bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rising Above the Flood: Emergency Management and Gerontological Social Work
Authors: Beltran Susanny , Luigi Paola , Kusmaul Nancy 
Published: December 2020

Abstract
Older adults, particularly those from low-income communities, are disproportionately negatively affected by natural disasters. As the older adult population grows and natural disasters increase in frequency and intensity, social workers must consider their role in supporting the needs and safety of this population. Social workers practice in varied roles including policy advocate, service broker, and educator, all of which are crucial in disaster management. This systematic review summarizes the literature on the social work profession’s involvement with emergency management with older adults, and identifies gaps. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, authors searched AgeLine, CINAHL Complete, MEDLINE, PsycINFO, and Social Work Abstracts for peer-reviewed publications between January 1, 2009 and March 1, 2020. Examples of the terms searched include social work*, respon*, prepar*, disaster, crisis, emergency, geriatrics and older adults. The initial searches yielded 298 publications. After removing duplicates and screening articles for relevance based on titles and abstracts, 21 publications were retained for full review. A total of 11 articles met inclusion criteria. The body of literature identified was small. The majority of the publications constituted conceptual papers, textbook reviews, and letters to editors requesting greater emphasis on emergency management. Only three empirical studies were identified. Broadly, the publications discussed: (1) policies and resources; (2) needs; (3) capacity across practice settings; and (4) interventions. Findings reveal an underdeveloped area of social work practice, and highlight opportunities for researchers and practitioners to define gerontological social workers’ role in emergency management and detail best practice guidelines.
Polysomnographic Indicators of Restorative Sleep and Body Mass Trajectories in the Wisconsin Sleep Cohort Study
Authors: Reither Eric , Barnet Jodi , Palta Mari , Liu Yin , Hagen Erika , Peppard Paul 
Published: December 2020

Abstract
Previous research suggests that reductions in restorative sleep—i.e., slow-wave (N3) and rapid-eye movement (REM) sleep—are associated with weight gain and obesity in mid-to-late life. This study extends prior work by examining how within-person changes and between-person differences in restorative sleep are associated with body mass trajectories among participants in the Wisconsin Sleep Cohort Study (WSCS). We used data from 4,862 polysomnographic sleep studies and physical exams collected from 1,187 WSCS participants over an average follow-up duration of 15 years. For both men and women, we found that (1) below-average N3 and REM sleep is associated with above-average BMI, and (2) within-person loss of N3 and REM sleep is associated with larger gains in BMI, particularly between ages 30-50. Our findings highlight the importance of restorative sleep in mid-to-late life, suggesting that future clinical treatments and public health policies will benefit from heightened attention to sleep quality.
Biopsychosocial Determinants of Cognitive Health in Later Life: The Harmonised Cognitive Assessment Protocol
Authors: Cadar Dorina , Abell Jessica , Brayne Carol , Batty G David , Llewellyn David , Steptoe Andrew 
Published: December 2020

Abstract
Despite strong evidence for a socioeconomic gradient in many health outcomes, including cognition, substantial gaps remain in understanding these disparities. We investigated the biopsychosocial mechanisms underlying the associations between socioeconomic status (SES) and later-life cognitive health using the Harmonised Cognitive Assessment Protocol (HCAP), a sub-study of the English Longitudinal Study of Ageing (ELSA) which comprises of 1,273 ELSA participants aged 65+. A latent g factor was derived using 12 tests covering a broad range of cognitive domains (memory, language, executive function, and psychomotor speed). We estimated direct and indirect pathways between SES indicators, Apolipoprotein E, inflammatory markers, chronic conditions, and depression. We found that higher education was associated with better cognition, while wealth was not. Increased depressive symptoms were linked with lower cognition, while prior inflammation was indirectly associated with cognition via depressive symptoms and chronic conditions, supporting evidence for a psychosocial role in the context of a socioeconomic gradient.
The Role of Health, Social Network, and Race in Advance Care Planning Among Medicare Beneficiaries
Authors: Kwak Jung , Moon Heehyul , Roh Soonhee 
Published: December 2020

Abstract
Advance care planning (ACP) is linked with high-quality end-of-life outcomes. However, ACP engagement level among older adults varies significantly by demographic, social, and health characteristics. In this study, we sought to identify characteristics associated with informal and formal ACP, in order to inform development of targeted education and outreach efforts that are tailored to diverse groups of older adults. The data came from a nationally representative study of Medicare beneficiaries living in communities, the National Health and Aging Trends Study (Round 8, N= 5,547). Multivariable logistic regressions were conducted to identify individual characteristics (i.e., race/ethnicity, age, gender, income, functional disability, cognitive function, perceived health, and numbers of people in social networks) associated with ACP engagement. Rates of informal ACP (talking to someone), and formal ACP, completing a healthcare power of attorney (HPOA) and a living will (LW), were 56%, 60.5%, and 56% accordingly. Logistic regression showed that individuals who were married or had a larger social network, and had higher functional impairment and health needs were significantly more likely to engage in both informal and formal ACP. However, individuals with memory problems (only informal ACP) and African Americans and Hispanics were significantly less likely to engage in both informal and formal ACP. African Americans without dementia were more likely to have completed HPOA compared with Whites. Findings suggest an important role of social network, and functional and cognitive health in ACP with implications for developing targeted outreach efforts in faith-based or social group settings, and healthcare settings.
Caregiver-Provider Communication About Pain in Persons With Dementia
Authors: Riffin Catherine , Lee Sylvia , Reid M Cary , Herr Keela , Pillemer Karl 
Published: December 2020

Abstract
Pain in older persons with dementia (PWD) is severely under-detected and under-managed. Family caregivers can play an important role in addressing these disparities by acquiring the requisite skills to communicate PWD’s pain symptoms and behaviors to health care providers, but little is known about how caregivers of dementia patients and their providers approach such pain-related discussions. We employed qualitative methods to explore the perspectives of family caregivers of PWD (n=18) and health care providers (geriatricians, general internists, neurologists, emergency room physicians) involved in PWD’s treatment (n=16) regarding pain communication. We specifically focused on participants’: 1) priorities and expectations for communicating about pain and dementia, 2) challenges to communicating about pain and dementia, and 3) strategies and recommendations for optimizing communication about pain and dementia. Analyses revealed that caregivers and health care providers expected to receive accurate, detailed information from one another, but uncertainty in both groups around differentiating pain behaviors from dementia symptoms acted as a barrier to effective information exchange. Additional challenges to productive pain-related discussions were identified by caregivers, including provider fatalism and lack of interpersonal skills, and by providers, including patient-caregiver disagreement about pain symptoms and unreliable caregiver reporting. Participants endorsed using practical approaches, such as pain scales and logs, as well as rapport-building strategies, such as affirmation of caregivers’ input, to facilitate collaborative discussions.
Emotional Experiences of Dementia Caregiving Transitions
Authors: Ihara Emily , Tompkins Catherine , Kennedy William , Vance-Cheng Rhea , Kwan Bianca , Barrett Kendall 
Published: December 2020

Abstract
Research indicates that family caregivers of individuals living with dementia are at risk for high levels of stress, depression, physical health declines, and illness. The health and well-being of family caregivers is critically important to a long-term care system that is dependent on them to continue their caregiving role. In-depth individual and focus group interviews of 16 dementia caregivers were conducted to explore the emotional experiences of caregiving stress during transitions of individuals living with dementia to a higher level of care. Data were transcribed verbatim, checked for accuracy, and analyzed by at least two members of the research team. Line-by-line coding, memo writing, and constant comparative analyses were conducted until redundancy, when no new themes were discovered. Caregivers described various levels of feeling overwhelmed and symptom progression leading to the move to a nursing facility. Social isolation featured prominently, with caregivers describing a gradual erosion of their social network and socializing opportunities because of their caregiving responsibilities and the care recipient’s deteriorating symptoms. Caregivers described feeling isolated and stigmatized. One caregiver said, “…you’re being less invited, you’re being less involved. People don’t know how to deal with you…I don’t know if they become the pariah or I become the pariah.” At the same time, maintaining social connections and having help with caregiving featured prominently in the coping mechanisms described. The health of caregivers is equally as important as the person living with dementia, and programs, interventions, and resources should be a priority for supporting families through transitions.
Healthcare Experiences of LGBTQ+ Elders: Two Focus Groups
Authors: Foley Kierra , Hodgson Nancy , Bauermeister José 
Published: December 2020

Abstract
LGBTQ+ elders experience significantly higher rates of disability, poor general health, and behavioral health problems than heterosexual and cisgender older adults; additionally, LGBTQ+ elders are less likely to seek medical attention or have a primary care provider than other older adults. In previous qualitative studies, LGBTQ+ elders have reported difficulties navigating healthcare systems due to provider incompetence in treating this population, financial barriers, systemic homophobia/transphobia, and high disease burdens. However, few qualitative studies have been conducted with this population from a nursing perspective, and little is known about the role of nurses in the health and wellness of LGBTQ+ elders. Nurses are uniquely positioned to help address both the physiological and psychosocial needs of older LGBTQ+ adults, and garnering an understanding of these needs directly from this community can help better direct future research. Accordingly, two focus groups were conducted with LGBTQ+ elders at different queer community centers in Philadelphia by a nurse scientist. This community engaged research aims to learn more about how nurses can serve this population through identifying their priorities. Through thematic analysis, it was found that LGBTQ+ elders reported being concerned about housing access, discrimination from healthcare providers, and challenges in accessing mental health care. Additionally, the researchers’ hypotheses were triangulated with the participants’ responses to demonstrate the utility of continued community engagement in addressing specific population needs.
Age Matters: Building Blocks Needed to Inform Nurse Staffing Hours Requirements in Residential Care for Older Adults
Authors: Wu Heng , Kelly Christopher , Holley Lyn 
Published: December 2020

Abstract
This study addresses the need for more complete information about the impact of nurse staffing hours (NSH) on nursing home quality of care. We used national data to examine the relationship between three types (Registered Nurse, Licensed Practical Nurse, and Nurse Aide) of hours, and long-stay quality of care measures over time, taking into account the possible confounding influence of regional differences. Data analyzed were from U.S. Nursing Home Compare datasets which reflect quarterly reports, July 1, 2018 - June 30, 2019 (14,768 facilities). The hours for each staff type in each facility were compared with the facility’s four-quarter quality average scores for each of the 12 measures. Results showed only one strong and statistically significant relationship (Beta= .548; p&lt; .001) between Nurse Aide hours and the quality measure used in data sets to exemplify facilities that serve “lower-risk” residents. Analyzes using multiple R (.517) indicate that the linear combination of the three NSH types strongly and significantly (p&lt; .001) predicted the four-quarter average scores and explained 27% of the variance in the scores. Holding the other two NSH types constant, the scores for that measure increased by 63 for each additional increase in the Nurse Aide nurse staffing hours per resident per day. There was no multicollinearity among the three types of staffing hours. This research adds information to the foundation needed for future research about process indicators to assess their efficacy as measures of actual quality of care, and will be submitted as a Technical Note to journals.
Longitudinal Changes in Functioning and Support After Initial Survey for Individuals With Severe Mental Illness
Authors: Finkel Deborah , Bulöw Per , Bulöw Pia , Torgé Cristina Joy , Wilińska Monika , Jegermalm Magnus , Bravell Marie Ernsth 
Published: December 2020

Abstract
After the Swedish Mental Health Care reform was enacted in 1995, many individuals with severe mental illness were released from long-term care institutions. As a result, they had new living and support situations. Following 236 individuals over time supported investigation of the effectiveness of social support services in caring for these individuals. Surveys were conducted in 1996, 2001, 2006, and 2011 and annual data were available from national registries. Primary diagnosis was psychosis (over 60%); depression was the second highest diagnosis (20%). Mean age in 1996 was 60.8 (range = 45 to 86) and 47% of the sample were women. Only 36% of the group had more than nine-year compulsory education. Compared with other groups in the larger study, this group was more likely to have never married (66%) and 18% had accumulated more than 10 years in an institution over their lifetime (mean = 6 years). Even after correcting for age, functioning as measured by the Global Assessment of Functioning and a 9-item measure assessing hygiene, economy, food preparation, etc. declined over time. As a result, although 49% were living independently (with or without support) at the first wave, only 34% were doing so at the last wave; by 2011 66% were living in a special home or institution. Examination of longitudinal trends in income indicated that disposable income and total income from all sources was constant between 1990 and 1995 but increased significantly over time after reform was enacted. Overall, results suggest mixed success of social support services.
Research Participant Interest in Alzheimer’s Disease Biomarker Disclosure
Authors: Erickson Claire , Chin Nathaniel , Gleason Carey , Johnson Sterling , Clark Lindsay 
Published: December 2020

Abstract
Researchers can characterize the pathophysiological progression of Alzheimer’s disease (AD) even in the absence of symptoms. As we better understand the role of biomarker accumulation in the clinical manifestation of AD, disclosing personal biomarker information will become increasingly relevant. Yet, interest and preferences for AD biomarker disclosure are not well understood. We developed a 30-minute phone survey to gather information from Black and white participants on likelihood to enroll in biomarker disclosure studies, reasons for enrolling, and potential outcomes following a hypothetical positive result. Data were collected from cognitively healthy participants (n=334, mean age=64.8±7.7, 45% Black) enrolled in the Wisconsin Alzheimer’s Disease Research Center or Wisconsin Registry for Alzheimer’s Prevention. 49.7% of participants were very or extremely likely to enroll in an AD biomarker disclosure study. This result varied by biomarker method, with about half the sample very or extremely likely to enroll in PET scan disclosure (45.5%), fewer likely to enroll in cerebrospinal fluid disclosure (32.2%), and a majority likely to enroll in blood-based biomarker disclosure (86.2%). The most important reasons for learning biomarker results included informing lifestyle changes to help prevent dementia (82.9% responded very or extremely important) and knowing more about personal AD risk (69.1% responded very or extremely important). These results suggest that as biomarker collection method burden decreases, willingness to participate in a biomarker disclosure study increases. Further, personal dementia prevention and risk are a strong motivator for learning biomarker results. Moving forward, these results may inform AD biomarker protocol development.
Testing Cellular Proliferation Responses to Oxidative, Glucocorticoid and Metabolic Challenges in the Baboon
Authors: Adekunbi Daniel , Li Cun , Nathanielsz Peter , Salmon Adam 
Published: December 2020

Abstract
Aging is associated with progressive loss of cellular homeostasis which results from intrinsic and extrinsic challenges. Testing how such challenges relate to the aging process is often limited by the available model systems. We use primary cells (fibroblasts) isolated from baboons as a non-human primate cellular model to address how stressful challenges affect resilience. Using a real-time live-cell imaging system, we characterized a protocol for testing the effects of pro-oxidant compounds (e.g hydrogen peroxide (H2O2), paraquat and thapsigargin), dexamethasone and low glucose environment on cellular proliferation in fibroblasts derived from baboons across the life-course. The inhibitory effect of H2O2 (50 and 100µM), an oxidative stress, on cell proliferation was dose-dependent, with a higher impact in old males (age 14.52-14.80 years; average life span 21 years) compared to young males (6.35-6.39 years). Exposure to a different oxidative stress, paraquat (100 and 200µM) tended to reduce cell proliferation rate with age in males but not females. Inhibitory effects of thapsigargin, an endoplasmic reticulum stress inducer, on cell proliferation were dependent on challenge duration (2 vs 24h), concentration (0.1 and 1µM) and donor age, with greater resilience in young males than young females (4.33-6.70 years). Dexamethasone (100 and 500µM), a glucocorticoid, reduced cell proliferation dose-dependently, with older males exhibiting more resilience than females. In response to low glucose (1mM), cell proliferation reduced with age. Donor’s chronological age and sex are important variables in cellular response to challenge compounds faced during aging, which will guide our on-going studies on the cellular transcriptome and proteome.
The Association between Environmental Factors, Race, and Cognitive Status
Authors: Cheung Ethan Siu Leung , Mui Ada 
Published: December 2020

Abstract
Based on the data from National Social Life, Health and Aging Project, Wave 3, this study examined two research questions: what is the role of race in predicting cognitive status? and what are predictors of cognitive status between white and black older adults? Cognitive status was assessed using the 18-item survey-adapted Montreal Cognitive Assessment. Using the ecological framework, correlates of cognitive status were conceptualized in three levels of environments: micro- (personal health), meso- (social relationship), and macro-environments (community characteristics). Hierarchical regressions analyses were employed. Findings indicated that 83% of the sample (n= 2,829) were whites and the mean age was 72.95. Bivariate analyses suggested significant racial differences in cognitive status, marital status, income, education, health, social relationship, and community characteristics. Additive and interactive models showed that race had an independent effect as well as joint effects with the three levels of environments in explaining cognitive status. Parallel regression analyses for each racial group were undertaken and models were significant (P &lt; .0001). In two separate models, common predictors for better cognition included being younger, more educated, fewer IADL impairments, and less depression. For older whites, unique correlates for better cognition were being female, higher income, sense of control in life, safer community, and neighbor relations. The only unique correlate for older blacks to have better cognition was community cohesion. Results provided insights on racial differences in cognition experienced among community-dwelling older Americans, and emphasized the need for social programs that promote race-sensitive, age-friendly communities to protect against cognitive decline.
The Effect of Midlife Cardiovascular Risk Factors on Cognitive Function Nearly Half a Decade Later
Authors: Warren Teresa , Pahlen Shandell , Xian Hong , De Anda Jennifer , Kremen William , Franz Carol 
Published: December 2020

Abstract
Several cardiovascular risk factors (CVRFs) have been associated with poor cognitive function. However, few studies have examined these factors longitudinally during midlife. We hypothesized that more midlife CVRFs would predict worse cognitive function approximately six years later. Participants were 886 men who participated in waves 2 and 3 of the Vietnam Era Twin Study of Aging. The American Heart Association’s “Life’s Simple 7” index was used to measure CVRFs. CVRFs were assessed at mean age 61 (range 55-66) and included smoking, physical activity, diet, body mass index, cholesterol, glucose, and blood pressure. Each factor was coded on a 3-point scale (0-2), ranging from poor to ideal status. These scores were then used to create a composite CVRF index (0-14). We examined several cognitive domains assessed at mean age 67 (range 61-73): abstract reasoning, episodic memory, processing speed, executive function, working memory, general verbal fluency, and semantic fluency. Analyses were adjusted for ethnicity, and education, and mean age 61. In the generalized estimating equation models, there were significant main effects indicating that the CVRF index at mean age 61 significantly predicted cognitive function at mean age 67 in episodic memory, 95% CI [.01, .08], p = .01, processing speed, 95% CI [.02, .09], p = .01, and executive function, 95% CI [.00, .06] ], p = .03. The CVRF index did not predict cognitive function in the other cognitive domains. These results suggest that poor cardiovascular health in late midlife may exacerbate cognitive decline.