bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric Properties of the PHQ-9 and CESD-R Depression Measures with Older Adults
Authors: Katz Emma , Spalding Rachael , Edelstein Barry 
Published: December 2020

Abstract
Our understanding of older adult depression has been impeded by the paucity of assessment instruments with validity evidence for older adults. Therefore, measures of depression that were initially developed for use with younger adults are commonly used with older adults as well, such as the Center for Epidemiological Studies Depression Scale-Revised (CESD-R; Eaton et al., 2004) and Patient Health Questionnaire-9 (PHQ-9; Kroenke, Spitzer, & Williams, 2001). The CESD-R (Jiang et al., 2019; Van Dam & Earleywine, 2011) and PHQ-9 (Indu et al., 2018; Levis, Benedetti, & Thombs, 2019) have strong psychometric support for their use with young adults, and are two frequently used depression measures. In light of age-related differences in the experience and presentation of depression (e.g., Balsamo, et al., 2015; Fiske, Wetherell, & Gatz, 2009; Hybels, Laderman, & Blazer, 2012; Wuthrich, Johnco & Wetherell, 2015), the present study examined the psychometric properties of these instruments with older adults. Two-hundred-and-seventy-seven older adults (ages 65 and older) completed an online survey including the PHQ-9, CESD-R, and instruments measuring several other constructs with anticipated relations to depression (anxiety, general depression, positive and negative affect, self-esteem, personality traits, and satisfaction with life). The relation between the two depression scales and measures of the other constructs were examined. Both the PHQ-9 and CESD-R evidenced good internal consistency reliability (a = .82 and .83, respectively) and strong correlations in anticipated directions with many of the related constructs. These results support the use of the CESD-R and PHQ-9 with community-dwelling older adults.
A Narrative Review on the Relationship between Female Reproductive Factors and Longevity
Authors: Costanian Christy , Farah Raymond , Bahous Sola , Sibai Abla 
Published: December 2020

Abstract
This review presents findings on the role of female reproductive factors on longevity.A comprehensive systematic literature search was conducted using four electronic databases: OVID Medline, Web of Science, PubMed and Google Scholar from inception until May 2020 and restricted to English language articles that tackle the relationship between reproductive factors and longevity in its various definitions. Our search yielded a total of 306 articles. After screening based on the eligibility criteria,37 articles were included for review. The majority of studies were prospective and conducted in Western populations. The most consistent findings were between parity and increased longevity. The role of ages at menarche and menopause, premature menopause, as well as reproductive lifespan on longevity were not conclusive. Whether gender of offspring is related to maternal longevity is yet to be fully elucidated.Variations in findings are in the majority due to differentials in the definition of longevity as an outcome. Further longitudinal studies based in developing countries are needed to examine reproductive factors related to longevity.
A mobile app for tracking non-motor symptoms of people with Parkinson’s disease: A usability study
Authors: Lee JuHee , Suh Yujin , Kim Yielin 
Published: December 2020

Abstract
Smart phone-based technology for people with Parkinson’s disease has been developed worldwide. Unmonitored non-motor symptoms decrease quality of life of people with Parkinson’s disease, so the needs for technology to manage non-motor symptoms are increasing. The technology is needed to detect subtle changes in non-motor symptoms by healthcare professional. There is no mobile app which manage comprehensive symptoms of Parkinson’s disease including non-motor symptoms. It is necessary to develop a new tracking system that can effectively manage non-motor symptoms as well as motor symptoms of Parkinson’s disease. We developed a prototype of mobile app for Android smartphones, with cooperation with Mazelone company. we also have shaped functions for monitoring of motor symptoms and medication adherence. It also provided a section for caregivers to use on behalf of people with Parkinson’s disease who have difficulty to use app due to hand tremor. Through Delphi technique, we obtained content validity from eight medical and nursing experts on the contents of the application. We provided regular telephone counseling to improve and encourage their app usage. Fifteen participants used the app for 6 weeks. To evaluate usability of mobile app, we provided constructed questionnaire and conducted individual telephone interview. A mobile app for tracking non-motor symptoms demonstrated high usability and satisfaction. We learned lessons about facilitators and barriers when implementing an app such as perception and acceptance of mobile technology. The mobile app will improve continuum of care. Future studies need to improve the contents and refine technical approach for people with Parkinson’s disease.
Review of type-2 diabetes mellitus illness perceptions and associations with illness management
Authors: Hatala Samuel , Shields Cleveland 
Published: December 2020

Abstract
Objective: Determine illness perceptions associated most frequently with measures of type-2 diabetes mellitus (T2DM) maintenance. We measured illness perceptions using the Illness Perception Questionnaire (IPQ) and variants (IPQ-Revised and Brief IPQ) Design: Review of literature from publication of IPQ to September 2020. Searched for articles utilizing IPQ but no other models of illness perception and studying T2DM Main Outcome Measures: Glucose control (measured by HbA1c levels), adherence to medications, and adherence to diet, exercise, and other lifestyle recommendations Results: Symptom attribution and fear of consequences are frequently associated with worse T2DM management and sense of control of illness progression and positive emotional valence are frequently associated with better T2DM management. Other subscales have less frequent but generally positive associations with the exceptions of recurring thoughts about T2DM duration, which had a negative association with management, and understanding the causes of T2DM, which had no associations at all. Other reviews found similar associations and highlighted a need for more general T2DM education. Conclusion: Future T2DM management interventions should promote sense of control over illness progression and positive emotional valence and provide education regarding symptoms to expect. Interventions should also consider managing patient fear, which has many associations with worse management.
Within-Guideline Alcohol Consumption Protects Against Dementia?: Offset Effect of History of Drinking Problems
Authors: Brennan Penny 
Published: December 2020

Abstract
Research on the prospective relationship between older adults’ alcohol consumption and their subsequent risk of dementia and cognitive impairment, no dementia (CIND) has been limited by inconsistent definitions of “moderate” drinking, use of short follow-ups, and an exclusive focus on either amounts of alcohol, or history of drinking problems, as predictors. To overcome these limitations we analyzed a longitudinal, 18-year Health and Retirement Study cohort (n=4,421) to determine how older adults’ baseline membership in one of six drinking categories (Non-Drinker, Without and With a History of Drinking Problems (HDP); Within-Guideline Drinker, Without and With a HDP; and Outside-Guideline Drinker, Without and With a HDP) predicted dementia and CIND 18 years later. Among participants with No HDP, 12.6% of Non-Drinkers, 5.2% of Within-Guideline Drinkers, and 8.8% of Outside-Guideline Drinkers were classified as having dementia at the 18-year follow-up; among participants With HDP, 14.1% of Non-Drinkers, 8.9 % of Within-Guideline Drinkers, and 6.9% of Outside-Guideline Drinkers were classified with dementia. Being a baseline Within-Guideline Drinker with No HDP reduced the likelihood of dementia 18 years later by 45%, independent of baseline demographic and health characteristics; being a baseline Within-Guideline Drinker With a HDP reduced the likelihood of dementia by only 13% (n.s.). Similar patterns obtained for the effects of baseline drinking group membership on likelihood of CIND at follow-up. These findings suggest that consuming alcohol at levels within validated guidelines for low-risk drinking may protect against dementia and CIND, but only among older adults who have no history of drinking problems.
Life review on psycho-spiritual outcomes among older adults with life-threatening illness: A systematic review
Authors: Liu Mandong , Wang Ying , Chi Iris 
Published: December 2020

Abstract
Life review has been widely conducted to help older adults enhance well-being and cope with burdens. Spirituality is an important part of an older adult’s overall well-being, especially for those with life-threatening illnesses. However, there is no review study examining the effectiveness of life review interventions on psycho-spiritual outcomes among this population. The aim of the study was to examine the effectiveness of life review on psycho-spiritual well-being among older adults with life-threatening illnesses. A systematic review with meta-analysis consistent with the recommendations of the Cochrane Collaboration was conducted. Database searches included PubMed, PsycINFO, the Cochrane Library, the Campbell Library, EBSCO, CNKI, and the Airiti Library up to March 2020. Grey literature and reference lists from relevant articles were also searched and reviewed. 34 studies were included in the systematic review and 33 were included in the meta-analysis for outcomes of anxiety, depression, and quality of life. Other psycho-spiritual outcome measures that were not included in the meta-analysis due to the small number of studies included mood, apathy, life satisfaction, meaning in life, spiritual well-being, and some multi-dimensional instruments. The studies greatly varied in program design, content, format, length, interventionist, and more. The meta-analyses demonstrated standardized mean differences in favor of life review compared with the control with small to moderate effect sizes. The reviewers call for including more psycho-spiritual well-being measures among interventions for older adults with life-limiting illnesses, as well as studies with adequate sample size and rigorous designs in future research.
Influence of Provider Characteristics on Geriatric Mental Health Workforce Training Needs
Authors: Mitchell Travis , Sorocco Kristen , Wyman Mary , Vincent Andrea , Wray Laura , Slaughter Lindsey 
Published: December 2020

Abstract
Approximately half of VA users are 65 years of age or older, with a substantial subset having complex and interacting medical, neurocognitive, and behavioral disorders. The goal of the present study was to assess knowledge and training gaps of VA mental health staff using a Web-based training needs assessment developed specifically for VA personnel. Provider characteristics, confidence in working with older adults with and without cognitive disorder, and geriatric training needs were assessed. VA psychologists, psychiatrists, social workers, nurses, and peer support specialists (N=3313) were invited to participate via email. Respondents were 489 mental health providers, a response rate of 13.8 percent. Respondents reported less confidence in treating and assessing older adults with cognitive disorders then older adults in general. This did not differ by any of the examined provider characteristics, including age, gender, or professional experience. Training need endorsement was high across most of the training categories; however, a few differences according to provider characteristics were noted. Providers under the age of 50 endorsed a greater need for training in psychotherapy with older adults with cognitive disorder (p = .02). Female providers endorsed a greater need for training on providing psychoeducation about cognitive disorder, such as dementia, to older adults and their families (p = .02). In sum, VA MH providers in general reported strong interest in a wide range of geriatric MH training topics, indicating a need for universal geriatric-related staff education. For some topics, endorsing geriatric expertise predicted stronger interest in training.
Fear of Falls & Quality of Life in Community-Dwelling Older Adults: Is Diabetes an Effect Modifier?
Authors: Whitehouse Christina , Mensinger Janell , McKay Michelle 
Published: December 2020

Abstract
Prior research suggests that diabetes is a risk factor for falling. Moreover, older adults with diabetes are more likely to experience hip fractures when compared to older adults without diabetes. Research has also shown a relationship between fear of falling and quality of life. This study aimed to examine the moderating role of diabetes in the relationship between fear of falling (FoF) and quality of life (QoL) among older adults in a program for all-inclusive care for the elderly (PACE). This was a retrospective single cohort study that included 84 older adults in a PACE program located in the Northeastern United States. Participants were 55 years of age or older (M=70.33; SD=6.46) and cognitively intact. Diabetes diagnosis (n=46) was determined according to chart review. Fear of Falling was assessed with the Falls Efficacy Scale-International, and the Short Form 12v2 (SF-12v2) was used to measure the quality of life, including physical and mental domains. Hayes’ Process Macro was used to conduct moderation analyses (model 1) controlling race, gender, age, and comorbidities. Alpha was set at .10 to account for low power to detect interaction effects with small groups. Our results indicate the interaction between diabetes status and FoF was significant for mental QoL (p=.09) and not significant for physical QoL (p=.99). The association between FoF with lower mental QoL was stronger for patients with diabetes than for patients without diabetes; this finding was not replicated for physical QoL. Regardless of diabetes status, physical QoL significantly decreased as FoF increased.
Implementation of an Opioid and Benzodiazepine Deprescribing Program for Older Adults in an Outpatient Setting
Authors: Armistead Lori , Busby-Whitehead Jan , Ferreri Stefanie , Henage Cristine , Hughes Tamera , McBride Jack , Roberts Ellen , Urick Ben 
Published: December 2020

Abstract
The United States spends $50 billion each year on 2.8 million injuries and 800,000 hospitalizations older adults (age 65 years and older) incur as the result of falls. Chronic use of central nervous system (CNS)-active medications, such as opioid and/or benzodiazepine (BZD) medications, increases the risk of falls and falls-related injuries in this older adult population. This Centers for Disease Control and Prevention (CDC)-funded randomized control trial uses electronic health record (EHR) data from primary care outpatient clinics to identify older adult patients at risk for falls due to chronic opioid or BZD use. The primary program aim is to test the efficacy of a targeted consultant pharmacist service to reduce the dose burden of these medications in the targeted population. Impact of this intervention on the risk of falls in this population will also be assessed. Licensed clinical pharmacists will review at-risk patients’ medical records weekly and make recommendations through the EHR to primary care providers for opioid or BZD dose adjustments, alternate medications, and/or adjunctive therapies to support deprescribing for approximately 1265 patients in the first two cohorts of intervention clinics. One thousand three hundred eighty four patients in the control clinics will receive usual care. Outcome measures will include reduction or discontinuation of opioids and BZDs and falls risk reduction as measured by the Stop Elderly Accidents, Death and Injuries (STEADI) Questionnaire. Primary care provider adoption of pharmacists’ recommendations and satisfaction with the consult service will also be reported.
Antecedents to Caregiving Differences in Black and White Families
Authors: Wood Kristie , Ng Yee To , Huo Meng , Fingerman Karen 
Published: December 2020

Abstract
Researchers have observed racial differences in midlife adults’ caregiving for aging parents. Black adults typically provide more parental caregiving and report greater rewards in doing so. We asked whether Black and White young adults differ in their support to midlife parents, and furthermore, whether this support differs based on parental gender. We also examined cultural beliefs and rewards of providing support underlying racial differences in support to parents. Black and White young adults from the Family Exchanges Study II (2013; aged 18–30 years; n=114 Black and, n=358 White) reported support provided to parents, and beliefs and rewards associated with support. We assessed 6 types of support (emotional, advice, listening to talk, socializing, practical, and financial) to each parent rated 1 = once a year or less often to 8 = everyday. Multilinear models revealed that Black young adults gave significantly more support to parents than White offspring, and these racial differences were mediated by filial obligation beliefs. Compared to White young adults, Black offspring provided more frequent support to their mothers and reported that it was more rewarding, and endorsed more negative relationship quality with mothers than with fathers. Research has shown that involvement correlates with conflict, which may underlie these findings. Further, compared to White offspring, Black young adults show significantly more behaviors that lead to caregiving in later life, and there are nuanced gender differences within Black parent-child relationships, which may need to be better understood to support Black caregivers.
Using Medicare Data to Inform Intervention and Care Delivery for the Most Expensive Patients
Authors: Amodeo Sam , Kowalkowski Henrik , Brantley Halley , Bangerter Lauren , Jones Nicholas , Cook David 
Published: December 2020

Abstract
Older adults with high medical spend require tailored interventions and care delivery models to meet their complex needs. Segmenting high-spend patients is a promising approach to designing such interventions. In this study we explored patient spend across 4 years (2016-2019) using claims from 799,205 patients continuously enrolled in UnitedHealth Group Medicare Advantage (mean age=73.7; S.E.=0.01). Patients with healthcare spend in the top decile were segmented into three subgroups: catastrophic, persistent, and semi-persistent. Catastrophic patients had more acute events (acute myocardial infarction and hip/pelvic fracture) driving their cost. Persistent patients were younger (mean age=67.8; S.E.=0.06) and had significantly more medications. Semi-persistent patients were older (mean age=76.6; S.E.=0.04) and had significantly more chronic conditions and frailty, indicating their cost was driven by medical complexity. These subgroups displayed different temporal stability in their healthcare costs over time. Each year, 79-81% of the catastrophic group dropped out of the top decile. In contrast, nearly 72% of the persistent group remained in the top decile whereas only 37% of the semi-persistent group remained year over year. As the global population continues to age, it will be necessary to design interventions and care delivery models that address the complex needs of older adults in the high-spend patient population. Our study suggests that segmenting high-spend patients into potentially actionable subgroups is an important first step in achieving these goals.
1-Year Rehospitalization and Mortality Rates in Geriatric Patients after Acute Hospitalization
Authors: Paek Sun , Volpi Elena , Deer Rachel 
Published: December 2020

Abstract
Hospitalization for an acute illness often leads to accelerated sarcopenia, debility, and loss of independence in geriatric patients. These post-hospitalization effects can further deteriorate health and lead to rehospitalizations and sometimes death. To improve health outcomes in these patients, it is important to determine predictive factors for increased readmission and mortality rates. Data regarding readmission and mortality within 1 year post-discharge were collected from the PACE and GRAMS studies (NCT02203656, NCT02990533) conducted at UTMB Galveston (Jan 2014 - Mar 2019). Readmission and mortality rates were analyzed to find associations with total days hospitalized and total number of readmissions within 1 year, demographics (age, highest education level, BMI, percent fat, baseline SPPB score), and interventions (exercise with protein supplementation, exercise with placebo, protein supplementation, placebo supplementation, and testosterone injection). Of the 175 subjects, 63.4% were rehospitalized and 9.7% died within 1 year. We found that patients who were rehospitalized within a year of their initial hospitalization were over 4 times more likely to die that year than patients who were not rehospitalized. Patients who died within one year had twice the amount of hospitalization within the year and spent three times the number of days hospitalized. Of the interventions studied, a single testosterone injection at discharge from the index admission appeared the most effective to reduce rehospitalizations.
Diet Quality and Biological Risk in a National Sample of Older Americans
Authors: Choi Yeon Jin , Ailshire Jennifer , Kim Jung Ki , Crimmins Eileen 
Published: December 2020

Abstract
Biomarkers are sensitive to current health status and capture aspects of health that may precede the development of disease and other health problems. Using comprehensive measures of biological risk, this study aims to investigate the relationship between intake of individual dietary components, overall diet quality, and biological dysregulation. For the analysis, we used nutrition and biomarker data from 3,641 older adults (over age 50) in the Health and Retirement Study. Eleven out of 13 individual dietary components were associated with lower biological risk. After controlling for SES, health behaviors, and access to health care, a high intake of fruits, greens and beans, whole grains, seafood and plant proteins, and fatty acids and a low intake of sodium and saturated fat were still associated with lower biological risk. Respondents with poor/suboptimal quality diet had higher biological risk than those with good quality diet. After controlling for SES, health behaviors, and access to health care, respondents with poor/suboptimal quality diet continued to exhibit higher biological risk than those with good quality diet, though the differences in biological risk were reduced. Findings from this study emphasize the importance of healthy eating in improving health of older adults. Encouraging intake of fruits, greens and beans, whole grains, seafood and plant proteins, and fatty acids, while limiting consumption of sodium and saturated fat would improve overall diet quality and contribute to the prevention of chronic diseases and morbidity.