bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perception of Life-Control Is Associated With Medical Care Satisfaction in Chronically Ill Rural Older Adults
Authors: Halli-Tierney Anne , Noh Hyunjin , Lee Lewis 
Published: December 2020

Abstract
Prior studies show patient populations have varied experiences with healthcare systems, and this may influence satisfaction with medical care. Patients feeling control over life circumstances may have resilience and ability to adapt to adverse situations. Given socioeconomic and medical differences in older adults we examined factors influencing satisfaction with medical care in the setting of chronic conditions and pain. 100 older adults in rural West Alabama with chronic illnesses and pain were recruited from community senior centers and interviewed with a structured questionnaire. Participants were queried about medical interventions for chronic conditions and satisfaction with medical care. Overall assessment of life-control was measured by the West Haven Yale Multidimensional Pain Index (WHYMPI). Bivariate correlation and multivariate analysis were conducted. Correlations between satisfaction with medical intervention and life-control scores were significantly positive (r=.21, p&lt;.05). Satisfaction with medical intervention and other covariates explained approximately 14.1% variance in life-control scores, R2=.141. Multivariate regression results confirmed those highly satisfied with medical intervention were marginally significantly likely to have increased life-control scores, b=.20, SE=.12, p=.088. Married persons were more likely to have higher life-control scores than those with other marital statuses, b=.84, SE=.34, p&lt;.05. Income was positively associated with life-control scores, b=.18, SE=.08, p&lt;.05. Older adults may perceive greater satisfaction from medical care if they feel greater control over life circumstances. Socioeconomic factors (marital status, income) are associated with life control. These findings can help predict satisfaction with healthcare and find ways to make healthcare more accessible to all.
A Preliminary Analysis of Hearing Loss and Its Association With Mild Cognitive Impairment
Authors: Yuk Mary Caroline , Allen Rebecca , Hay-McCutcheon Marcia , Carroll Dana , Halli-Tierney Anne 
Published: December 2020

Abstract
Age related hearing loss, or presbycusis, is a global condition that is increasing in its prevalence. Despite being one of the most common chronic conditions among the older population, there is much more to understand about its association with other aspects of physical and emotional health and well-being. Current research is suggesting that hearing loss is more prevalent in those with cognitive impairment compared to those without cognitive impairment. This study analyzed the incidence of hearing loss and its linkage to mild cognitive impairment in a community-dwelling geriatric population. With the increasing prevalence of this condition in both rural and urban communities of Alabama, it becomes a more pressing matter to understand comorbidities and risk factors for future decline in functioning. This study was conducted in an interdisciplinary geriatrics primary care outpatient clinic in a Family, Internal, and Rural Medicine department affiliated with a university medical center in the Deep South. Ninety-one participants completed the Montreal Cognitive Assessment (MoCA) and a hearing screening. Hearing screenings were conducted in quiet rooms in the medical center using Phonak hearing screening cards. Detection of 500, 1000, 2000, and 4000 Hz tones was assessed. Pearson correlation analyses demonstrated an association between hearing loss mild cognitive impairment. Poorer hearing was significantly associated with lower scores on the MoCA. Conducting behavioral health screenings like this in other primary geriatrics clinics and community settings could improve care and identification of patient needs by integrating important data regarding comorbidities and independent living.
Ain’t I Supposed to Be Doing Something?: Identifying and Discussing Cognitive Issues in Lupus
Authors: Vandenberg Ann , Drenkard Cristina , Goldstein Felicia , Dunlop-Thomas Charmayne , Lim S Sam , Bowling C Barrett , Plantinga Laura 
Published: December 2020

Abstract
Lupus is a complex chronic disease associated with a high prevalence geriatric syndromes and reduced cognitive functioning, consistent with accelerated aging. Although patients with lupus commonly report cognitive symptoms or “lupus fog,” cognitive assessment is not routine and little is known about day-to-day cognitive problems and their effect on chronic disease management. As part of a pilot exploring the use of a cognitive functioning report prototype for shared decision making in clinical encounters (Approaches to Positive Patient-Centered Experiences of Aging in Lupus study), we conducted four focus groups, two with lupus patients (n=18) and two with lupus providers (physicians and nurses; n=9) addressing cognition. We compared how the NIH Toolbox fluid cognition domains (episodic (retrospective) memory, working memory, processing speed, attention and inhibitory control, cognitive flexibility, and overall fluid cognition) matched with patient- and provider-identified cognitive problems and needs. In open questioning using a standard interview guide, patients identified all domains with rich experiential examples; providers identified fewer domains with less detail. An unanticipated additional domain was prospective memory, problems in remembering future actions, whether in the near future (e.g., forgetting what they needed to do on entering a room) or in the not-so-near future (e.g., forgetting about a medical appointment). Technological aids (e.g., smartphone alerts) were mentioned by some patients, but not providers, and represent a potential opportunity for medical care. Providers envisioned using cognitive assessment to distinguish cognitive issues (e.g., forgetting to take medication) from other problems (e.g., medication non-adherence) in order to tailor chronic disease management messaging.
Functional Disability in the Context of Cancer Diagnosis: Examining the Within- and Between-Person Associations
Authors: Yang Rumei , Liu Yin , Fauth Elizabeth 
Published: December 2020

Abstract
Physical functioning is essential for independent living and aging in place among older adults. Although older adults show a general trend of increasing functional disability, it was unclear how cancer diagnosis, which also has an increased incidence rate among older adults, may potentially aggravate the progress of functional decline at the within- and between-person levels. Using 3 waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015), the current study examined the trajectory of functional disability and associated factors over 5 years among older adults with (n = 139) and without cancer (n = 212), who were matched on key demographic characteristics. We considered four contributing factors to disability as specified in the Disablement Process model as covariates, in the context of cancer diagnosis timing at both the within- and between-person levels. These factors were psychological (i.e., depressive symptoms), physical limitations (i.e., pain, fall, and frailty), cognitive impairment (i.e., self-reported memory problems and word recall), and environmental constraints (i.e., social contact and availability of support). Consistent with the literature, there was a general trend of increasing functional disability among all participants over time. At the within-person level, although cancer diagnosis timing was associated with higher levels of functional difficulty, we found a slower increasing rate over time. At the between-person level, functional disability trajectory was not associated with cancer diagnosis timing. These findings suggest that maintenance of physical functioning should be considered at the within-person level, and personalized care is recommended for Chinese older adults with cancer.
Examining Nostalgia in Old Life: Antecedence and Outcome
Authors: Zhou Linming , Lu Minjie , Zhang Chaobin , Fung Helene 
Published: December 2020

Abstract
Nostalgia is a self-conscious, bittersweet but predominantly positive and fundamentally social emotion. The regulatory model of nostalgia suggests that experiencing nostalgia can buffer against social threat (e.g. social exclusion) by providing individuals with sense of social connectedness (Sedikides, et al., 2015). In the current research, we propose that this salutary effect of nostalgia may be stronger among older adults compared to younger adults because older adults value social meaningfulness to a greater extent. Fifty-nine younger adults (Mage = 20.15, SD = 0.215) and 56 older adults (Mage = 71.02, SD = 0.679) completed daily questionnaires three times a day for ten consecutive days, and reported their emotional experience and social activities. Results showed that perceiving social threat was positively correlated with nostalgia experience reported at the subsequent time point, and this association was stronger among older adults. In addition, nostalgia positively correlated with subsequent social activities among the older participants but not among the younger participants. These findings highlight that nostalgia brings beneficial psychological (sense of social connectedness) and behavioral (social engagement) outcomes to older adults.
Estimating the Frequency of Suicide Related to Driving Cessation Among Older Adults: A Data Science Approach
Authors: Ko Tomohiro , Kalesnikava Viktoryia , Mezuk Briana 
Published: December 2020

Abstract
Up to 35% of older adults in the United States engage in partial to complete driving cessation. Suicide risk is highest among older adults, and driving cessation can precipitate psychosocial changes linked with elevated risk of suicide, such as loss of independence, mobility, and socialization. Little is known about the association between suicide and driving cessation among older adults. We developed a supervised machine learning natural language processing algorithm to estimate the frequency of and characterize suicides associated with driving cessation from restricted-access case narratives in the National Violent Death Reporting System (NVDRS, 2003-2015) from suicides and undetermined deaths among adults 55 years and older in 27 states. Among 47,759 decedents, preliminary results identified 972 deaths associated with driving cessation, with a mean age of 71.4, 91.5% White, and 78.3% Male. 13.8% of the decedents of driving cessation-associated suicide had a crisis contributing to the suicide within 2 weeks of death. This analysis assesses the relationship between contextual geographic features such as population density and the distribution of driving cessation-associated suicides across the US. Government and clinical stakeholders should invest in public transportation infrastructure catered to older adults and implement policies to reduce the burden of driving cessation. Increased accessibility of technological innovations such as self-driving cars may also enhance quality of life for a growing older adult population.
Hearing Impairment and Risk of Depression in Older Adults in Health ABC
Authors: Powell Danielle , Betz Joshua , Yaffe Kristine , Kritchevsky Stephen , Strotmeyer Elsa , Simonsick Eleanor , Lin Frank , Deal Jennifer 
Published: December 2020

Abstract
Whether hearing impairment (HI) is associated with depressive symptoms remains disputed for older adults, in part due to varying definition employed, use of subjective hearing measures, or cross-sectional analysis. We studied 1936 men and women (mean age 74.1 years, 41.7% black race) enrolled in the prospective Health, Aging and Body Composition study Hearing thresholds at 500-4000 Hz were averaged to create a pure tone average (PTA) and HI was defined using clinical cutpoints in the better-hearing ear. Depression was measured using the Center for Epidemiologic Studies Depression Scale (CES-D) or the CES-D 10, a revised 10 question scale depending on visit. Linear mixed effects models with random intercepts and slopes were used to estimate difference in rates of change in depressive symptomatology by hearing status over nine years. Cox proportional hazard models were used to examine the association between HI and incident depression defined as change in CES-D score &gt;=10 points. In models adjusted for demographic and clinical covariates, participants with HI demonstrated a higher baseline prevalence of depressive symptoms compared to those with normal hearing (20.7% vs. 8.4%).Rates of change did not differ by HI status. Participants with moderate or greater HI had an increased risk of 9-year incident depression (HR=1.28, 95% CI: 1.00-1.62) compared to participants with normal hearing. HI is associated with increased risk of incident depression and a greater overall prevalence of depression compared to normal hearing, underscoring the importance of further research on whether rehabilitative therapies can mitigate this association.
Psychiatric History and Trajectories of Cognitive Change Predict Risk of Nursing Home Residence
Authors: Brown Maria , Mutambudzi Miriam 
Published: December 2020

Abstract
Previous research indicates that a history of psychiatric, emotional or nervous problems can affect cognitive function at age 65 and cognitive trajectories over time. To explore the potential impact of this relationship on nursing home use, we applied latent class growth curve models to five waves (1998-2008) of Health and Retirement Study data to identify four classes of cognition trajectories, defined by baseline cognitive function scores (low, medium, high) and rate of change (stable or declining). We then ran survival analyses using HRS years 2008 to 2016 to determine risk of nursing home residence based on psychiatric history and cognition trajectory class. We hypothesized that self-reported history of psychiatric, emotional or nervous problems will be associated with greater risk of nursing home residence, and that self-reported history of psychiatric, emotional and nervous problems will interact with cognition trajectories to predict level of risk of nursing home residence. Results indicate that psychiatric history is independently associated with greater risk of nursing home residence, net the effects of a variety of life course variables in the model. Further, psychiatric history interacts with “low cognition declining” and “medium cognition declining” trajectories to increase the risk of nursing home residence. Evidence of the relationship between psychiatric history, cognitive decline, and nursing home residence can be used to enhance public understanding of the impact psychiatric history has on the long-term care system, and to educate policy-makers and providers about the need for appropriate psychiatric training for staff in community-based and residential long term care programs.
Polysomnographic Sleep Is Associated With Time to Develop Dementia: A Study Using 19-Year VA National EHR Data
Authors: Nowakowski Sara , Razjouyan Javad , Sharafkhaneh Amir , Kunik Mark , Naik Aanand 
Published: December 2020

Abstract
Few studies have longitudinally investigated the association between objectively measured sleep and time to develop dementia. This study leverages polysomnography (PSG) sleep data extracted from the VA national electronic health records (VA-EHR) to assess the association between sleep and time to develop dementia. We identified 61,165 PSG reports from the VA-EHR from 2000 to 2019 using CPT codes. Patients who developed dementia were identified using all-cause dementia ICD-9/10 codes documented on two separate visits starting one year after the PSG study until the end of 2019 in a 1-year sliding period (n=1,534). Using the first appearance of ICD-9/10 code as dementia onset time, patients were clustered into 3 groups of early-, mid-, and late time to develop dementia (mean = 2.7, 7.5, 12.8 years, respectively). Natural language processing was used to extract sleep efficiency (SE) and sleep onset latency (SOL). Univariate analysis was used to compare the groups. After adjusting for age, SE was significantly higher in the late (76%) vs early (69%) group and SOL was significantly shorter in late (21m) versus early (33m) group. SE was higher and SOL was shorter in patients who developed dementia later compared to those who developed dementia earlier. Greater sleep continuity in late dementia onset group suggests that sleep may be a modifiable risk factor that could potentially delay the onset of dementia.
Disparities in EOL Care by Dementia Status and Race
Authors: Reinhardt Joann 
Published: December 2020

Abstract
Prior research shows that minority and dementia status are associated with suboptimal end-of-life (EOL) care quality; care that is more aggressive, invasive, and futile. We conducted a retrospective study of EOL care for 300 decedents of varied race/ethnicity in a skilled nursing facility. The purpose of this secondary analysis was to test whether the EOL experience (medical orders in place, treatments, distressing symptoms, discussions with providers) differed by dementia status for different race/ethnic groups (Black, White, Hispanic). Chi-square tests were used to examine the relation between these four sets of EOL variables and dementia status (yes/no) separately for the three groups. Findings showed that for White decedents, PWD were less likely to have had a DNR or a DNI discussion with a provider in the nursing home. Also for White decedents, PWD were less likely to have had shortness of breath or pain. For Black decedents, PWD were more likely to have a DNR order. Also, for Black decedents, PWD were less likely to have been hospitalized. For Hispanic decedents, EOL variables and dementia status were not significantly associated. Overall, findings showed differences by race/ethnic groups in EOL experience based on dementia status. Black decedents with dementia were more likely to have escaped the acute care default. Findings for White decedents with dementia were mixed for aggressive versus comfort care. The EOL experience did not differ by dementia status for Hispanic decedents. Thus, efforts to promote positive EOL care for persons with dementia need to account for differences by race/ethnicity.
Social Integration and Risk of Dementia Among Older Adults
Authors: Zhang Yan , Shen Shannon , Yang Yulin 
Published: December 2020

Abstract
We examine the relationship between social integration and cognitive impairment and dementia among older adults using longitudinal data from Waves 1-8 of the National Health and Aging Trends Study (NHATS). The sample includes 7,492 respondents age 65 and older at baseline. We test multidimensional measures of social integration and cognitive well-being using discrete-time hazard models. The risk of dementia is calculated by a series of performance-based tests. Measures include levels of dementia: no dementia, cognitive impairment not dementia (CIND), and dementia, and three domains of cognition functioning: orientation, executive function, and memory. Social integration is an additive index measured by several questions, including marital status, living arrangement, social network, social contact, and social participation. Our results indicate that people with higher social integration have a lower risk of both cognitive impairment (not dementia) and dementia compared to those with lower social integration. This pattern continued across specific domains of cognitive functioning, including lower risk of orientation impairment, executive function impairment, and memory impairment for those with higher social integration. Tests of both gender and racial interactions did not yield any significant differences. Our findings demonstrate the strong association between social integration and lower risk of dementia among older adults. This study can speak to policy makers as the life expectancy of Americans increases and the aging population grows, highlighting the importance of giving support to older adults who are lack of social connectedness.
Who Wants to Be Alone? Antecedents of Motivation for Solitude in Adulthood
Authors: Yuan Jing , Grühn Daniel 
Published: December 2020

Abstract
Objectives: As an inevitable part of daily life, solitude has both positive and negative consequences which are moderated by one’s motivation for solitude. Self-determined motivation correlates with few psychological risks, whereas other-determined motivation correlates with higher risks (e.g., loneliness, depression, lower well-being). However, little is known about the antecedents of different motivations for solitude. The purpose of this study is to investigate the antecedents of motivation for solitude in a sample with younger, middle-aged, and older adults. Methods: We recruited 468 participants from Amazon Mechanical Turk and Introduction to Psychology class (age range: 17-70, M = 30.7, 50.4 % females). Preference and motivation for solitude were measured with the Preference for Solitude Scale and Motivation for Solitude Scale-Short Form. Age, sex, marital status, education level, living arrangement, instrumental activities of daily living (IADLs), civic engagement, social contact frequency, introversion, and empathy were measured as antecedents. Results: People with older age, higher empathy for fictional characters, lower personal distress, higher introversion, and females tended to have higher general preference for solitude. People with higher empathy for fictional characters tended to have higher self-determined motivation. People with higher empathy for fictional characters, lower empathic concern, higher personal distress, higher IADLs, and higher introversion were more likely to have higher other-determined motivation. Discussion: A person with an introverted personality, functional limitation, more negative empathic reactions towards others are likely to have maladaptive motivation for solitude and may need intervention. Future research should further investigate other antecedents for self-determined motivation.
Suicidal Ideation in Dementia Family Caregivers
Authors: Puga Frank , Wang Danny , Pickering Carolyn 
Published: December 2020

Abstract
Family caregivers of individuals living with Alzheimer’s disease or related dementias (ADRDs) are exposed to unique stressors that put them at risk for depression and suicidal ideation. To date, little is known about contextual factors surrounding suicidal ideation among ADRD family caregivers. We investigated individual caregiver characteristics (gender, age, relationship to care-recipient, history of depression and anxiety) and daily environmental stressors (behavioral symptoms of dementias; BSDs) associated with daily suicidal ideation using a micro-longitudinal design and ecological momentary assessment methods. Data were collected from a national sample of family caregivers (N=51) who completed daily diaries over 21 days (n=911). Suicidal ideation was endorsed on forty-seven days (5.16%) during the sampling period, with 11 participants (22%) endorsing suicidal ideation at least once. Suicidal ideation did not differ based on the caregiver’s age and relationship to the care-recipient (spouse or child). Participants with a history of mild depression and anxiety endorsed more days with suicidal ideation. Finally, family caregivers were more likely to endorse suicidal ideation on a day when more than one type of BSD was reported (OR = 1.25, 95% CI: 1.04-1.50, p = 0.018) and when BSDs were perceived as more bothersome than average (OR = 1.12, 95% CI: 1.05-1.19, p &lt; 0.001). In this investigation, we identified descriptive and predictive factors that will inform the development of targeted interventions for ADRD caregivers at high risk of suicidal ideation.