bluuebunny/crossref_metadata_2025_split huggingface dataset:
CARDIOVASCULAR RISK MODERATES THE EFFECT OF RESISTANCE TRAINING ON PHYSICAL PERFORMANCE IN OLDER ADULT WOMEN
Authors: Marcotte Lauren , Barha Cindy , Liu-Ambrose Teresa 
Published: November 2019

Abstract
We aimed to examine whether the Framingham Cardiovascular Risk Profile Score (FCRP) moderates the effect of progressive resistance training (RT) on mobility in older adult women. This is an exploratory analysis of a single-blind, 12-month randomized controlled trial in 155 omen, aged 65 to 75 years old, who were randomized to: 1x/week progressive RT; or 2x/week progressive RT program; or 2x/week balance and tone (BAT). At baseline and trial completion, mobility was measured using the Short Physical Performance Battery (SPPB). The SPPB is a composite measure of usual gait speed, standing balance, and sit to stand performance; scores &lt; 9/12 are indicative of functional decline. Baseline 10-year cardiovascular risk was calculated using the FCRP. Participants were classified as either low risk (&lt;16.5% FCRP score; LCVR) or high risk ≥16.5% FCRP score; HCVR). A complete case analysis (n=126) was conducted using a two-way analysis of covariance (ANCOVA) to evaluate the interaction effect of group by FCRP risk on SPPB scores at trial completion; baseline SPPB scores and age in years were entered as covariates. There was a significant interaction effect (F(1,126)=3.74, p=0.027). At trial completion, both 1x/RT and 2x/RT participants with HCVR demonstrated greater SPPB scores than those with LCVR (11.59 vs. 11.38 for 1x/week; 11.86 vs 11.46 for 2x/week). In contrast, BAT participants with HCVR demonstrated worse SPPB scores than those with LCVR (11.18 vs 11.66). Our data suggest that RT may be more efficacious for improving mobility in older women with higher cardiovascular risk than women with lower risk.
BILINGUAL SPEAKERS POSTPONE SYMPTOMS OF COGNITIVE DEFICIT IN PARKINSON’S DISEASE
Authors: Saidi Ladan Ghazi 
Published: November 2019

Abstract
Maintaining cognitive abilities despite healthy aging, neurodegeneration or acute damage is known as cognitive reserve (Stern, 2002; Stern, et. al., 2018). There is evidence for a higher cognitive reserve in bilingual speakers (Kavé, et. al., 2008), mainly due to their improved executive functioning and attention. Thus, I hypothesized that patients with Parkinson’s disease would manifest PD related cognitive symptoms later than monolinguals as a result of better compensation. The aim of this study is to explore how bilingualism affects cognitive abilities in PD patients with cognitive deficit. QPN publicly available database was used to analyze the data on PD patients with (PD-CD) and without (PD) cognitive deficit and their demographic information including the number of spoken languages. Monolingual PD and PD-CD patients were compared to their bi- and multilingual peers on their age of on-set of their cognitive decline as well as descriptive demographic information. The results showed that PD-CD patients who speak more than one language manifest symptoms of cognitive impairment at least three years later than their monolingual peers. These results bring evidence that life-long bilingualism contributes to a stronger cognitive reserve and better compensation in case of a neurodegenerative disorder such as PD.
BLOOD THICKER THAN WATER? STEPGAP IN INTERGENERATIONAL RELATIONSHIPS
Authors: Öberg Peter , Bildtgard Torbjorn 
Published: November 2019

Abstract
The increasing prevalence of ageing stepfamilies and stepchildren’s potential to act as a source of support for older parents has prompted research about intergenerational cohesion in step-relationships. Previous research has hypothesized a qualitative gap (a step-gap) between step and biological relationships to the advantage of the latter. In this Swedish study we compare emotional closeness between older parents and adult children among parents (aged 66-79) who have had both biological and stepchildren, and children (aged X-Y) who have had both biological and stepparents. Qualitative interviews (n=24) of family histories including a hierarchical convoy model of family relationships were collected and analyzed. Results show that with few exceptions biological relationships are rated as emotionally closer than step-relationships, both by parents and adult children, supporting the step-gap hypothesis. While the older parents tend to deemphasize the importance of blood for their ratings, the adult children often emphasize the importance of blood. The difference is explained by a parental adherence to an ideology of equal treatment of children, while the adult children stress the importance of biology for their identity and belonging.
ATTITUDES TOWARD PARENTAL FINANCIAL SUPPORT OF YOUNG-ADULT CHILDREN
Authors: Svynarenko Radion 
Published: November 2019

Abstract
Studies have shown that Americans do not save enough for retirement because they prioritize providing support of their young-adult children over saving for retirement. Attitudes toward parental support has been largely overlooked in existing literature. Using a factorial vignette experimental design and a sample of 500 Americans of age 40 and older, this study investigated how manipulation of contextual factors changed endorsement of parental support. This study found that endorsement of parental support varied depending on the goal of support, whether it was to purchase a car, pay for school tuition, or to pay for down payment for a house. Thus, 67% of respondents endorsed parental financial assistance with purchasing a car, 44% endorsed down payment for a house, and only 38% endorsed paying for college tuition, reflecting overall social importance of these three elements in becoming an adult person. Gender of the child did not affect endorsement of parental financial support to adult children, indicating that there were no gender specific social expectations of who should receive more support from parents, daughters or sons. The major motives of parental support included (a) desire to be a “good parent” and to take responsibility for the child, (b) expectation that children would eventually pay back their parents, and (c) desire to make sacrifice for own children. Parental support may provide numerous benefits to both children and their parents; however, it is important to educate parents on ways to support their children without threatening their own financial needs in retirement.
GAMEPLAN4CARE: AN ONLINE TRANSLATION OF REACH II REFINED THROUGH EARLY STAKEHOLDER USABILITY TESTING
Authors: Cho Jinmyoung , Stevens Alan B , Birchfield Thomas , Sanghi Sandhya , Vernon Ashley , Ory Marcia G 
Published: November 2019

Abstract
Despite a number of evidences on the implementation of multicomponent education and support programs to improve the lives of dementia caregivers, there is still a need to adapt these interventions to various implementation settings and preferences of a new generation of caregivers. In this study, we present the development and usability testing of a dementia caregiver support program, GamePlan4Care (GP4C), an online translation of the Resources for Enhancing Alzheimer’s Caregiver Health II (REACH II) intervention. The goal of the GP4C is to create an online family caregiver support system that would facilitate delivery of an evidence-based skills-training and support for dementia caregivers with the potential of both scalability and sustainability. GP4C includes the full breadth of REACH II education and skill-building materials, delivered within an automated, online platform with integrated support from a Dementia Care Specialist via telephone/video conferencing. Dementia caregivers, community agency staff, and other experts are involved in usability testing to ensure acceptability of this new approach to intervention delivery. The software development is completed and usability testing is currently underway. The feasibility and success of this new modality of intervention delivery will be made possible by an innovative intervention design supported by appropriate technical and content elements. We will also present the strategies employed to adapt the intervention to an online platform capable of supporting caregiver self-directed exposure to therapeutic content, the results of usability testing with approximately 32 caregivers, and feedback from other external stakeholders on the feasibility of this approach.
RATES OF HOSPITALIZATION AND EMERGENCY DEPARTMENT VISITS AND THE QUALITY OF NURSING HOMES IN THE U.S.
Authors: Breunig Ian , Zheng Qing , White Alan , Williams Christianna , Muma Allison 
Published: November 2019

Abstract
CMS strives to reduce costs and improve care for nursing home (NH) residents by reducing acute care transfers. We used a national database of Medicare claims and the Minimum Data Set to build NH stays from July 2017 through June 2018 and identify dates of hospital admissions and emergency department visits without hospitalization (ED) among all residents. We calculated rates of 30-day re-hospitalization and ED among short-stay (rehabilitation) residents, and the number of hospitalizations or ED per long-stay resident day (LSRD), then examined associations with NH Five-Star ratings (data.medicare.gov) and other provider characteristics available from Medicare administrative data. We identified 1.79 million short-stays and 898,290 long-stays at 15,576 NHs. Nationally, the 30-day re-hospitalization rate is 22.6%, the short-stay ED rate is 12.0%, there was one hospitalization every 561 LSRD (1.8 per 1000 LSRD), and there was one ED every 617 LSRD (1.6 per 1000 LSRD). Median facility rates were 22.3% (IQR=17.8%, 27.1%) for 30-day re-hospitalizations, 12.0% (IQR=8.7%, 16.1%) for short-stay EDs, 1.6 hospitalizations per 1000 LSRD (IQR=1.1, 2.3), and 1.4 ED per 1000 LSRD (IQR =0.9, 2.2). Higher rates were strongly associated with lower Five-Star ratings, particularly staffing ratings, and larger, for-profit, non-hospital facilities; even after risk-adjustment. NH variation and associations with provider characteristics suggest it is possible to further reduce acute care transfers. CMS incorporated these measures into the Five-Star rating system, providing greater transparency for residents and possibly incentivizing NHs to improve through competition. Future research should monitor success or identify the need for other avenues to improve.
THEORY-DRIVEN ROLE MODEL STORIES’ EFFECTIVENESS IN IMPROVING PALLIATIVE CARE KNOWLEDGE AMONG A DIVERSE POPULATION
Authors: Hoe Deborah , Rahman Anna , Johari Kayla , Enguidanos Susan 
Published: November 2019

Abstract
Palliative care, specialized medical care for seriously ill people, has been demonstrated to reduce pain and symptoms while increasing satisfaction with health care. Yet, national surveys show that less than 10% of people are aware of palliative care, and among these, many believe it to be synonymous with hospice. The purpose of this study is to determine the effectiveness of 3-minute long theoretically-driven role model video stories at improving knowledge of palliative care. We recruited 161 adults age 50 and older from senior centers, assisted living, and other community-based sites. Pretest-posttest study design was employed and each participant completed 20 question surveys about palliative care knowledge, intent to seek palliative care, and perceptions about the videos. We also recorded participants’ opinions of the videos. Regression analysis was conducted to test the effectiveness of the role model video stories and qualitative analysis to elicit the major themes in participants’ opinions. Overall, palliative care knowledge score (max=13) improved from an average of 4.64 to 9.99 (t=11.99, p&lt;0.001). Two-sample t-test revealed no significant difference in change of score by race. Regression analysis revealed that belief in the role models as real people and participants with 12 years of education significantly predicted higher change in knowledge scores. Conversely, being non-white and widowed were significant predictors of lower changes in score. Qualitative analysis of participants’ perspectives revealed two major positive themes: authenticity and informativeness of videos. This study suggests that theoretically-driven role model video stories may be an effective strategy to improve palliative care knowledge.
CHANGES IN THE MEDICARE HOME HEALTH CARE MARKET: THE IMPACT OF ACA REIMBURSEMENT POLICY
Authors: Torain Jamila M , Davitt Joan , Bright Charlotte L , Miller Nancy , Chard Sarah , Orwig Denise 
Published: November 2019

Abstract
This study evaluated the effect of recent ACA changes to Medicare Home Health Care (HHC) reimbursements on the mix of agencies and staff in the HHC market. We used Provider of Services (POS) data and logistic regression, to determine which agency characteristics were associated with the likelihood of exiting the HHC market and likelihood of decreasing staff before (n=13,878) and after (n=13,702) implementation of the ACA-mandated reimbursement cuts. Free standing agencies had 1.35 times the odds of exiting from the HHC market post ACA cuts. There were no differences in the odds of exiting the HHC market between for-profit and non-profit agencies. Agencies in the New York, Atlanta, and Chicago regions had a greater likelihood of exiting the HHC market post ACA cuts. Small agencies had two times the odds of exiting (aOR= 2.09) and agencies with one or more branch had less than half the odds of exiting (aOR= 0.46) from the HHC market. The average number of all staff was similar before and after the ACA cuts; however, office staff and home health aides experienced the greatest decrease in number. Agencies that were for-profit, free-standing, small, and/or with one or more branch were more likely to decrease staff post the ACA cuts. Agencies in the New York, Atlanta, Chicago, Dallas and Kansas regions were more likely to decrease staff. Overall, the reimbursement cut effects varied by geographic region and had greater impact on more vulnerable agencies and staff that were non-skilled.
METHODOLOGICAL STRATEGIES AND CHALLENGES FOR EVALUATING PARTICIPANT VIEWS ON DEMENTIA RESEARCH RECRUITMENT
Authors: Block Laura , Mullen Shannon , Thomas Gay , Kaiser Betty , Gilmore-Bykovskyi Andrea 
Published: November 2019

Abstract
There is an urgent need to expand enrollment in clinical Alzheimer’s disease (AD) research. Current recruitment methods for AD research predominantly identify patients from primary/specialty clinic settings, potentially creating barriers for individuals unconnected to care. In response to these challenges, the 2018 National Strategy for Research Recruitment and Participation has called for the development of an applied science of recruitment to inform best strategies. However, progress in this area is hindered by methodological challenges to accurately measure AD patient/caregiver participant views on research participation. The objective of this presentation is to report methodological strategies developed to during a prospective qualitative study to investigate AD patient/caregiver views on acute care research recruitment and participation. Participants included patients with dementia (N=2) who had recently been hospitalized and/or their informal caregivers (N=15). We engaged in iterative development and revision of data collection approaches (i.e. semi-structured questions, audiovisual tools, interview guidance) through collaboration with a Community Advisory Board (CAB). Detailed memos were generated to document interview-related challenges, successes and revisions. Therapeutic misconception in delineating research from clinical care was common during interviews regardless of prior research participation. Interview strategies that focus on lived experiences, remove ambiguity from hypothetical recruitment scenarios, and incorporate supportive visual tools that clarify processes around recruitment improved data collection. Challenges included the lack of a common, shared language around recruitment, which was addressed through CAB guidance and input. In conclusion, thoughtful collaboration with community/lay advisers can successfully inform and data collection methods used in applied recruitment research.
SUCCESSFUL AGING AND HEALTHCARE SERVICE UTILIZATION IN EAST ASIA: NATIONAL COMPARISONS OF CHINA, KOREA, AND JAPAN
Authors: Cho Jinmyoung , Nakagawa Takeshi , Yeung Dannii 
Published: November 2019

Abstract
As the older population increases and lives longer, the demand for healthcare has been increased dramatically. To date, it is unknown whether older people’s healthcare utilization varies between countries and how it relates to successful aging. Using Rowe and Kahn’s model, we examine cross-national differences in the relationship between successful aging and healthcare service utilization in East Asia. Harmonized datasets at baseline from China Health and Retirement Longitudinal Study (CHARLS), Korean Longitudinal Study (KLoSA), and Japanese Study on Aging and Retirement (JSTAR) were used. Including 7,651 participants (aged 65-75 years), successful agers were identified using Rowe and Kahn’s criteria (i.e., no disease, no disability, high cognitive function, and active engagement). Healthcare service utilization includes hospital visit, number of hospital stay, number of nights per hospital stay, regular medical center visit, number of medical center visits, and possession of private insurance in previous year. Generalized linear models showed that successful agers’ healthcare service utilization is significantly different from non-successful agers (e.g., OR=2.19, p&lt;.001 for regular medical center visits), and Korean and Chinese healthcare service utilization is different from Japanese (e.g., OR=0.44 and OR=10.18 for Chinese and Korean number of medical center regular visits, respectively, p&lt;.001). Furthermore, the number of nights in hospital among Chinese and Korean successful agers tend to be greater than that of Japanese successful agers (OR=2.93 and OR=1.99 for Chinese and Korean successful agers, respectively, p&lt;.001). This study indicates cross-national variations in pattern of healthcare service utilization between successful and non-successful agers in East Asia.
OUTCOMES OF DISCONTINUING CHOLINESTERASE INHIBITORS IN NURSING HOME RESIDENTS WITH SEVERE DEMENTIA
Authors: Niznik Joshua D , Zhao Xinhua , He Meiqi , Aspinall Sherrie , Hanlon Joseph , Nace David , Thorpe Joshua , Thorpe Carolyn 
Published: November 2019

Abstract
Some clinical guidelines advocate for the withdrawal of cholinesterase inhibitors (ChEIs) in patients with severe dementia. However, there have been no studies of the outcomes of deprescribing ChEIs specifically in patients with severe dementia, and concerns about subsequent worsening of behavioral symptoms may serve as a barrier to ChEI discontinuation. Our objective was to evaluate the impact of deprescribing ChEIs on aggressive behaviors and depression severity in older nursing home (NH) residents with severe dementia. We conducted a retrospective cohort study using Medicare claims, Part D prescriptions, Minimum Data Set (MDS) v3.0, Area Health Resource File, and Nursing Home Compare, for non-skilled NH residents aged 65+ with severe dementia receiving AChEIs with ≥2 MDS assessments in 2016 (n=30,788). The Aggressive Behavior Scale (ABS) and the Patient Health Questionnaire (PHQ-9) evaluated aggression and depression, respectively. Marginal structural models with inverse probability of treatment weights evaluated the association of deprescribing with outcomes, accounting for time-dependent confounding. The sample was primarily white (78.7%), female (76.6%), &gt;80 years old (77.6%), and 22.8% were deprescribed ChEIs. In adjusted models, deprescribing was not associated with aggression (0.002 point increase in ABS, p=0.90) or depression (0.04 point increase in PHQ-9, p=0.50). Deprescribing ChEIs in NH residents with severe dementia did not lead to an increase in aggressive behaviors or depression severity. Our findings provide insight into the potential risks and benefits associated with deprescribing ChEIs and help inform decision-making in patients with severe dementia.
THE IMPACT OF A PLANT-BASED DIETARY PATTERN ON DEMENTIA RISK: A PROSPECTIVE COHORT STUDY.
Authors: Lin Ming-Nan , Chiu Tina H , Chang Chiao-Erh , Lin Ming-Nan 
Published: November 2019

Abstract
High antioxidants and phytochemicals from plant foods may protect against cognitive decline, while saturated fats from animal based foods considered as risk factors have been associated with dementia. Plant-based diets with limited animal products have been shown to improve glycemic control and reduce diabetes risk. The study aims to examine the association between vegetarian diet and dementia risk in a prospective cohort study. Quantitative data collected from 12,062 participants of Tzu Chi Vegetarian Study from 2005 to 2014 in Taiwan. Data included self-administered questionnaire on demographics, medical history, life-style, and a 57-item food frequency questionnaire (FFQ), National Health Insurance Database and the National Death Registry. Findings show that compared with non-vegetarians, vegetarians had 38% lower risk of dementia (HR = 0.62, 95% CI = 0.39, 0.98) after adjusting for age, sex, education, marital status, physical activities, smoking, alcohol drinking, hypertension, diabetes, hyperlipidemia, and ischemic heart diseases.
HOME ALONE REVISITED: FAMILY CAREGIVERS PROVIDING COMPLEX CARE
Authors: Reinhard Susan 
Published: November 2019

Abstract
In 2012, the Home Alone report brought to light the 46 percent of family caregivers that perform complex medical/nursing tasks. This presentation highlights new research conducted as part of a second Home Alone study to look closer at the family caregivers who perform these complex tasks with a specific focus on key medical/nursing tasks, including incontinence care, special diets, as well as certain sub-populations (e.g., multicultural communities, men, Millennials). An analysis of the increasing complexity of the challenges facing family caregivers who perform medical/nursing tasks in addition to assisting with instrumental activities of daily living and activities of daily living, will be shared. Presenters will also discuss its findings and the implications for individuals, their family caregivers and the healthcare providers who work with them.
NIH PATHWAYS TO PREVENTION WORKSHOP: RESEARCH GAPS FOR LONG-TERM DRUG THERAPIES FOR FRACTURE PREVENTION
Authors: Joseph Lyndon , Chen Faye 
Published: November 2019

Abstract
The NIH Pathways to Prevention Workshop was held on October 30-31, 2018 to present scientific evidence, as well as physician and patient perspectives to better understand the benefits and harms of drug therapies for osteoporosis fracture prevention. Osteoporotic fractures lead to substantial morbidity, mortality, and economic costs. The underlying medical condition, is a skeletal disorder characterized by compromised bone strength predisposing to increased fracture risk. Several medications approved by the U.S. Food and Drug Administration to prevent osteoporotic fractures have been effective when taken by people who are at high risk of fracture. These include bisphosphonates , denosumab, teriparatide, estrogens, and selective estrogen-receptor modulators. However, rare but serious adverse events, such as atypical femoral fractures and osteonecrosis of the jaw associated with bisphosphonates have raised questions regarding the safety of their use. There is limited evidence on the benefits and harms of long-term osteoporosis drug therapy, including the timing and duration of drug discontinuation or drug holidays. It is not clearly known which patients will benefit or may be harmed from continued drug intervention, who should and should not be put on drug holiday, how to identify such patients and properly treat them, and how to predict their outcomes. Key scientific areas covered by the workshop included: the benefits and risks of osteoporotic drugs with short-term and long-term use and factors that influence outcomes; the impact of drug discontinuation and drug holidays on outcomes; and patient and clinician factors that impact the use of and adherence to osteoporotic drugs.