bluuebunny/crossref_metadata_2025_split huggingface dataset:
VIEWS ON AGING: NEW PERSPECTIVES FOR THEORY AND RESEARCH
Authors: Klusmann Verena , Kornadt Anna E 
Published: November 2019

Abstract
Over the past 20 years, research on views on aging has substantiated their importance for successful development and sustained quality of life over the full length of the life span. However, a deep understanding of the origins of views on aging and the underlying processes of their lifespan development and manifestation is lacking. Since 2017, the scientific network “Images of Aging” funded by the German Research Foundation (http://www.health.uni-konstanz.de/images-of-aging) assembles national and international renowned experts in the field. The network engages in empirical clarifications on both the distinctness and validity of the construct (contribution of Klusmann et al.) as well as in critically reviewing terminology and measures of views on aging (contribution of Notthoff et al.). The network aims to help clarifying the dynamic interplay of determinants and outcomes in the context of health (contribution of Wolff et al.) as well as disentangling intra- and intergenerational stereotypic perceptions (contribution of Kornadt et al.). Both of these are understudied issues with highly practical implications for two of the largest demographic challenges: shaping the coexistence of generations as well as providing adequate health care supply. Integrating both pertinent theoretical approaches and empirical findings the network regards views on aging under a lifespan perspective. Recently, it suggested three core principles of views on aging regarding lifelong bio-psycho-social development, their multidimensional nature, and their impact across life. These considerations provide a background for an integrative discussion of the symposium’s contributions.
COMPARISON OF A FRAILTY INDEX WITH CARDIOVASCULAR RISK SCORES IN PREDICTING CARDIOVASCULAR DISEASE MORTALITY
Authors: Kehler Dustin S , Theou Olga , Rockwood Kenneth 
Published: November 2019

Abstract
We compared the predictive and discriminative ability of frailty with traditional cardiovascular risk scores to estimate 10-year cardiovascular disease (CVD) mortality risk. Individuals aged 20-79 years old from the National Health and Nutrition Examination Survey who were free from CVD were included (n= 32,066). A 33-item frailty index (FI) which excluded CVD and diabetes-related variables was calculated. We calculated the Framingham Disease Risk (FDR) Hard Coronary Heart Disease and General CVD risk scores, the American Heart Association/American College of Cardiology (AHA/ACC) atherosclerotic cardiovascular disease risk equation, and the European Systematic Coronary Risk Estimation tool. A total of 322 individuals died (1.0%) from CVD. There was a low correlation between the FI and CVD risk scores (spearman’s r= 0.19-0.33; p&lt;0.0001) and a weak to strong correlation between CVD risk scores (spearman’s r=0.19-0.88; p&lt;0.0001). The competing-risks hazard ratio for CVD mortality for every 1% increase in the FI was 1.040 (95% CI: 1.032-1.048; p&lt;0.0001) in an age and sex-adjusted model. The FI was independently predictive of CVD mortality when the other CVD risk scores were added to the model. The area under the receiving operating characteristic (ROC) curve was 0.800 (95% CI: 0.789-0.808; p&lt;0.0001) for the FI. ROC values for the CVD risk scores ranged from 0.710 (95% CI: 0.700-0.721; p&lt;0.0001) for the AHA/ACC risk score to 0.779 (95% CI: 0.770-0.789; p&lt;0.0001) for the FDR General CVD risk score. An FI calculated with non-CVD and diabetes variables can predict 10-year CVD mortality risk independently of traditional CVD risk scores.
HYPERTENSION TREATMENT IN U.S. LONG-TERM NURSING HOME RESIDENTS WITH AND WITHOUT DEMENTIA
Authors: Boockvar Kenneth , Song Wei , Lee Sei , Intrator Orna 
Published: November 2019

Abstract
Background: Treatment of hypertension in individuals with dementia has benefit-harm tradeoffs. The objectives of this study were to describe patterns of antihypertensive treatment in U.S. nursing home (NH) residents and determine the association between intensity of antihypertensive treatment and outcomes important for persons with dementia. Methods: Medicare claims and Minimum Data Set (MDS) assessments were used to capture information on dementia, hypertension, comorbid conditions, cognitive function, activities of daily living (ADLs), and hospitalizations in Medicare-enrolled long-term care residents in 2013. Intensity of hypertension treatment was defined as number of antihypertensive drugs received on the date of an index MDS according to Medicare part D claims. Outcomes ascertained were hospitalizations, ADL decline, and mortality within 180 days of the index MDS. Results: A total of 262,285 residents had both hypertension and dementia. Residents were 85.7 years old on average and 77% female. At baseline, 30%, 40%, and 30% were receiving 0, 1, and 2+ antihypertensive medications, respectively. In multivariable logistic regression models, increased intensity of antihypertensive treatment was associated with increased hospitalization among residents with dementia (OR 1.03 per added medication; 95%CI 1.01-1.04), but decreased hospitalization among residents without dementia (OR .98 per added medication; 95%CI .97-1.00; p-value for interaction &lt; .0001). In residents with and without dementia, increased intensity of antihypertensive treatment was associated with increased hospitalization for cardiovascular diseases, but small decreases in ADL decline and mortality. Conclusion: Study findings suggest that long-term NH residents with hypertension and dementia may not experience benefit from more intensive blood pressure control.
PHENOTYPES OF CARDIOVASCULAR DAMAGE AND THE RELATIONSHIP WITH COGNITIVE DECLINE: LATENT CLASS ANALYSIS
Authors: Miller Lindsay , Wu Chenkai , Hirsch Calvin , Lopez Oscar , Cushman Mary , Odden Michelle 
Published: November 2019

Abstract
The association between subclinical cardiovascular disease (SCVD) and cognitive function is well established, however, current tools for addressing subgroups of SCVD have focused on the overall burden of disease. Identifying risky combinations of characteristics may lead to a better understanding of pathophysiologic changes that underlie cognitive decline. Participants included 5,072 older adults from the Cardiovascular Health Study without cardiovascular disease at baseline and followed for 6 years. Using latent class analysis, we identified cardiovascular damage phenotypes based on vascular (internal intima-media thickness, ankle-arm index, white matter grade, and brain infarctions), cardiac (major echocardiogram abnormalities, ST2, and N-terminal pro-brain natriuretic peptide) and inflammatory (interleukin-6, galectin-3, and cystatin C) markers. Using the maximum probability assignment rule, participants were assigned to phenotypes based on the highest posterior probability of membership. We used adjusted linear mixed effects models to evaluate the association between phenotype and cognitive decline, measured annually using the Modified Mini-Mental State Exam. The analysis yielded 5 prevalent phenotypes: healthy (65%), cardiac (10%), inflammatory (10%), multisystem morbidity (11%), and vascular (4%). The vascular phenotype had the greatest rate of decline at 0.88 points per year (95% CI= -1.33, -0.44), followed by the multisystem morbidity phenotype (β=-0.72, 95% CI= -1.07, -0.38), the inflammatory phenotype (β=-0.67, 95% CI= -0.95, -0.38), and the cardiac phenotype (β=-0.45, 95% CI= -0.70, -0.21) compared to the healthy phenotype. Among patterns of cardiovascular damage, vascular damage appears to have the greatest influence on cognitive decline. Identification of these phenotypes may give rise to more informed clinical interventions.
LONG-TERM CARE IV A REVIEW OF THE LONG-TERM CARE INSURANCE PROGRAMS IN 15 PILOT CITIES IN CHINA
Authors: Lin Yan , Miller Edward A , Cohen Marc A , Nadash Pamela , Du Peng 
Published: November 2019

Abstract
China is now making all the efforts to solve the problem of who pays the bill for the rapidly increasing long-term care services. Since 2016, 15 cities in China have begun their pilot programs in long-term care insurance. Each city designed its own program. Some cities finance their long-term care services from medical insurance funding solely. Others supplement it with individual and/or employer contributions. This study documents the nature and extent of implementation of long-term care insurance across the 15 pilot cities to draw lessons for subsequent implementation nationally. This study used qualitative methods, including document review and key informant interviews with long-term care insurance administrators, medical insurance administrators, service providers in different settings and families and individuals who use long-term care services. Results reveal considerable variation in the specific attributes of the long-term care insurance programs implemented across the 15 participating cities, with respect to such characteristics as the target population, policy coverage, and payment methods, etc. Results also shed light on the achievements and challenges in implementing the long-term care insurance program. This study’s examination of long-term care insurance adoption in 15 Chinese cities serves as an important base with which to inform future national long-term care insurance design and implementation. It suggests that successful adoption of long-term care insurance across China will require administering jurisdictions to anticipate and address policy bottlenecks and implementation barriers that might otherwise inhibit program impact and effectiveness in addressing the growing long-term care needs of China’s aging population.
HEALTHY RESIDENCE IN RICHARDSVILLE: A PHOTOVOICE PROJECT ON AGING IN PLACE
Authors: Lewinson Terri , Simpson Gaynell M 
Published: November 2019

Abstract
Based on AARP’s domains of community livability, this presentation presents findings from a photovoice study of residents in an urban community in Atlanta, Georgia. Richardsville (pseudonym) is one of many communities in Atlanta’s inner city that has transformed from a blighted, long-derelict area to a hotbed of high rent apartment units, mixed with quarter-million-dollar-plus homes. With property values skyrocketing and rents soaring, it has becoming increasingly difficult for longtime, older residents of this historically African-American community to remain in the vicinity. Richardsville Senior Residences, an affordable rental unit, was built to provide housing for a mix of incomes and ages and retain longtime residents in Atlanta’s neighborhoods. Therefore, from this qualitative study, we share about residents’ motivations for moving into Richardsville Senior Residences and their perceived livability of the environment that influence healthy aging in place.
THE ROLE OF GERONTOLOGISTS IN CONTRIBUTING TOWARD PUBLIC POLICY TO ACHIEVE THE UN’S SUSTAINABLE DEVELOPMENT GOALS
Authors: Finkelstein Ruth 
Published: November 2019

Abstract
The UN SDGs are aspirational goals whose achievement requires intentional policy-making at each level of government. Advocates for older people argued for goals specifically addressing older people, the fastest growing segment of the world’s population. While unsuccessful, we did achieve a targets monitoring template that reports outcomes separately by age. This innovation will bring helpful attention to generational differences in needs and progress, but gerontologists must play a critical role for this innovation to be realized as a benefit. Gerontologists must actively prevent SDG implementation for older people from being siloed into aging services departments. Aging services agencies do not have the resources or skills to achieve the SDGs – they do not control policy levers to end poverty, ensure gender equity or sustainable urban development. Yet, too often, once a population is separately counted, responsibility for its wellbeing follows. Gerontologists must help governments adopt an “age in everything” lens.
THE ASSOCIATION BETWEEN COGNITIVE FUNCTION AND TAI-CHI: FINDINGS FROM THE PINE STUDY
Authors: Chao Ying-Yu , Chao Ying-Yu , Zha Peijia , Dong Xinqi 
Published: November 2019

Abstract
The study examined the association between cognitive function and Tai Chi practice among older Chinese Americans. Data from the Population Study of Chinese Elderly in Chicago (N=3,157) was analyzed by multivariate logistic regression. Cognitive function was assessed by global cognition, episodic memory, executive function, working memory, and Chinese Mini-Mental State Examination (C-MMSE). The results showed that cognitive function was significantly associated with Tai Chi practice. Participants with higher scores of global cognition (OR = 1.44, 95% CI: 1.20–1.73, p = 0.00), episodic memory (OR =1.27, 95% CI: 1.10–1.47, p = 0.00), executive function (OR = 1.017, 95% CI:1.00–1.03, p = 0.01), working memory (OR = 1.07, 95% CI: 1.02–1.12, p = 0.01), and C-MMSE (OR = 1.06, 95% CI: 1.03–1.09, p = 0.00) were more likely to practice Tai Chi. This study demonstrated that Tai Chi may benefit cognitive function in Chinese older adults.
RACIAL-ETHNIC DISPARITIES IN HEALTHCARE SATISFACTION
Authors: Mueller Collin , Farmer Heather 
Published: November 2019

Abstract
This paper explores how perceptions of unfair treatment shape healthcare satisfaction across race/ethnicity. We investigate the overall impact of life course exposure to healthcare discrimination on current healthcare satisfaction across race/ethnicity among a sample of midlife and older Black, Latinx, and White Americans age 50+ in the Health and Retirement Study. We then test whether everyday healthcare discrimination mediates the impact of major medical discrimination on healthcare satisfaction, controlling for sociodemographic factors, mental and physical health characteristics, functional status, life course stress exposure, and lifetime and everyday discrimination in contexts beyond healthcare settings. Black Americans had poorer healthcare satisfaction than White Americans. Everyday discrimination in healthcare settings mediated a modest amount of the relationship between lifetime healthcare discrimination and healthcare satisfaction, and this association varied in strength across White, Black, and Latinx Americans. Results underscore the need for future work identifying and addressing mechanisms shaping healthcare satisfaction.
AN INFLAMMATORY SIGNATURE OF POSTOPERATIVE DELIRIUM
Authors: Vasunilashorn Sarinnapha , Ngo Long H , Dillon Simon , Otu Hasan , Tripp Bridget , Inouye Sharon , Libermann Towia A , Marcantonio Edward R 
Published: November 2019

Abstract
Delirium is a common, morbid, and costly geriatric syndrome, yet its pathophysiology remains poorly understood. In a nested matched case-control study within the Successful Aging after Elective Surgery (SAGES) study, a cohort of adults age ≥70 without dementia undergoing major non-cardiac surgery, we previously identified inflammatory proteins to be associated with delirium. Using the entire SAGES cohort, the current study examines the independent associations of these inflammatory proteins with postoperative delirium. Plasma was collected preoperatively (PREOP) and on postoperative day 2 (POD2). Neuroinflammatory marker chitinase-3-like protein [CHI3l1 or YKL-40]; PREOP and POD2) and systemic inflammatory markers interleukin [IL]-6 (POD2 only) and C-reactive protein (CRP; PREOP and POD2) were measured using enzyme-linked immunosorbent assays. Generalized linear models were used to determine the independent (multivariable) associations between the inflammatory markers, measured in sample-based quartiles (Q). All models adjusted for age, sex, baseline cognition, surgery type, Charlson comorbidity index, and medical complications. Among the 555 patients (mean age 77 years, standard deviation, SD 5.2), 58% were female and 86% underwent orthopedic surgeries. Postoperative delirium occurred in 24%. High YKL-40 PREOP and IL-6 at POD2 (Q4 vs. Q1) were significantly associated with an increased risk of delirium: relative risk (RR) [95% confidence interval (CI)] 2.2[1.1-4.4] and 2.7[1.3-5.7], respectively. CRP (PREOP and POD2) was not significantly associated with delirium (p=0.37 and p=0.73, respectively). This work underscores the importance of inflammation (YKL-40 and IL-6) in the pathophysiology of postoperative delirium.
SNF TO HOME: OUTCOMES OF THE SNF RE-ENGINEERED (RED) DISCHARGE PROCESS
Authors: Popejoy Lori L , Wang Yan , Mehr David , Vogelsmeier Amy A , Wakefield Bonnie , Galambos Colleen M , Petroski Greg 
Published: November 2019

Abstract
Re-engineered (RED) Discharge Process has been effective in hospitals but little tested in SNFs. This study tested the effect of an 18-month adapted RED implementation in four Midwestern SNFs on 30, 60, 180 day hospital, SNF, and emergency department (ED) readmissions. The sample included 1026 SNF residents discharged to the community during 2013 (n = 526) and 2015 (n = 500). We used Medicare claims Data and Minimum Data Set (3.0) File to identify SNF admissions and readmissions to SNF, acute care, or ED. Data were linked across all four facilities by year and compared using appropriate statistics for descriptive, comparison, and regression tests. Residents discharged in 2013 had statistically significantly higher Charlson Comorbidity Scores 4.65 vs 3.97 in 2015 (p &lt; 0.01), while those discharged in 2015 had significantly worse cognitive status, mood, and ADL self-performance. Overall, rates and number of 30, 60-day, 180 rehospitalization, SNF readmission, ED visits with rehospitalization were lower for all 2015 compared to 2013, but not statistically significantly different, except for the number of 180-day rehospitalizations in 2015. Likewise, the only statistically significantly different result was in the regression model was 180 day rehospitalizations. However, in the two facilities that had the best uptake of the intervention, numbers of readmissions were lower at 60 and 180 days (p=.0106 and .0013, respectively for regression results). SNF RED may be a useful tool for SNFs to use to reduce rehospitalizations after discharge; however, benefit depends on the degree of adoption of the intervention.
THE INFLUENCE OF LONELINESS AND RURAL RESIDENCE ON DEPRESSION IN LATER LIFE
Authors: Sun Na , Hua Cassandra , Qiu Xiao , Brown J Scott 
Published: November 2019

Abstract
Loneliness is associated with depression among older adults. Limited research has examined the role of rurality in relationship to loneliness and depression; the extant research has mixed findings. The socioemotional selectivity theory states that as people age the quality of relationships become more important than the quantity (English & Carstensen, 2016). Individuals in rural areas may have a low quantity of relationships but deeper social ties within the community; thus, they may be less likely to become depressed over time. The association between loneliness and depression may be amplified for people in non-rural areas because they are surrounded by other people but lack close relationships that are most important during the aging process. This study examines the effect of living in rural areas on loneliness on predicting baseline depression and loneliness, as well as changes in these outcomes over time. Data are from the 2006-2014 waves of Health Retirement Study. Regression models examine the relationship between depression loneliness and rural residence controlling for health conditions and demographic characteristics. Latent curve models examine the disparity in trajectories of loneliness and depressive symptoms by urban and rural residence. Older adults who feel lonely (p&lt;.001) and in urban areas (p&lt;.0.05) are more likely to be depressed. Furthermore, the effect of loneliness on depression is weakened by rural residence (p&lt;.05). It is salient to understand the protective effect of rural residency on depression among older adults in the U.S. We discuss implications for policy.
COMMUNITY CAPACITY AND SOCIAL PARTICIPATION AMONG COMMUNITY-DWELLING MIDDLE-AGED AND OLDER CHINESE
Authors: Li Min , Huang Fang-Yi 
Published: November 2019

Abstract
Objectives. This study investigates how social participation of the aging population is associated with the community capacity, measured by the number of amenities and organizations within the community. Method. Using nationally representative survey data from the China Health and Retirement Longitudinal Study (2011), this study examines the availability of community amenities and organizations in rural and urban areas, and investigates the associations between community capacity and social participation among the middle aged and older Chinese using multilevel analysis. Results. The results of this study indicate that both community amenities and community organizations are positively associated with the social participation of the middle-aged and older Chinese. Additionally, the association between community organizations and the frequency of formal social participation is stronger among urban communities than rural ones, even after controlling for the individual-level socioeconomic status and health conditions. Conclusion. This study highlights the importance of building the community capacity by developing community-based grassroots organizations to promote the social engagement and participation of the aging population.
NEW ACCELEROMETRY PATTERNS IN FRAILTY: HOURLY ACTIVITY AND VARIANCE.
Authors: Huisingh-Scheetz Megan , Wroblewski Kristen , Waite Linda , Huang Elbert , Hedeker Donald , Schumm L P 
Published: November 2019

Abstract
Wearable sensors may improve our ability to identify frailty in the community. Frailty has been historically defined, in part, by reduced average activity; however, new analytic methods of aggregate, free-living accelerometry data suggest that frailty may be more fully characterized above and beyond reduced average activity. Using mixed-effect regression models of awake hourly activity from the National Social Life, Health and Aging Project dataset, we have shown that frail adult activity is most reduced in the morning relative to pre- and non-frail adults rather than the afternoon or evening. High residual between- and within-subject activity variance in this model prompted further study of activity variance. A follow-up analysis using a mixed-effect location-scale model of hourly activity data revealed that increasing frailty in older adults is associated with greater between-subject as well as within-subject hourly activity variability, particularly in the morning and afternoon. Study implications and future directions will be discussed.