bluuebunny/crossref_metadata_2025_split huggingface dataset:
IN HIP FRACTURE, GENDER CONFOUNDS COGNITION ASSESSMENT, TIME TO DEATH, AND COGNITION-RELATED MORTALITY
Authors: Mutchie Heather L , Orwig Denise , Gruber-Baldini Ann 
Published: November 2019

Abstract
Of 300,000 annual hip fractures in the US, about 30% occur in men, over 30% experience cognitive impairment or dementia, and 30% die within one year. This study compares time-to-death and cognition-related cause of death (CR-COD) by gender after hip fracture using different methods of cognitive impairment ascertainment. Baseline hospital charts and Modified Mini-Mental State Examination (3MS) were from the Baltimore Hip Studies 7th cohort (2006-2011) (171 women, 168 men). National Death Index was obtained up to December 31, 2014. Cox models assessed dementia diagnosis in chart and 3MS&lt;78 as predictors of mortality and CR-COD (died n=204). Men were more likely to fail the 3MS (Men:26.2%, Women:16.2%; p=0.025), die (Men:73.8%, Women:46.8%; p&lt;.0001), and die sooner (Men:µ=30.8months, Women:µ=39.2months; p=0.0159). Significantly more women died with CR-COD (Men:17.7%, Women:31.2%, p=0.0253). Among men, those with any cognitive impairment (3MS:µ=21.5months, chart:µ=21.3months; both:µ=22.0months) died sooner than non-impaired (µ=22.0months). Among women only those with both chart and 3MS (µ=16.7months) died sooner than all other groups (3MS:µ=47.8months, chart:µ=35.1months, none:µ=42.9months). With respect to CR-COD, men with cognitive impairment from any source (3MS:µ=5.0months, chart:µ=43.4months, both:µ=30.5months) differed from non-impaired (µ=91.6months). While women with hospital chart alone (µ=14.0months) differed from non-impaired (µ=3.6months), 3MS alone (µ=8.5months) and both (µ=9.5months). Men had worse 3MS scores but similar chart diagnosis, indicating a potential underdiagnosis of men’s cognitive impairment. Gender confounds the relationship between cognition and death or CR-COD. In men, any impairment predicts death overall and CR-COD. In women, chart with 3MS impairment predicted overall death, but chart alone was more predictive for CR-COD.
EXPLORING ASSOCIATIONS BETWEEN FRAILTY AND ORAL HEALTH IN COMMUNITY-DWELLING OLDER PEOPLE
Authors: Everaars Babette , Jerković - Ćosić Katarina , Bleijenberg Nienke , de Wit Niek J , van der Heijden Geert j 
Published: November 2019

Abstract
This study explores associations between frailty and oral health in cross-sectional data of 1,202 community-dwelling older people. Two dichotomous outcomes were used: 1. Potential frailty, using routine primary care data; 2. Self-reported frailty, using a questionnaire. Oral health concerned dental record data and self-reported oral problems. Following exploration of univariate associations, age and sex adjusted multivariate logistic regressions were performed. For potential frailty and self-reported frailty associations were found with dental emergency visit (odds ratio (OR)= 2.0, 95% confidence Interval (CI)=1.33;3.02 respectively OR=1.58, 95% CI=1.00;2.49), experiencing oral problems (resp. OR=2.07, 95% CI=1.52;2.81 and OR=2.87, 95% CI= 2.07), making dietary adjustments (resp. OR=2.66, 95% CI= 1.31;5.41 and OR=5.49, 95% CI= 3.01;10.01). Additional associations were found for self-reported frailty with wearing dental prosthesis (OR=3.33, 95% CI=1.49;7.44) and missing periodontal information (OR=1.56, 95% CI=1.05;2.32). The cross-sectional data of this study show that in community dwelling older people oral health is associated with frailty.
NATIVITY AND DISABILITY TRAJECTORIES AMONG TWO COHORTS
Authors: Vasquez Elizabeth , Zhang Weihui , Botoseneanu Anda 
Published: November 2019

Abstract
Nativity is an important characteristic in the context of disability in older adults, as it may influence attitudes and behaviors that can delay or accelerate the disability process. This study aims to assess trajectories of disability (defined as lower-body functional limitations, limitations in daily and instrumental activities of daily living, and gross mobility) in foreign-born and US-born Mexican Americans between 1993 and 2013. We used eight waves (1993 -2013) from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (HEPESE; N=3050, mean age at baseline=73.6 (±6.8). Disability was assessed using self-reported limitations in activities of daily living (ADL /IADL). Nativity and age-at-migration were collected by self-report. We used linear and quadratic growth curve models to evaluate the trajectory of ADL/IADL disability over a period of 20 years and assessed variations by nativity status while adjusting for potential confounders. Approximately 19% of foreign-born and 17% of US-born reported having at least one ADL, while 51.5% natives and 58.7% of foreign-born had at least one IADL. Our results showed that after controlling for age at baseline, sex, marital status, self-reported health, chronic conditions, and education, foreign-born older adults were less likely to have ADL/IADL disability at baseline, but exhibited a faster rate of increase in disability over time (β =0.31 for ADL, β=0.07 for IADL). Our findings show that foreign-born older adults are accumulating disability at faster compared with their native peers, highlighting the importance of evaluating nativity differences in the health outcomes of Hispanic population at old age.
POLYPHARMACY IN DIABETIC PEOPLE: EVIDENCE FROM THE ENGLISH LONGITUDINAL STUDY OF AGEING (ELSA)
Authors: Huang Yun-Ting , Zaninotto Paola , Steptoe Andrew , Wei Li 
Published: November 2019

Abstract
Diabetes among older people is becoming more common worldwide, and usually accompanied by polypharmacy. However, the role of polypharmacy in older people with diabetes remains uncertain. A nationally representative cross-sectional study, ELSA 2012/2013, was used and 7729 participants aged 50-109 were investigated. Polypharmacy was defined as taking five to nine long-term used medications daily for chronic diseases or chronic symptoms, while using ten or more medications was excessive polypharmacy. The presence of illness was defined as either self-reported diagnosis or being prescribed specific medications for the condition. Data showed the prevalence of polypharmacy was 21.4%, and only 3% was excessive polypharmacy. 51.6% of diabetic people reported polypharmacy and 10.2% excessive polypharmacy. These rates were significantly higher than the 16.4% polypharmacy and 1.8% excessive polypharmacy among people without diabetes (p &lt; 0.001). Among people with three or more comorbidities, polypharmacy was present in 61.5% of people with diabetes, compared with 36.0% in people without diabetes. Significant risk factors for polypharmacy were diabetes (Relative-risk ratios/RRR=4.06, 95% CI 3.38, 4.86), older age (RRR=1.02, 95% CI 1.01, 1.03), male (RRR=0.64, 95% CI 0.55, 0.75), more comorbidity (RRR=2.46, 95% CI 2.30, 2.62), living with a partner (RRR=1.20, 95% CI 1.01, 1.42), and less wealth (RRR=0.93, 95% CI 0.87, 0.98). However, age, cohabitation, and wealth were not significantly related to excessive polypharmacy. Diabetes and the number of comorbidities were predominant risk factors for excessive polypharmacy. Current evidences confirmed both health condition and socioeconomic status were associated with medication use in older adults.
POTENTIAL CLINICAL CONSEQUENCES OF ADMINISTRATIVE ISSUES REGARDING MEDICATION IN HOME CARE PATIENTS
Authors: Dijkstra Nienke E , Sino Carolien , Schuurmans Marieke J , Bouvy Marcel L , Bouwes Aline , Heerdink Rob R 
Published: November 2019

Abstract
Home care professionals observe drug-related problems (DRPs) as administrative problems (e.g. inconsistent registration of (changes in) drug prescription) and side effects which may have clinical consequences for older patients. This study aims to determine the potential clinical impact of administrative problems. A retrospective descriptive study was performed, using reports of home care professionals of the eHOME system (system that assist monitoring/reporting DRPs). Administrative problems of a one year period were assessed by three experts on potential discomfort/clinical deterioration using a 3-point scale. 309 DRPs of 120 out of 451 patients (age ≥65) were assessed. Problems involved undelivered medication administration record lists (n=103,33.3%), inconsistent registration of drug prescription (n=188,60.9%) and insufficient drug delivery (n=18,5.8%). 58.2% of the DRPs had the potential to cause moderate to severe discomfort or clinical deterioration. The results underlines the importance of the observation function of home care professionals and the need to improve pharmaceutical administration issues.
CARING FOR CHILDREN WITH DEVELOPMENTAL DISABILITIES: WHAT ARE THE OUTCOMES FOR HEALTH IN AGING?
Authors: Hoyle Jessica , Laditka James N , Laditka Sarah B 
Published: November 2019

Abstract
Eight to ten percent of children have a developmental disability (DD). Caring for a child with DD can be rewarding. It can also be difficult, particularly for older parents or other caregivers (hereafter parents). Few studies have examined their experiences. We followed parents for 18 years using the nationally representative Panel Study of Income Dynamics (PSID). We defined DD with criteria used in research and education law, as: (1) autism, intellectual disability, learning disorder, epilepsy with seizures, attention deficit disorder/attention deficit hyperactivity disorder, cerebral palsy, or traumatic brain injury; and (2) qualification for professional services. We used three waves of the PSID’s Childhood Development Study, 1997-2007, linking children’s and parents’ PSID data (n=4,070) to study three outcomes: parents “not very” or “not at all” satisfied with “life as a whole”; nonspecific psychological distress; and reports that depressive feelings interfered with life or activities “a lot.” Discrete-time hazard models controlled for: child disability; children’s and parents’ age, sex, and education; survey design; and repeated measures. Among parents ages 47-61 at baseline (65-79 in 2015), those who cared for a child with DD were significantly more likely to report low satisfaction with life (hazard ratio, HR 4.6, 95% confidence interval, CI 1.6-13.2), distress (HR 2.8, CI 1.1-6.9) and, among women, depressive feelings (HR 1.3 CI 1.0-1.8). We found no such differences for parents less than age 65 in 2015. Results highlight the need to provide emotional support, respite, or other services for older adults caring for children with disabilities.
DEPRESSION IN CAREGIVERS OF VETERANS: THE INTERACTION OF PERCEIVED SOCIAL SUPPORT AND AGE
Authors: Scicolone Monica , Parmelee Patricia A 
Published: November 2019

Abstract
Caregiving is a risk factor for increased psychological stress and depression (Pinquart & Sörensen, 2003). Perceived social support (PSS) is strongly associated with emotional well-being and, for informal family caregivers, may be an important predictor of caregiver psychological outcomes. Although much is known about the effects of global PSS, there is a gap in research regarding numerous identified functional dimensions of support, particularly among family caregivers. Thus, this secondary data analysis examined how dimensions of PSS predict depression, and the moderating effects of age on this relationship, utilizing data from 240 family caregivers of elderly veterans receiving outpatient care at the Atlanta VA. The analysis utilizes a multidimensional measure of PSS (Sherbourne & Stewart, 1991) with four sub scales: emotional/informational, tangible, affectionate, and positive social interaction. Preliminary OLS regression analyses, regressing depression on relevant demographic variables and PSS domains, revealed a significant overall model (p &lt; .001). All domains besides tangible support significantly predicted depression. Because age was the only demographic variable associated with depression, we tested hypotheses of an interaction of PSS and age with PROCESS macro (Hayes, 2017). Moderation analyses revealed a significant interaction of support and age on caregiver depression (p = .0145). Of unique social support dimensions, only emotional/informational social support interacted with age (p = .0075), demonstrating decreased depression at high levels of emotional/informational support, but a weaker effect for those of increased age. The original study was supported by the U.S. Department of Veterans Affairs Rehabilitation R&D Service.
STRESS, DEPRESSION, AND COGNITIVE FUNCTION IN ADRD FAMILY CAREGIVERS
Authors: Puga Frank , Meyer Kylie , Pickering Carolyn E 
Published: November 2019

Abstract
The rapidly growing number of individuals over the age of 55 stresses the need to identify unique factors to decrease older adults’ vulnerability to psychiatric and neurodegenerative disorders, especially among high-risk groups such as family caregivers to persons with Alzheimer’s disease or related dementias (ADRD). In this project, we investigated physiological stress responses, depression, and cognitive functioning. Using data from the Midlife in the United States database, we examined differences in physiological stress responses, depressive symptoms, and cognitive function (including working memory, episodic memory, verbal ability, processing speed, and executive functioning) between ADRD and non-ADRD caregivers. Results from the secondary analysis revealed a decrease in cognitive function, an increase in depressive symptoms and disrupted physiological responses in ADRD caregivers. These data suggest that the unique aspects of ADRD caregiving are a risk factor for the onset of psychiatric and neurodegenerative disorders. The results of this study support the development of targeted interventions to reduce the risk of depression and cognitive decline among ADRD caregivers. The specific focus on older adult ADRD caregivers, physiological processes, mental health, and dementia is unique in the field of aging and provides a critically needed new paradigm for identifying strategies to support ADRD caregivers and understanding the development of ADRD.
COGNITIVE ENHANCEMENT FOR GRANDPARENTING: REDUCED LONELINESS AS A MEDIATOR
Authors: Chang Yuanqing , Li Yin , Zhang Xin 
Published: November 2019

Abstract
Grand-parental care, an important form of family care in China, However, its health effect on older adults, including their physical and mental health and cognitive function, is often not well understood. In the present study, we investigated the differences in terms of physical and mental health (measured by SF-36 Quality of Life Scale), self-aging attitudes (measured by the Philadelphia Senior Center Morale Scale), and cognitive functions (measured by WAIS, the subscales of Wechsler Adult Intelligence Scale) between those who provide grand-parental care and those who do not. Two studies were conducted. The first study examined 150 older adults who provided grandparental care and another 150 older adults who did not. Six months later, we randomly selected 103 older adults to conduct a longitudinal follow-up, of which 53 were older adults who provided grandparental care, and another 50 older adults were those who didn’t. The results of both cross-sectional and longitudinal studies showed that, compared with older adults who did not provide grandparental care, those providing grandparental care has significantly better physical and mental health, more positive self-aging attitudes and even enhanced cognitive functions. Further path analysis showed that loneliness mediated the association between providing grandparental care and enhancement in functions, such that providing grandparental care can reduce loneliness of the older adults, which in turn can improve their physical and mental health and even enhance their cognitive functions. These results shed light on the practical implications of grandparenting in China for the society.
IT’S BETTER TO GIVE THAN RECEIVE, OR IS IT? THE EFFECT OF SOCIAL SUPPORT ON THE PSYCHOLOGICAL WELL-BEING OF OLDER PARENTS
Authors: Blanco Erik 
Published: November 2019

Abstract
The longevity revolution has led to more years of shared lives between older parents and adult children. Having these extra years together can be offset by the stressful life transitions of widowhood, health declines, and increased level of disability experienced by older parents. These transitions can lower older parents’ psychological well-being. Although social support to/from adult children has the potential to buffer these effects, most older parents wish to remain independent, even in later life, making them reluctant to accept social support from their adult children. The purpose of this paper is to examine whether the provision or receipt of social support between older parents and adult children, influences positive mood and negative mood. Secondary data on older adults (n = 461) with adult children who participated in the 2004 wave of the LSOG were used. The results revealed that the provision of social support by older parents to adult children significantly increased parents’ positive mood showing that it is better to give than receive. The results for the receipt of social support were more complex. Results suggest that when someone has a higher level of disability and does not receive social support their negative mood increases, but when someone has a high level of disability and does receive social support there is no effect on negative mood. This proposes that the receipt of social support is particularly important when the parent is in need of support and it is better to receive than give when parents are in need.
LOWER URINARY TRACT AND BOWEL SYMPTOMS PREDICT QUALITY OF LIFE IN GAY AND BISEXUAL PROSTATE CANCER SURVIVORS
Authors: Talley Kristine M , Polter Elizabeth , Capistrant Benjamin D , West William G , Konety Badrinath , Rosser B R Simon 
Published: November 2019

Abstract
Little is known about disparities in prostate cancer survivorship experienced by gay and bisexual men (GBM). However, early evidence suggests GBM may experience worse urinary and bowel symptoms than heterosexual men. This cross-sectional Internet-based survey describes the prevalence of lower urinary tract (LUTS) and bowel symptoms and their associations with physical and mental health related quality of life (QOL) in GBM treated for prostate cancer. This study enrolled 193 men who identified as gay or bisexual and had received prostate cancer treatment. The Expanded Prostate Cancer Index Composite instrument measured LUTS and bowel symptoms. The MOS SF-12 measured physical and mental QOL. Participants had a mean age of 63.4 years, were 5.6 years past treatment, and were treated with prostatectomy (52%), radiation (19%), or combined or systemic treatment (29%). The most common symptoms were nocturia (77%), urinary frequency (67%), urinary leakage (59%), bowel urgency (45%), bowel frequency (35%), and watery bowel movements (34%). Mean scores were 81.4±19.2 for urinary function, 74.5±20.7 for urinary bother, 88.9±12.1 for bowel function, 84.5±16.3 for bowel bother, 52.5±8.8 for physical QOL, and 46.0±11.4 for mental QOL. In multivariable models adjusted for age, race, treatment type, and time since diagnosis, urinary bother was associated with worse physical QOL (Adjusted Mean Difference (AMD): 0.11, 95%CI: 0.02-0.21), and bowel bother was associated with worse mental QOL (AMD: 0.23, 95%CI: 0.05-0.42). LUTS and bowel symptoms were common. Symptom bother rather than function predicted QOL. Understanding these disparities will help tailor treatments for this underserved population.
THE ATTITUDE OF MEDICAL PRACTICES TOWARD LGBTQ OLDER ADULTS BEFORE AND AFTER INTERVENTION
Authors: Kim Mackenzi , Wilson Lynn M , Biery Nyann , Frutos Brenda 
Published: November 2019

Abstract
Individuals who identify as lesbian, gay, bisexual, transgender or other non-heterosexual or binary gender identifiers (LGBTQ) face tremendous obstacles in search of quality healthcare. Older LGBTQ adults face these obstacles in the setting of more complex health problems with few social services and support. Negative treatment from healthcare professionals has proven to be one of the most pervasive barriers to care faced by older LGBTQ adults. Sensitization training with the film, Gen Silent, is one way knowledge gaps and biases of healthcare professionals has been addressed. By utilizing the survey previously validated by Porter et al., health professionals’ knowledge, perceptions, and attitudes toward LGBTQ older adults before and after viewing Gen Silent were assessed in Lehigh Valley Health Network (LVHN)-affiliated primary care practices. The principle outcome of this study was a statistically significant change in responses. Primary care practices were recruited for 45-minute sessions that included the showing of an educational, abbreviated version of Gen Silent to available staff. It was preceded by administration of a pretest survey and followed by a posttest survey and discussion. A paired t-test was conducted to determine significance of differences between pre- and posttest responses. Seventeen individuals (N=17) viewed the film and finished pre- and posttest surveys. Nearly all questions exhibited changes between pre- and posttests. Significantly, respondents indicated increased awareness of additional barriers to care faced by LGBTQ older adults compared to heterosexual peers. While limited, these results indicate that primary care professionals would benefit from training specific to the aging LGBT population.
CONNECTING PROVIDER TO HOME: BRIDGING GAPS IN CARE
Authors: Weir Melanie , Moreno Gerardo , Loza Rosaneli , Desai Lisa , Tseng Chi Hong 
Published: November 2019

Abstract
When the physician has limited knowledge of the patient’s condition and functioning at home it may result in non-adherence to treatment plans, goals of care not being met and avoidable utilization. Connecting Provider to Home (CP2H) deployed teams of a social worker and community health worker to act as the eyes and ears of the doctor in patients’ homes and close the information gap in primary care. Study objectives were to 1) reduce unnecessary utilization, 2) increase provider and patient satisfaction, and 3) Improve communication between patient/caregiver and the healthcare team. A total of 416 adult patients were enrolled with a mean age of 76 years, and 58% were female. CP2H participants demonstrated statistically significant reductions in acute hospitalizations and ER use when compared to 700 controls. Acute hospitalizations were reduced by 216 and ER visits by 531 in the intervention group. The average per patient per year reduction in acute hospitalizations was 0.67. The average per patient reduction in ER use was 0.58. CP2H patients reported high levels of satisfaction and rated the program favorably. Stakeholder interviews found that physicians and staff believed the program improved clinical outcomes, provided valuable insight about patients’ social barriers to self-care and added value. CP2H study results provide evidence that social workers and community health workers can be successfully and cost-effectively incorporated into the primary care team to address patient needs and priorities, observe the patient in the home environment and assist the physician in adapting treatment plans to optimize patient care.