bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHRONIC DISEASES IN MIDDLE-AGED ADULTS WITH SUBJECTIVE COGNITIVE DECLINE: UNITED STATES, 2015-2017
Authors: Taylor Christopher A , Bouldin Erin D , McGuire Lisa C 
Published: November 2019

Abstract
While adults aged 65 years and older are most at risk for chronic conditions, studies show that middle-aged adults aged 45–64 years also have growing numbers of comorbid chronic diseases. Regardless of age, managing chronic conditions requires decision-making abilities to manage treatments effectively. Symptoms of memory loss and confusion may impair a person’s ability to manage their health. This study examined chronic conditions in persons with subjective cognitive decline (SCD), defined as the self-reported experience of increased memory problems or confusion. Behavioral Risk Factor Surveillance System data from 2015–2017 were used to define SCD and disease status for eight chronic conditions (heart disease, stroke, cancer, arthritis, asthma, depression, diabetes, and chronic obstructive pulmonary disease) for adults 45–64 years from 49 states, District of Columbia, and Puerto Rico that collected data on cognitive decline. Among adults aged 45–64 years, 10.8% reported SCD. Among those with SCD, 77.4% had at least one chronic disease compared to 47.1% of those without SCD. Those with SCD had a higher prevalence for all eight conditions compared to those similarly-aged without SCD. Adults with at least one chronic condition were more likely to discuss their symptoms of SCD with a health care professional (54.2%) compared to those with no chronic conditions (30.3%). Poor management of chronic conditions can result in increased health care costs and might worsen existing symptoms of confusion and memory problems. Self-care interventions for chronic disease management should consider the importance of an individual’s cognitive status, including SCD.
EARLY IDENTIFICATION OF COGNITIVE IMPAIRMENT AMONG VULNERABLE OLDER ADULTS LIVING AT HOME
Authors: Brown Maria T , Brangman Sharon A 
Published: November 2019

Abstract
African Americans are twice as likely as Caucasians to develop Alzheimer’s disease and related dementias (AD/D), are at greater risk of frailty if they have AD/D, and are less likely to seek a diagnosis before experiencing a crisis. This collaborative community-based project aimed to evaluate the processes and outcomes of adding a Mini-Cog© screening to existing Area Agency on Aging (AAA) assessments performed by a neighborhood advisor in a lower-income African American neighborhood in a mid-sized northeastern city. AAA clients receive initial in-home screenings to assess their need for income-related services to help them continue living safely in the community, but are not screened for potential cognitive issues that may exacerbate or be masked by the very conditions that AAAs aim to address. This pilot was designed to introduce a mechanism for the early identification of previously undetected cognitive impairment, provide referrals for comprehensive cognition screening at a Center of Excellence for Alzheimer’s Disease (CEAD), and increase access to needed health and community support services. We hypothesized that adding the Mini-Cog© to existing AAA assessments would increase the early identification of vulnerable older African Americans with or at risk of AD/D. Process outcomes included challenges encountered when engaging community caregivers on the project team, learning to interpret Mini-Cog© results, the labor-intensive nature of scheduling Mini-Cog© assessments with existing clients, addressing client stigma and fear of AD/D, and client resistance to comprehensive testing. This presentation reviews process and outcome evaluation data from the pilot, and discusses implications for expanding the intervention.
RACE, DEATH OF A SIBLING, AND DEMENTIA RISK AT LATE ADULTHOOD
Authors: Xu Minle 
Published: November 2019

Abstract
The death of a family member is a stressful life event that compromises health and well-being. Considerable research has documented the detrimental health effects of parental, child, and spousal death. However, much less is known with regard to the health consequences of sibling death especially in late adulthood. Relationship with sibling is one of longest and intimate social relationships and the death of a sibling can be a devastating life event especially for older adults as they are more vulnerable to adverse effect of stress. As sibling death is more prevalent in late adulthood, it is important to examine whether sibling death increases risks of dementia which has become a public health concern due to its deleterious effects on individuals, families, and societies. Therefore, this study investigates the association between sibling death and dementia incidence in later life by using longitudinal data from the Health and Retirement Study. Results from discrete-time hazard models show that respondents who experienced the death of a sibling between 1992 and 2000 are more likely to develop dementia during follow-up. This positive association between the death of a sibling and dementia incidence remains unchanged after accounting for respondents’ health status before sibling death and shared family social status during childhood. Further analyses indicate that psychological distress, health behaviors, and health status cannot explain the relationship between sibling death and dementia incidence. In addition, the association of sibling death with dementia incidence is similar for non-Hispanic whites and non-Hispanic blacks.
THE IMPACT OF INTERGENERATIONAL SUPPORT ON DEPRESSIVE SYMPTOMS AMONG OLDER MEXICAN AMERICANS: DOES GENDER MATTER?
Authors: Pei Yaolin , Cong Zhen , Wu Bei 
Published: November 2019

Abstract
The study examined gender differences in the impact of living alone and intergenerational support on depressive symptoms among Mexican American older adults. The sample included 335 parent-adult child dyads which were nested within 92 Mexican American respondents in a city in West Texas. Each respondent reported their specific relationships with each child. The results from clustered regression showed that men provided and received less intergenerational support than women, but their depressive symptoms were more susceptible to living alone and different types of intergenerational support. Factors such as living alone, and receiving instrumental support were related to higher levels of depressive symptoms among Mexican American older men than among in their female counterparts, whereas emotional closeness with children was associated with lower level of depressive symptoms in men than in women. The findings can be used to develop and target a gender-specific approach for depression interventions among older Mexican Americans.
LONGITUDINAL INTERRELATIONSHIP BETWEEN SENSORY LOSS, SOCIAL SUPPORT, LONELINESS, AND COGNITION
Authors: Ge Shaoqing , Pan Wei , Wu Bei , Plassman Brenda , McConnell Eleanor S 
Published: November 2019

Abstract
This study aims to understand the roles that psychosocial factors play on the longitudinal associations between sensory (including hearing and vision) loss and cognitive decline. Specifically, we hypothesized that (1) loneliness mediates the associations between sensory loss and cognitive decline; and (2) social support moderates the associations between sensory loss and cognitive decline. We used longitudinal parallel process (LPP) modeling with data from the Health and Retirement Study (HRS) and the Aging, Demographics, and Memory study (ADAMS). Age variable centered at its mean age of 82. In the most parsimonious model, loneliness fully mediated the associations between vision loss and the average cognitive status at age 82 (p &lt; .05). Social support moderated the associations between vision loss and the average cognitive status at age 82 (β= .14, p &lt; .05). No moderation or mediation effect was found for the psychosocial factors on the associations between hearing loss and cognition.
LIFE COURSE EXAMINATION OF GLOBAL AND DAILY PSYCHOSOCIAL IMPACTS OF FAMILY CAREGIVERS IN MIDLIFE AND LATE ADULTHOOD
Authors: Wong Jen D , Wong Jen D , Shobo Yetty , Hodgdon Barbara T 
Published: November 2019

Abstract
Family members often serve as informal caregivers for the first line of care. The complexity of family caregiving suggests the need to examine the personal and environmental resources that contribute to caregivers’ psychosocial well-being. Informed by the life course perspective, this study investigates the impacts of providing care to a family member on global and daily psychosocial well-being, and the moderating influences of age, gender, marital status, and social support. The sample consists of 1449 (M=55.99, SD=9.31) participants from Midlife in the United States (MIDUS-II: Main and Diary) survey. Regression and multilevel models results indicated greater global negative affect and daily stressors in caregivers as compared to non-caregivers. In line with the positive correlates of caregiving, caregivers reported greater daily positive events. Age, gender, and marital status significantly moderated the associations between caregiving and well-being. Findings showed that services aimed at family caregivers should take into account of personal resources.
GENDER AND HEALTH IMPLICATIONS OF EXTENDING WORKING LIFE: CROSS-NATIONAL PERSPECTIVES
Authors: Leime Aine Ni , Street Debra A 
Published: November 2019

Abstract
This symposium addresses the issue of extended working life policy by considering the influence of gender and health on the experiences of older workers. In response to population ageing, policies designed to extend working life have been introduced in many countries. These policies include raising state pension age and linking the amount of state pensions more closely to years spent in paid employment. Such policies tend to be undifferentiated by gender or health status – in most countries, state pension age has been raised to the same age for men and women. Yet, research evidence indicates that women in all countries are disadvantaged in relation to employment at older ages and pensions. There are also health inequalities for older workers, depending on their occupation and whether they are in precarious or secure employment. Extended working life is of pressing societal concern. This symposium brings together the work of a group of leading international scholars who have been researching and reflecting on its implications in a forthcoming book on the topic across 34 countries. The symposium begins with an overview and analysis of the empirical landscape of older employment and pension policy by Martina Rasticova and Jim Ogg; Paper 2 offers a discussion of the theoretical perspectives and policy debates across 34 countries by Clary Krekula; there will be an analysis of extended working life policy in Ireland by Aine Ni Leime and a final presentation synthesising policy recommendations and mapping future research directions in extended working life by Debra Street.
GENDER, HEALTH, AND EXTENDED WORKING LIFE IN IRELAND
Authors: Leime Aine Ni 
Published: November 2019

Abstract
This presentation is based on a forthcoming book chapter which analyses policies, statistical evidence and qualitative data to investigate the gender and health implications of Extended Working Life policy in Ireland. The qualitative data is from a study conducted in 2018 that investigated attitudes to extended working life and experiences of late life work among sixty older workers, 30 men and 30 women in three different occupations, health care workers/cleaners, teachers and academic faculty.The data were analysed using a lifecourse approach. Workers in physically-demanding occupations, those in precarious employment and women were found to be more likely to be disadvantaged in relation to options for extending their working lives. It is recommended that policies be modified to address the disadvantages faced by these groups of workers.
LONG-TERM CARE FACILITY VARIATION IN THE INCIDENCE OF PNEUMONIA AND INFLUENZA HOSPITALIZATIONS
Authors: Bosco Elliott , Zullo Andrew , McConeghy Kevin , Moyo Patience , Aalst Robertus van , Chit Ayman , Mor Vincent , Gravenstein Stefan 
Published: November 2019

Abstract
Pneumonia and influenza (P&I) increase morbidity and mortality among older adults, especially those residing in long-term care facilities (LTCFs). Facility-level characteristics may affect P&I risk beyond resident-level determinants. However, the relationship between facility characteristics and P&I is poorly understood. We therefore identified potentially modifiable facility-level characteristics that might influence the incidence of P&I across LTCFs. We conducted a retrospective cohort study using 100% of 2013-2015 Medicare claims linked to Minimum Data Set 3.0 and LTCF-level data. Short-stay (&lt;100 days) and long-stay (≥100 days) LTCF residents aged ≥65 were followed for the first occurrence of hospitalization, LTCF discharge, Medicare disenrollment, or death. We calculated LTCF risk-standardized incidence rates (RSIRs) per 100 person-years for P&I hospitalizations by adjusting for over 30 resident-level demographic and clinical covariates using hierarchical logistic regression. The final study cohorts included 1,767,241 short-stay (13,683 LTCFs) and 922,863 long-stay residents (14,495 LTCFs). LTCFs with lower RSIRs had more Physician Extenders (Nurse Practitioners or Physician’s Assistants) among short-stay (44.9% vs. 41.6%, p&lt;0.001) and long-stay residents (47.4% vs. 37.9%, p&lt;0.001), higher Registered Nurse hours/resident/day among short-stay and long-stay residents (Mean (SD): 0.5 (0.7) vs. 0.4 (0.4), p&lt;0.001), and fewer residents prescribed antipsychotics among short-stay (21.4% (11.6) vs. 23.6% (13.2), p&lt;0.001) and long-stay residents (22.2% (14.3) vs. 25.5% (15.0), p&lt;0.001). LTCF characteristics may play an important role in preventing P&I hospitalizations. Hiring more Registered Nurses and Physician Extenders, increasing staffing hours, and reducing antipsychotic use may be modifiable means of reducing P&I in LTCFs. Funding provided by Sanofi Pasteur.
PREDICTORS OF CONCOMITANT COGNITIVE AND PHYSICAL FUNCTION DECLINE: RESULTS FROM THE HEALTH ABC STUDY
Authors: Handing Elizabeth , Leng Iris , Hayden Kathleen , Rosano Caterina , Kritchevsky Stephen 
Published: November 2019

Abstract
Although many individual risk factors for cognitive and physical decline have been identified, less is known about factors that predict concomitant or “dual decline”. Utilizing data from the Health ABC study (n=2,553), we examined trajectories of decline based on repeated measures of the Modified Mini-Mental State Exam (3MS) and Short Physical Performance Battery (SPPB) across 5 years. Next, we calculated four mutually exclusive trajectories of decline derived from the slope: no decline (change in slope ≥ 0, n= 1,190), cognitive decline (lowest quartile of slope in 3MS; n=445), physical decline (lowest quartile of slope in SPPB; n= 407), and dual decline (lowest quartile for both cognitive and physical decline; n= 211). Logistic regression tested the association of 23 baseline risk factors with dual decline. Odds of dual decline where higher in relation with depression (CES-D &gt;16) (Odds Ratio [OR]: OR:2.77, 95% Confidence Interval [95% CI] [1.25- 6.15]), and lower for individuals with a better score on the Digit Symbol Substitution Test (DSST) (OR: 0.97 [0.95-0.98]), grip strength (OR: 0.97 [0.94-1.00]), and 400m gait speed (OR: 0.11 [0.03-0.40]). Among the predictors identified, depressive mood at baseline nearly tripled the odds of developing dual decline, but was not associated with decline in either the cognitive or physical domains. Depressive mood is uniquely associated with dual decline; future studies should focus on the overlap between mood states and function, as mood may be modifiable.
LATE-LIFE SUICIDE: IDENTIFYING PREVENTION TARGETS AND MOBILIZING COMMUNITIES TO MANAGE RISK
Authors: Ebert Alexandria R , Bower Emily S , Conwell Yeates 
Published: November 2019

Abstract
Adults aged 70 and older have the highest suicide rates in most countries across the globe (World Health Organization, 2014). Prevalence may increase as the Baby Boomers transition into older adulthood (Phillips, 2014). Disease and disability increase risk for late-life suicide, thus identifying opportunities to intervene within the network of services utilized by older adults with illness and disability could reduce suicide risk. This symposium will explore the impact of disease and disability on late-life suicide risk, and present novel ideas for intervention and prevention. Emphasizing the conference theme, we will discuss prevention points spanning networks of care, including mental health and social services, and long-term care. Dr. Bower will frame the scope of the problem by presenting findings of age-stratified associations between physical illness and suicide attempt among older veterans using secondary data from a retrospective case-control study of veterans. Ms. Lutz will present findings on the relationship between disability and suicidal thoughts from a clinical trial of problem-solving therapy. Dr. Lane will discuss management and identification of suicide risk factors during the transition from independent living to long-term care through the lens of a case-series. Dr. Fullen will present preliminary findings from a novel, randomized controlled trial of a community-based suicide prevention training program for nutrition service volunteers. Dr. Yeates Conwell, Co-Director of the Center for the Study and Prevention of Suicide and Director of the Geriatric Psychiatry Program at the University of Rochester Medical Center, will serve as the discussant.
CHANGES IN OLDER ADULTS’ INFORMAL CARE NETWORKS
Authors: Lin I-Fen , Wu Hsueh-Sheng 
Published: November 2019

Abstract
Many older adults rely on informal care networks to overcome challenges in life and maintain well-being. The composition and function of the informal care network may change as existing caregivers leave and new caregivers join the network over time. The majority of prior studies on caregiving to older adults are based on cross-sectional data and thus cannot examine changes in older adults’ informal care networks. Although some have followed older adults’ informal caregivers over time, they usually focus on primary caregivers, rather than the entire informal care network longitudinally. The newly available panel data on a nationally representative sample of caregivers from the National Study of Caregiving (NSOC) provide an excellent opportunity for researchers to understand how older adults’ informal care networks change over time and what factors relate to discontinuation of care. Using the NSOC 2015 and 2017, we found that 70% of older adults (N = 1,395) experienced changed in informal care networks within two years. Only a small portion of spouses (6%) discontinued giving care to older adults, whereas 21% adult children, 56% other kin, and 77% nonkin stopped caregiving by 2017. We further examined how older adults’ needs for support, caregivers’ resources and constraints, and caregiving experiences were associated with discontinuation of care. This study is expected to advance gerontological research by broadening our understanding of informal caregiving in late life and providing practical implications on how to sustain informal care.
PERCEIVED DISCRIMINATION, ANGER CONTROL, AND INFLAMMATION IN MIDLIFE: THE ROLE OF EARLY-LIFE ADVERSITY
Authors: Lee Chioun , Coons Jennifer , Harari Lexi 
Published: November 2019

Abstract
Early life adversity has severe consequences for adult biological health particularly in minority group individuals. Two ways in which it may be possible to reduce these negative consequences on adult health are individual differences in perceived discrimination due to early life adversities and learning internal skills (i.e. anger control) to help cope with early life adversities and perceived discrimination. The current study utilized 2,118 participants (55% female) from the MIDUS Projects. Early life adversities included three constructs: low socioeconomic status, family instability, and abuse (sexual, physical, and emotional). The best-fitting model from the latent class analyses revealed four distinct groups: 1) no early life adversities group, 2) low socioeconomic status only group, 3) low socioeconomic status and family instability group, and 4) all three early life adversities group. Minority groups were more likely to reside in the all three early life adversities group. Perceived discrimination was measured via two pathways: lifetime discrimination and daily discrimination. Anger control (one measure of an internal skill one learns to cope with early life adversities and perceived discrimination) was assessed with an anger-control scale. Inflammation markers were used as an indicator of biological health. Experiencing more early life adversities was related to greater inflammation and this relationship was partially explained via the pathway of greater early life adversities, greater perceived lifetime/daily discrimination, worse anger control, and greater inflammation. The findings support the need for a more holistic measure of early life adversities as it has a clear impact on adult inflammation.
DRIVING CESSATION AND SOCIAL ISOLATION IN OLDER ADULTS
Authors: Qin Weidi , Xiang Xiaoling , Taylor Harry O 
Published: November 2019

Abstract
This study aimed to investigate the impact of driving cessation on social isolation in older adults. Data came from the National Health and Aging Trends Study round 1 through round 6 surveys. Study sample consisted 6,916 Medicare beneficiaries aged 65+ who were eligible drivers at baseline. Social isolation measure was based on social domains concerning marriage, family and friends, church participation, and club participation. The impact of driving cessation on social isolation was assessed using mixed-effects ordered logistic regression and piece-wise regression. In multivariable mixed-effects ordered logistic regression, past-year non-drivers had a two-fold increase in the odds of being in a higher social isolation category (OR=2.1, p&lt;.001). The odds of social isolation were higher among persons aged 85-89 (OR=1.40, p&lt;.001) or 90+ (OR=1.99, p&lt;.001) as compared with those aged 65-69, among men as compared with women (OR=2.54, p&lt;.001), among persons living alone (OR=3.95, p&lt;.001), with elevated depressive symptoms (OR=1.54, p&lt;.001), and with possible (OR=1.39, p&lt;.001) or probable dementia (OR=1.51, p&lt;.001). The odds of social isolation decreased significantly as education and family income levels increased. Functional limitation was associated with higher odds of social isolation. Piecewise regression analysis showed social isolation score increased by 0.08 points (p=.024), indicating short-term impacts of incident driving cessation. Driving cessation is associated with higher risk of social isolation in older adults. Interventions to provide alternative transportation resources and reduce social isolation among older adults may improve public health impact by targeting older adults who recently stopped driving.