bluuebunny/crossref_metadata_2025_split huggingface dataset:
ELECTRONIC MEDICAL RECORD ALGORITHM TO IDENTIFY UNDIAGNOSED (PRE)DIABETES: A CASE STUDY FROM HAWAIʻI
Authors: Stupplebeen David , Sentell Tetine L , Ching Lance , Nett Blythe , Taylor Hermina , Lemmen Tiffany , Pirkle Catherine M 
Published: November 2019

Abstract
An estimated one-quarter of United States’ older adults (≥65 years) have diabetes (DM) while half have prediabetes (PreDM). Timely diagnosis can prevent disease progression, but significant proportions of PreDM/DM are undiagnosed. Among Hawai‘i adults, one-third of diabetes and two-thirds of prediabetes cases are undiagnosed; rates for older adults are unknown. Algorithms integrated into Electronic Medical Records (EMR) may improve care by identifying probable undiagnosed cases in patient panels using clinical/laboratory measures. We assessed one algorithm developed by the Hawai‘i Department of Health that identified individuals overdue for screening or with Pre/DM using the records of 20,362 adult patients (51.33% were &gt;65) from a major state health system. 6,371 (31.3%) patients were excluded from analysis; they had no HbA1c screening in the past year or were overdue for screening (70%) based on standard guidelines. Of the remaining 13,991 patients, 7317 were older adults; 6130 (84%) had a PreDM (50.6%) or DM (33.2%) HbA1c value; the rest were controlled or false-positive. Of those older adults with probable PreDM/DM, 38.6% were undiagnosed. Adults &gt;65 were significantly more likely to be flagged with undiagnosed PreDM compared to their younger counterparts (58 versus 54%, p&lt;.001). Notably, 61% of older men flagged with PreDM were undiagnosed. Of the 5,737 patients identified with DM, 22% of those 65 were undiagnosed. Given the recognized high burden of diabetes among older adults, results indicate substantial missed opportunities for the prevention and early treatment of this condition as identified by an EMR algorithm.
THE INFLUENCE OF HUMOR AND SPIRITUALITY ON THE RESILIENCY OF COMMUNITY-DWELLING OLDER ADULTS
Authors: Kenaley Bonnie L , Gellis Zvi D , Kim Eun hae , Mclive-Reed Kimberly 
Published: November 2019

Abstract
Older adults are confronted with many distinct challenges, which require the use of various coping mechanisms to maintain psychological balance, including humor and spirituality (Bonanno et al., 2012; Koenig, 2012). This study examined the influence of humor and spirituality on resiliency of 156 (age 60 years and older) community-dwelling members of an Osher Lifelong Learning Institute located in the western region of the United States who completed a pen and paper and electronic newsletter surveys. The majority of the sample used humor to cheer themselves when feeling depressed, were amused by the absurdities of life, used humor to feel better and to cope with problems, and believed their humorous outlook prevented them from being upset or depressed. Almost three-quarters of the sample looked to a spiritual force for strength, support, and guidance, 58% worked together with a spiritual force and less than 39% thought about how their lives were part of a larger spiritual force. In the final hierarchical regression model (F (5, 143, = 8.895, p .000), only spirituality (beta = -.238, p &lt; .001) and humor (beta = .444, p &lt; .000) were statistically significant; whereas age, gender and living with another were not statistically significant. The findings suggests that humor along with spirituality are two internal resources that promote resiliency in older adults. Humor infused in informal interactions and planned activities as well as spiritual support may contribute to the promotion and enhancement of resiliency in community-dwelling older adults.
FILIAL PIETY AND RELATIONSHIP QUALITY AMONG OLDEST-OLD PARENTS AND OLDER-ADULT CHILDREN IN KOREA: A DYADIC APPROACH
Authors: Lee Kyuho , Min Joohong , Han Gyounghae 
Published: November 2019

Abstract
Objectives: Research has consistently reported the importance of adult children’s filial piety in maintaining relationship quality with their older-adult parents, especially in Asian countries due in large part to the influence of Confucianism. However, less attention has been paid to its effects in their later relationship—oldest-old parents and older-adult children, and very few studies employed a dyadic approach. Methods: In the current study, we examined the effects of actor- and partner effects of the attitudes toward filial piety on intergenerational relationship quality. Data from 105 dyads of very old parents, 81 to 97 years old (M = 87.9, SD = 2.8) and their older-adult children, 65 to 72 years old (M = 65.9, SD = 1.2) were utilized for the analyses. Results: Results showed that children’s attitudes toward filial piety were positively related to the relationship quality reported by both old children (i.e., actor-effects, β = .64, p &lt; .001) and oldest-old parents (i.e., partner-effects, β = .63, p = .001). The effect of actor’s and partner’s attitudes toward filial piety on relationship quality was not significant. Discussion: Findings suggest that children’s attitudes toward filial piety, as compared to parents, may play a more important role in the quality of relationships between oldest-old parents and their older-adult children in South Korea.
THE APOE-ε4 ALLELE AND AGE SYNERGISTICALLY DRIVE DISEASE PROGRESSION IN ALZHEIMER’S DISEASE
Authors: Kleineidam Luca , Zammit Andrea R , DeVito Alyssa , Lipton Richard B , Peters Oliver , Ramirez Alfredo , Wagner Michael , Terrera Graciela Muniz 
Published: November 2019

Abstract
The Apolipoprotein E (APOE)-ε4 allele is the strongest genetic risk factor for Alzheimer’s disease (AD) and other neurodegenerative dementias. Cross-sectional case-control studies suggest that the effect of APOE-ε4 decreases in old age. However, since APOE- ε4 is associated with mortality, these studies might be prone to bias due to selective survival. Therefore, we used multi-state-modeling in longitudinal cohort studies to examine the effect of APOE-ε4 on the transition through cognitive states (i.e. cognitively normal, mild cognitive impairment (MCI) and dementia) while taking death as a competing risk into account. Results from the German AgeCoDe study (n=3000, aged 75-101 years) showed that APOE-ε4 increases the risk for cognitive deterioration in all disease stages. Contrary to results from cross-sectional studies, the effect of APOE-ε4 on the transition from MCI to dementia increased with increasing age (HR=1.044, 95%-CI=1.001-1090). The direction of this effect was confirmed in a smaller sample from the Einstein Aging Study (n=744, HR=1.032, 95%-CI=0.949-1.122). To examine the pathophysiological basis of these results, generalized additive models were used to study AD biomarkers in the liquor of 1045 patients with MCI or AD-dementia. Here, increased amyloid (Abeta1-42) pathology was associated with increased tau pathology (pTau181), consistent with the amyloid-cascade-hypothesis. Interestingly, higher age and presence of the APOE-ε4 synergistically lowered the amount of amyloid required to exacerbate tau pathology (interaction p=0.012). Taken together, our results suggest that the effect of APOE-ε4 on disease progression increases with advancing age. An altered neuroinflammatory response to neurodegeneration should be further explored as potential underlying mechanism.
SMOKING BEHAVIOUR: PATTERNS AND COSTS OF HEALTH SERVICE USAGE USING HAGIS AND LINKED ADMINISTRATIVE HEALTH DATA
Authors: Douglas Elaine , Bell David 
Published: November 2019

Abstract
The associations between smoking and health are well documented. Using the Healthy Ageing In Scotland (HAGIS) survey linked to the administrative Scottish National Health Service (NHS) records this study analyses health service resource usage by older people according to self-reported smoking status. Individual level smoking status (current, ex-smoker, or never smoked), socio-demographic characteristics (age, gender, level of deprivation) and subjective health are sourced from people aged 50+ across Scotland using HAGIS. These responses are then linked to NHS Scottish Morbidity Records to analyse variation in health service usage as measured by the total number of days spent in hospital (daycases and inpatient stays), number of stays, and mean length of stay. Costs are then assigned by medical speciality. We use a two-part model to analyse the i) the probability of having been hospitalised at all, and ii) the quantum of resource usage and its associated cost for those who have been in hospital. Our study provides a conceptual and empirical framework for the associative relationship between smoking status and actual (rather than self-reported) health service usage and expenditure. This study demonstrates the insights to be gained from the linkage of individual survey responses to administrative health service data on resource usage and costs, and discusses the implications for health policy.
FINDING THE ELDERS WHO STAYED- CONDUCTING OUTREACH IN THE AFTERMATH OF HURRICANE MICHAEL
Authors: Tice Jessica L , Bond Megan 
Published: November 2019

Abstract
The Florida Department of Elder Affairs (DOEA) provides programs and services for over 65,300 older people and adults with disabilities. These individuals are uniquely vulnerable and may be displaced, and/or disoriented during natural disasters. DOEA clients are dependent upon community-based services to provide supervision or assistance to perform basic self-care, which often makes sheltering in place alone a danger to their health and well-being. During Hurricane Michael (2018) many older adults who previously were independent sought help for many issues including property damage, utility interruption, food and medicine scarcity, and physical or mental health problems associated with the storm and its aftermath. In normal conditions, DOEA identifies older populations via Census tracts and then conducts outreach events to inform the public how to access social services. However, after the widespread displacement post-storm, traditional outreach approaches were insufficient. A method was needed to remove areas that were rendered uninhabitable and find who remained in place. DOEA identified viable neighborhoods by overlaying property damage locations on base layers of Census tracts with concentrations of older adults and polling places with high percentage of age 60+ voter participation in the subsequent November election. Then in partnership with Feeding Florida, we provided information and registration assistance via local food distribution sites in those areas. This methodology of overlaying Division of Emergency Management property damage records and voter participation records against publicly available Census tract files is a strategy that could be replicated by other disaster and flood-prone communities or organizations that have similar needs.
THE INFLUENCE OF CUSTODIAL STATUS ON MARITAL AFFECTUAL SOLIDARITY AND MENTAL HEALTH AMONG GRANDPARENTS.
Authors: Kim Eunbea , Nadorff Danielle K , Scott Rachel , McKay Ian T 
Published: November 2019

Abstract
Increased life expectancy and the diversity of family structure have resulted in a substantial rise in the number of families with grandparents as the main caregivers (e.g. custodial grandparents). The structures of these families affect the well-being of all family members. After middle age, psychological well-being is associated with marital relationship quality, and raising one’s grandchildren is a known source of strain to relationships. The current study examined adults aged 40 and older (M age = 57.6 yr, 53% female) using a nationwide sample from MIDUS to assess the extent to which custodial grandparenting status influences marital affectual solidarity, depressive symptoms, life satisfaction, and perceived stress. Measures included the Center for Epidemiological Studies Depression Index, Spousal Affectual Solidarity, Satisfaction with Life Scale, and Perceived Stress Scale. Marital affectual solidarity was significantly related to custodial status and psychological well-being, and there were significant differences in marital relationship quality and psychological well-being between custodial grandparents and non-custodial grandparents. However, custodial status failed to moderate the relation between marital affectual solidarity and mental health. Although other factors surrounding custodial grandparents likely affect their marital relationship and mental health, these results suggest that grandparents raising grandchildren are under particular strain in their marriages and are in need of targeted interventions to ameliorate stress and depressive symptoms. These findings will inform the need for more research and supportive educational programs on family relationships and the psychological health of custodial grandparents.
MEN WITH PARKINSON'S MAY HAVE GREATER DISEASE BURDEN IN ASPECTS OF COGNITIVE AND PSYCHOSOCIAL FUNCTION THAN WOMEN
Authors: Hackney Madeleine E , Singh Eeshani , Leeth Ella , Bay Allison , Ni Liang 
Published: November 2019

Abstract
Early in PD, women may experience a more benign disease course than man. Limited research has examined differences between men and women with moderate, treated PD with a mean duration &gt;5 y. Retrospective analyses were performed on data collected from studies, conducted 2011–2019, that assessed motor, cognitive and psychosocial function in 199 people with PD (women=72). We compared performance using univariate analyses, adjusting for age, housing type and education. Men and women patients were not different in PD stage (Stage Mdn= 2, IQR=.5), age (mean±SD; 69.1± 8.9 y), education (16.4 ± 2.3 y), number of medications (5.9±4.1), comorbidities (3.4±1.8), physical function, nor time with PD (6.6±4.6 y). Women were more likely to live in assisted living or senior residences (p=.005). Men gave more correct answers in subtraction, (8.8 ± 4.0 vs. 6.4±3.7; p&lt;.001) but sexes did not differ in percent correct. On the MDS-UPDRS, Men exhibited more burden in subjectively rated non-motor (13.4 ± 7.6 vs. 10.7±7.3; p=.013), and motor experiences of daily living (16.9±8.9 vs. 10.6±7.1; p&lt;.001) and motor symptoms (34.1 ± 12.1 vs. 31.8±12.2; p=.014). Men performed worse at inhibition (6.4±4.6 vs. 7.8 ± 5.0; p=.014) but made fewer errors on inhibition/switching (7.0±3.9 vs.7.8±4.4; p=.05). Men had higher depression scores: 12.5±8.9 vs. 9.4±7.8; p=.016. No differences in performance on spatial cognition were noted. Men with moderate PD were more depressed, had worse motor and cognitive function, non-motor and motor experiences of daily living and motor symptoms than women. Sex-tailored therapies may reduce differences in performance between sexes.
ENGAGING AFRICAN AMERICAN FAMILIES IN END OF LIFE DISCUSSIONS: CHALLENGES AND FACILITATORS
Authors: Cacchione Pamela Z , Gill Le'Roi L , Sefcik Justine 
Published: November 2019

Abstract
Our previous study, African American Preferences Around End of Life, identified that AA Elders wanted to talk to their family about their preferences, but their family tended to avoid discussing end of life topics. We found that African American families often have a difficult time broaching the subject of end of life for a variety of emotional, cultural and religious reasons. Therefore, the purpose of this qualitative descriptive study was: To better understand the challenges and facilitators that influenced end of life conversations within the African American family. Methods: In this qualitative descriptive study, we interviewed 15 AA family caregivers of older adults. Participants were family members of older adults enrolled in an urban Program of All-inclusive Care for the Elderly. Individual interviews lasted on average 50 minutes. Data analysis was completed using conventional content analysis. Results: The majority of participants were between 55 - 65 years of age and adult children of the AA older adult. Two themes emerged for challenges: I’m not comfortable and We just don’t talk about it. For facilitators again, two themes emerged: Another person took the initiative (e.g. health care provider led the conversation) and participants’ previous experience with death led them to initiate EOL conversations. In addition, three participants reported that after participating in the interview they planned to talk to their loved one to find out their end of life preferences. The results of this study provide insight into how health care providers can facilitate these important end of life preferences conversations.
PROBLEMS AND PROSPECTS OF TECHNOLOGICAL AND BIOPHYSIOLOGICAL STUDIES OF TECHNOSTRESS IN MID-LIFE ADULTS
Authors: Mack Elizabeth , Cotten Shelia , Chang Chu-Hsiang , Bauschpies Wenda 
Published: November 2019

Abstract
Long-term exposure to stress places people at risk for chronic diseases including but not limited to obesity, Type-2 diabetes, and heart disease. Various aspects of technology use are associated with stress. Known as technostress, this unique stress is characterized by individuals’ inability to cope with demands generated by computer-related technologies. To date, studies on technostress have focused on young adults and older adults, with an emphasis on self-reported indicators of both technology use and stress. This study differs from prior work in two ways. One, it examines technology use and stress in mid-life adults (50-64), an understudied population in research on technostress. This segment of the population is important because their technostress may negatively affect their successful transition into older adulthood. Second, we use three types of data to elucidate the linkages between technology use and stress: (1) self-reported survey measures of technology use and stress; (2) objective measures of technology use from tracking applications, and (3) biophysiological measures of stress. The study focuses on smartphone use, which was the most commonly used technology by mid-life adults on both weekdays and weekends based on our initial results (N=40). The goal of this pilot study is to highlight the problems and prospects of conducting technostress research through the utilization of multiple data collection modes: self-report, tracking applications (apps), and biophysical indicators.
DEMENTIA WITHOUT BORDERS: BUILDING COMMUNITY CONNECTIONS TO REDUCE STIGMA AND FOSTER INCLUSION
Authors: Phinney Alison , Becker Marigrace , Burnside Lee , Puurveen Gloria 
Published: November 2019

Abstract
BACKGROUND: The concept of social citizenship is gaining traction in the field of dementia studies, but as a practical tool to guide development of supports and services, it remains poorly understood. A one year project to promote collaboration between University of Washington in Seattle and University of British Columbia in Vancouver addressed this very question. Activities were undertaken so these communities could know each other better, with researchers, service providers and people with dementia connecting to share knowledge and expertise. PURPOSE: The project culminated with a public festival to put into practice and share some of what was learned over the year. METHODS: People with dementia and care partners helped plan “Dementia Without Borders”, held at an international park straddling the border between Seattle and Vancouver. 150 people came from the US and Canada, including many people with dementia, family members and friends. The day began with a community walk and gift exchange, followed by a meal and creative activities including poetry readings, music, an art exhibit, and quilt making. RESULTS: Evaluation was overwhelmingly positive with people expressing a sense of hope and belonging. For some, it was their first time to speak openly about having dementia, and meeting others in this space was a joy-filled experience. CONCLUSIONS: This project has leveraged the symbolic power of an international border to raise awareness of the importance of social connection for people with dementia. We further explore how the notion of “dementia without borders” extends theoretical and practical understanding of social citizenship.
EFFECTS OF RESISTANCE EXERCISE TRAINING ON ENDOTHELIAL FUNCTION AND MUSCLE PERFUSION IN OLDER ADULTS WITH DIABETES
Authors: Randolph Amanda , Moro Tatiana , Odejimi Adetutu , Rasmussen Blake , Volpi Elena 
Published: November 2019

Abstract
BACKGROUND: Sarcopenia contributes to frailty, disability, and dependence in older adults, and is accelerated by Type 2 Diabetes Mellitus (T2DM). In addition to its direct role in increasing muscle mass, progressive resistance exercise training (PRET) may also reduce sarcopenia by improving endothelial function and muscle perfusion. METHODS: Fifteen older adults with uncomplicated and well-controlled T2DM participated in a PRET program 3 times weekly for 3 months. Prior to and immediately following the intervention, flow-mediated dilation testing was performed to assess large vessel endothelial function via ultrasound and muscle perfusion via near-infrared spectroscopy (NIRS). RESULTS: Preliminary ultrasound data from 9 subjects show a significant increase (5.21% to 8.73%, p=0.0448) in percent flow mediated dilation (%FMD), suggesting a modest improvement in endothelial function after 3 months’ PRET. Preliminary NIRS data from 7 subjects showed no significant changes in oxygen saturation or reperfusion rates as a result of the intervention. CONCLUSION: Our preliminary data indicate that, in older adults with T2DM, 3 months’ PRET is associated with modestly improved endothelial function in large vessels (as demonstrated by a significant increase in %FMD), but does not appear to be associated with improvements in muscle perfusion
EMERGING ADULT CAREGIVERS: PERCEPTIONS OF OLDER ADULT CARE RECIPIENTS, QUALITY OF CONTACT, AND AGEISM
Authors: Canell Anastasia E , Caskie Grace 
Published: November 2019

Abstract
Approximately 12-18% of family caregivers to older adults in the U.S. are 18-25 years old (i.e., emerging adulthood), yet minimal research has focused on this subgroup of caregivers (Levine, 2005; Smyth, Blaxland, & Cass, 2011). Individuals’ perceptions of an older adult’s social role relate to their attitudes toward older adults as a group (Hummert, 1999; Kite & Wagner, 2002). However, whether perceptions that emerging adult caregivers hold of older adults are specific to the social role of “care-recipient” has not been studied. A sample of 210 informal caregivers (ages 18-25) were surveyed to collect qualitative responses regarding perceptions of an older adult care-recipient (age 65+) and to assess quality of contact with the care-recipient and ageist attitudes. Participants were asked to provide five adjectives describing their older adult care-recipient. Approximately 43% provided a set of adjectives in which 80%-100% were coded as positive adjectives (e.g., “active”, “wise”); similarly, half of the sample’s adjective sets contained 0%-25% negative adjectives (e.g., “helpless”, “obnoxious”). The quality of contact with the care-recipient was significantly correlated (p&lt;.001) with the percentage of positive (r=.47) and negative (r=-.49) adjectives. Scores on the Fraboni Scale of Ageism were also significantly correlated (p&lt;.01) with the percentage of positive (r=-.19) and negative (r=.20) adjectives. Overall, these emerging adult caregivers had generally positive perceptions of their older adult care-recipients, and these perceptions reflected the positive quality of contact with the care-recipient. Less ageist attitudes’ relationship with more positive and less negative perceptions may have implications for experiences within a caregiving dyad.