health. Productive activities, such as work, have been linked to positive cognitive health outcomes in older adults. Yet, less is known about if the beneficial effects of work on cognition extend to the Native Hawaiian and Other Pacific Islander (NHOPI) older adult population. Thus, the purpose of this research is to investigate how work is associated with self-reported memory/concentration among NHOPI older adults. Moreover, the moderating role of education was explored. Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS), the study explores the associations between work and self-rated levels of difficulty remembering or concentrating. A total of 1,045 older adults ages 50 years and older were included for analyses. Weighted multivariate analyses with multiple imputation techniques were used. The NHPI NHIS is the first federal survey focusing on the NHOPI population in the United States. Those who were engaged in work had lower odds of having severe difficulty memorizing or concentrating while controlling for other sociodemographic and behavioral factors. Interestingly, there was a significant interactive effect of work and education on self-rated memory. Those with lower education levels have lower self-rated memory, but the odds of having memory difficulty decreased when they worked. Findings highlight the importance of productive aging in promoting healthy cognitive aging. Research and practice addressing productive aging and cognition should provide culturally relevant resources to NHOPI older adults.
Gentrification and Chronic Conditions in Older Adults: Service Providers’ Perspectives
Authors: Rooks Ronica 
Published: December 2020

Abstract
Where we live impacts our health, but this is more apt for older adults (aged 55+) aging-in-place in their neighborhoods. Gentrification, i.e. the transformation of neighborhoods from low to high value, can put community-dwelling older adults at risk for residential displacement with limited retirement incomes and financial stressors like increased housing costs and property taxes, residential turnover and changing access to resources. As a place-based stressor, gentrification may exacerbate social vulnerabilities (e.g., lower socioeconomic status and racial/ethnic minority status) related to chronic condition (CC) disparities. But, little gentrification research focuses on these issues. This research examines associations between gentrification and older adults’ CC management related to broader social determinants in Hamilton, Ontario, Canada from health and social service providers’ perspectives. Hamilton, a recovering steel industry city with in-migration from Toronto, is experiencing higher costs of living, income inequality and tension with recent gentrifiers. I conducted key informant interviews with service providers in city government and community-based organizations using thematic analysis. Across providers, food insecurity, social isolation and displacement were the biggest issues associated with gentrification and CC, particularly for older adults with lower incomes and government disability support. Results thus far reveal Hamilton has numerous older adult-focused providers, but older adults often have difficulties accessing services due to a lack of knowledge, not always asking or realizing when they need help and coordinated referral difficulties across providers. To address these challenges, providers consider environmental scans, mapping resources and advertisement in an online community information database from the city’s public library.
Dietary Behavior and Depressive Symptoms in Late-Life Marriage
Authors: Ali Talha , McAvay Gail , Monin Joan 
Published: December 2020

Abstract
Epidemiologic studies have linked dietary patterns to psychological health including depression, anxiety, and stress. However, no research has examined dyadic associations between dietary behavior and depressive symptoms in older married couples. In this study, one hundred and one couples 51 to 90 years of age who were married or in a marriage-like relationship and living together for at least 6 months were recruited. Participants completed questionnaires and self-reported their dietary behavior (i.e., the total number of meals, number of snacks, and number of fast-food meals eaten in a typical day and the number of meals they eat alone and eat sitting down). They also completed the 20-item Center for Epidemiologic Studies Depression Scale. Results of the Actor Partner Interdependence Models controlling for income, education, chronic conditions, and marital satisfaction, showed that for wives only, more meals eaten in a day were associated with lower depressive symptoms (actor effect). Additionally, more snacks eaten by the wife and more meals eaten alone by the wife were associated with higher depressive symptoms for the husband (partner effects). Findings suggest that wives’ dietary behavior is particularly important, not only for their own but also their husbands’ mental health in late-life marriage.
The Relationship Between Lifespan Volunteerism and Personality Among Oldest Old Adults
Authors: Lee Gina , Martin Peter 
Published: December 2020

Abstract
There has been a lack of studies exploring volunteerism from the life span perspective. This study aims to examine the relationship between personality and volunteerism among the oldest old population, using three types of volunteerism: “ever volunteered,” “last volunteered,” and “currently volunteering.” “Ever volunteered” assesses whether individuals ever volunteered in their life. “Last volunteered” examines when an individual last volunteered. “Currently volunteering” explores whether an individual is currently volunteering. By comparing the three volunteerism measures, this study took a life span view of volunteerism. Data of 208 oldest old adults, octogenarians (34.1%) and centenarians (65.9%), from the Georgia Centenarian Study were included in this study. The majority of the sample had volunteered sometime during their lifetime (88.9%), many of them still volunteered when they were in their 80s and 90s (40.4%), and the majority of the sample indicated that they were not currently volunteering (78.8%). Multiple regression analyses indicated that competence (a facet of conscientiousness) significantly predicted “ever volunteered,” and extraversion significantly predicted “last volunteered.” In other words, oldest old adults with high competence levels were more likely to have volunteering experiences in their life. Also, those with high levels of extraversion were likely to have more recent volunteering experiences. None of five personality traits significantly predicted “currently volunteering.” This study sheds light on the importance of different types of volunteerism which enables us to better understand the relationship between volunteerism and personality. We recommend future research to test the link between different types of volunteerism and well-being outcomes.
Chinese Americans’ Priorities and Practices for Designating a Healthcare Proxy
Authors: Liu Mandong , Chi Iris 
Published: December 2020

Abstract
Many Americans need decision-making from someone else due to cognitive impairment. Chinese comprises the largest Asian group in the U.S.; few studies have investigated factors influencing Chinese Americans’ health care proxy (HCP) designation. The aim of this study was to examine factors associated with Chinese Americans’ HCP designation, using Andersen’s Behavioral Model as a lens. Data were from the 2015 Asian American Quality of Life Survey. Hierarchical logistic regression analyses were conducted to test the incremental predictive power of predisposing, enabling, and needs factors. We found that age, marital status, religious affiliation, health insurance, acculturation, and self-rated health were predictors for HCP designation. The odds of having an HCP designation were 1.96 times higher for those aged 65 and above, compared to those aged 18-64 (p=0.045); The odds were 2.40 times higher for those who were married (p=0.006); The odds were 1.79 times higher for Protestants (p=0.042) and 2.25 times higher for Buddhists (p=0.025), compared to those with no religious affiliation; Having a health insurance increased the odds of having an HCP designation by 2.23 (p=0.022); For each additional unit in acculturation score, the odds of having an HCP designation increased by 0.65 (p=0.011); Compared to those who rated their health as excellent/very good/good, those rating health as fair/poor had a 2.97 times higher odds of HCP designation (p=0.001). We concluded that various factors influence Chinese Americans’ HCP designation, and appropriate and innovative practices should be used to assist HCP discussion and designation among Chinese and other ethnic minority populations.
Better Night’s Sleep and Subjective Cognition: The Role of Day and Night Work Shifts
Authors: Veal Britney , Mu Christina , Lee Soomi 
Published: December 2020

Abstract
Previous research indicates poor sleep and cognitive functioning are associated. Studies have yet to consider the role of work shift on this relationship. The current study examined the sleep and subjective cognition relationship in nurses, and if this relationship differed for day- and night- shift nurses. Sixty-one nurses (M=35.39, SD=11.73; 39 day-, 22 night-shift) reported their nightly sleep characteristics and next-day subjective cognition (i.e., processing speed, memory, and mental focus) using ecological momentary assessments for 2 weeks. Multilevel models controlled for sociodemographic characteristics and decomposed the variance attributed by between- and within-person levels. At the within-person level, better sleep the previous night was associated with better subjective cognition the following day. This relationship was more apparent in night-shift nurses than in day-shift nurses, such that (a) longer sleep duration predicted better mental focus (B=1.62, p&lt;.05) and (b) higher sleep quality predicted better memory (B=8.67, p&lt;.001). At the between-person level, better sleep overall was associated with better subjective cognition across days. This association was more apparent in day-shift nurses than in night-shift nurses, such that (a) better sleep quality and sufficiency predicted faster processing speed (B=34.33; B=26.28; p&lt;.001) and (b) better sleep quality and greater sleep sufficiency predicted better memory (B=30.94; B=23.09; p&lt;.001). Findings suggest that sleep characteristics are associated with subjective cognition in nurses day-to-day and on average. Specific sleep characteristics associated with subjective cognition differ between day- and night-shift nurses, presumably due to differences in their sleep issues and perceived cognitive abilities.
Longitudinal Changes in Arthritis Pain Contribute to Subsequent Changes in Body Mass
Authors: Finkel Deborah , Emery Charles , Aslan Anna Dahl 
Published: December 2020

Abstract
Prior studies have documented that body mass index (BMI) is positively associated with bodily pain. However, data on the temporal sequence of BMI and pain suggest mixed results, with some studies indicating a bi-directional relationship, and other research among older adults supporting a uni-directional relationship from BMI to increased pain. Thus, it is critical to further examine temporal dynamics between changes in BMI and changes in bodily pain to help explicate possible mechanisms influencing the relationship. This study evaluated bivariate dynamic models of longitudinal change (McArdle & Hamagami, 2003) in the relationship between BMI and bodily pain with data from older adults participating in the Swedish Adoption/Twin Study of Aging (SATSA). The sample included 858 individuals aged 45-88 at intake, with up to eight waves of follow-up over 26 years. BMI {weight(kg)/[height(m)]2} was evaluated with objective measures of weight and height recorded by a study nurse. Pain symptoms were measured with six self-report pain questions, reflecting two pain factors: (1) pain in neck, back, or shoulder; and (2) hip pain, history of arthritis, or use of arthritis medications. Results indicated that the relationship between BMI and arthritis pain was uni-directional, with changes in pain symptoms contributing to subsequent changes in BMI, but no evidence that changes in BMI contributed to subsequent changes in pain symptoms. Model comparison indicated that the impact of pain on BMI was greatest before age 70, and then reduced somewhat after age 70, when the impact of other factors on BMI (e.g., ill health) likely increases.
Patient Experience of an Osteoporosis Telemedicine Clinic
Authors: Steffen Melissa , Van Tiem Jennifer , Seaman Aaron , Miller Karla , Wardyn Shylo , Solimeo Samantha 
Published: December 2020

Abstract
Rural Veterans at risk of fracture due to osteoporosis remain underdiagnosed and undertreated, in part due to location-related barriers to accessing care. Despite lowered cost and travel barriers to osteoporosis care through implementation of a telehealth model directed at rural at-risk Veterans that took advantage of many strengths of the VA’s healthcare system, only 30% of eligible Veterans accepted care. To understand low acceptance, we conducted 39 semi-structured telephone interviews with Veterans eligible for the clinic, including 19 who accepted screening and treatment, 12 who completed screening but declined treatment, and 8 who declined screening and treatment. Veterans who opted to be screened and/or treated for osteoporosis did so because: it was recommended by the VA; they were interested in learning more about their health; thought they may be at risk of osteoporosis; or believed screening would not cause them harm. Conversely, Veterans refused screening or treatment because of past negative experiences with medications, both bone and non-bone; a wish to not put anything else into their bodies; or the belief that their bone loss is not severe enough to warrant treatment. Outside medical professionals and peers influenced Veterans’ decisions to not take or alter their treatment. Cost and travel distance remained a barrier for Veterans who did not live near a VA facility with the necessary screening and treatment infrastructure. Many barriers to osteoporosis care remain despite efforts to remove them. Delivery systems must account for both instrumental and social access to care to reduce fracture risk.
The Importance of Cancer-Related and Other Health Factors on Cognition Among Older-Adult Long-Term Survivors
Authors: Beck Gabrielle , Deimling Gary , Kahana Boaz , Kahana Eva , Phelps Erin , Ciaralli Spencier 
Published: December 2020

Abstract
Previous research has identified cancer and cancer-treatment related effects on survivors’ mental impairment including memory and concentration. However, research has not systematically examined the relative impact of cancer in the context of age and other age-related health challenges common in later life. This paper compares the effects of cancer-related factors with other health challenges faced by 471 older adult long-term survivors from an NCI-funded study of a randomly selected tumor registry sample from a major comprehensive cancer center. Having had chemotherapy is associated with several cognitive outcomes including memory and concentration. Survivors who reported more cancer-related symptoms during treatment reported a greater number of cognitive symptoms even decades after treatment. Importantly, other comorbid health problems as well as social factors were found to be important in explaining symptoms of cognitive impairment in this older adult sample. These findings suggest that health care and mental health providers consider the range of health challenges, including those related to cancer and its treatment, as they provide patient centered care.
Living Within and Without: Life-Space Mapping to Visualize Need and Resource Access of Rural Dementia Dyads
Authors: Loup Julia , Snow A Lynn , Hilgeman Michelle 
Published: December 2020

Abstract
Rural-dwelling veterans with dementia (PWD) and their family caregivers (CG) have unique needs and resource access limitations. Life-Space assessment models suggest older adults’ needs are reflected in their daily-life mobility and routines (Peel et al., 2005). Yet, medical treatment models seldom incorporate non-health related activities (e.g., transportation, groceries, distance to formal and informal support networks). This mixed-methods study proposes an exploratory life-space modeling visualization that integrates qualitative and quantitative daily-life data from rural dwelling dyads in Alabama. Two case studies are selected from a sample of 30 qualitative interviews to demonstrate this innovative analytic approach. One case depicts a married dyad (PWD and spousal CG) (CGage = 74; PWDage = 80, PWD MoCA score = 21) and the second visualization is of a PWD living alone (PWDage = 82, PWD MoCA Score = 20). Daily-life experiences and routines mentioned during interviews were categorized using a rapid analysis template approach and informed by unmet needs theories (Algase et al., 1996). Next, extracted data were placed into mapping visualization software. The maps include visual cues (colors, transportation routes, and icons) to designate met, unmet, and vulnerable needs and resources, allowing visual interaction with the two cases’ dementia caregiving context and qualitative responses. Life-space maps may be useful tools to visualize resource access and assist integrated health care systems in better understanding daily interactions and intervention gaps for difficult to reach populations. Future developments include ecological momentary assessment and Global Positioning System (GPS) data to develop life-space maps using real-time data collection.
Training Clinicians to Support Aging in Place in a Medicaid Home and Community-Based Waiver Program
Authors: Spoelstra Sandra , Schueller Monica , Sikorskii Alla , Ware Katelyn 
Published: December 2020

Abstract
A randomized trial in 18 home and community-based waiver sites implemented an aging-in-place model for 12,000 disabled older (mean age 78) adults. The trial was underpinned by the Knowledge-to-Action model and utilized 7 implementation strategies, including a 5.5-hour online social worker (SW) and registered nurse (RN) training. Baseline self-efficacy and attitudes of SWs and RNs were measured using validated scales, and knowledge uptake and satisfaction with a tool designed by the team. Characteristics, knowledge uptake, and satisfaction of SWs versus RNs were compared using t-, Wilcoxon, and chi-square tests. Two hundred forty-one RNs and 264 SWs participated. RNs were older (mean age 50; standard deviation [SD] 10.95) than SWs (41.35; SD=11.21) p&lt;.01; and &gt;90% overall were female. RNs had more professional experience, while SWs worked more years in the waiver (p&lt;.01). SWs had greater self-efficacy (t(497)=2.99, p&lt;.04), better attitudes (t(500)=2.59, p&lt;.01), employability (t(500)=2.99, p&lt;.04), and balance (t(491)=2.03, p&lt;.05) than RNs. No differences were found on leadership, organizational culture, motivation, pressure to change, or attitude toward evidence-based practice. Knowledge uptake (range 1-16) was high and did not differ for RNs (Mean=15.2, SD=1.23) versus SWs (Mean=15.26, SD=0.89). Training content, format, role explanation, and information satisfaction (range 0-50) means also did not differ for RNs (Mean=35, SD=10.2) or SWs (Mean=34.9, SD=9.8). While many of the characteristics and outcomes were similar for RNs and SWs, SW’s higher self-efficacy, better attitude, and employability despite less experience in the waiver indicate they may play a positive role in implementation of the intervention that is currently underway.
Are Home Care Aides Interested in Helping Clients Do Physical Activity?
Authors: Muramatsu Naoko , Yin Lijuan , Caceres Maria 
Published: December 2020

Abstract
The current home care paradigm dictates home care aides (HCAs) provide prescribed help with activities of daily living, rather than stimulating older adults’ reserves to maintain independence. Little is known about whether HCAs are interested in expanding their role to promote their clients’ health. This study examined HCAs’ interest in helping clients do physical activity among workers who care for their family members or clients assigned by home care agencies in a Medicaid-funded home care program. Data came from brief surveys completed by HCAs at state-mandated in-service training sessions (N=602; 42% caring for non-family clients only, 38% family clients only, 20% both family and non-family clients). Ordered logit analysis was conducted to examine whether HCAs caring for family clients differ from those caring for non-family clients in levels of interest in helping clients do safe physical activity as part of home care work, controlling for HCAs’ age, gender, language (English/Spanish), and years of home care experience. HCAs’ interest levels were high (62% very, 21% somewhat, 8% slightly, 9% not at all interested). Ordered logit analysis indicated that HCAs caring for family members had significantly higher interest levels than those caring for non-family clients only (83% higher among HCAs caring for both family and non-family clients, 30% higher among HCAs caring for family clients only). To reflect HCAs’ interests and to maintain clients’ independence, home care workforce training should direct its attention to empower HCAs to assume health-promoting roles.