bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disability and Long-Term Care in Singapore
Authors: Huijun Cynthia Chen , Chia Ngee Choon 
Published: December 2020

Abstract
Public systems for long term care (LTC) redistribute resources between generations. Population aging is one of the most significant transformations in the 21st century, where the number of older persons aged 60 years and above is expected to double by 2050, rising to 2.1 billion. We used the Future Elderly Model (FEM) to project the impact of population aging in Singapore up to the year 2050. The FEM is a dynamic economic and demographic microsimulation model. By 2050, the total number of older adults with potential limitation in activities of daily living (ADL) was projected to increase to 275 thousand (18.9%). With the increasing prevalence of disability and chronic diseases, older adults might not have sufficient savings to meet future needs sustainably, despite the expansion of disability insurance from ElderShield to CareShield Life. Lessons and best practices for LTC could be transferred from our experiences to other aging cities globally. Part of a symposium sponsored by International Comparisons of Healthy Aging Interest Group.
Uncovering Promising Practices for Supporting Older People Experiencing Homelessness
Authors: Canham Sarah , Humphries Joe , Burns Victoria , Sussman Tamara , Walsh Christine 
Published: December 2020

Abstract
Montréal, Calgary, and Vancouver have seen a dramatic increase in homelessness among adults aged 50+. In order to identify ‘promising practices’ that promote aging-in-the-right-place for older people experiencing homelessness (OPEH) in Montréal, Calgary, and Vancouver, we conducted an environmental scan and three World Café workshops with 99 service providers and OPEH. We identified 53 promising practices managed or operated by 42 providers which we categorized across a shelter/housing continuum: 1) Emergency/transitional/temporary shelter/housing; 2) Independent housing with offsite supports; 3) Supported independent housing with onsite, non-medical supports; 4) Permanent supportive housing with onsite medical support and/or specialized services; 5) Long-term care; and 6) Palliative care/hospice. Study findings provide a template for existing solutions to the diverse shelter/housing needs of OPEH and insight into the gaps in shelter/housing and services that would support OPEH to age-in-the-right place. Policy and practice implications for scaling promising practices will be discussed. Part of a symposium sponsored by the Environmental Gerontology Interest Group.
Research to Strengthen Policy, Practice, and Advocacy on Housing for Aging Societies
Authors: Greenfield Emily , Berlinger Nancy 
Published: December 2020

Abstract
Population aging alongside other global trends—such as urbanization, widening economic inequality, and climate change—accelerate the need for systematic efforts to improve housing for diverse individuals, families, and communities as they age. This symposium features gerontological research explicitly designed to advance policy, practice, and advocacy on aging and housing. The first presentation demonstrates the use of data from U.S. surveys to better characterize the nature of current and future challenges in access to affordable, accessible, and safe housing for older adults. The second paper presents findings from a mixed-methods action research project in Toronto involving tenants living in properties managed by the second largest senior housing provider in North America. The paper indicates how findings on facilitators and threats to aging in place directly inform policy implementation on integrated services in Toronto. The third paper presents findings from a longitudinal, in-depth interview study with leaders of age-friendly community initiatives in suburban New Jersey, demonstrating the simultaneous challenges and opportunities of embedding housing advocacy at the local level within broader age-friendly community change efforts. The fourth paper presents three case studies based on interviews with key stakeholders involved with anti-displacement housing preservation and public housing organizing in New York City, highlighting the often invisible work of older, lower income, African American women at the center of advocacy efforts to preserve affordable housing. Guided by interdisciplinary critical work on ethical responses to population aging, the discussant will integrate themes from the papers to propose a framework for research, policy, practice, and advocacy.
Neighborhood Social Deprivation and Caregiving Intensity for Community-Dwelling Older Adults With Disabilities
Authors: Fabius Chanee , Mulcahy John , Okoye Safiyyah , Wolff Jennifer 
Published: December 2020

Abstract
There is growing interest in the role of “place” in the provision of long-term services and supports (LTSS) for older adults with disabilities, who receive ~16 billion hours of care per year from family and unpaid caregivers, but information is lacking. Using data from the 2015 National Health and Aging Trends Study (NHATS) linked to census-tract-level information from the American Community Survey, we described the association between caregiving intensity (hours of care received per week) and neighborhood social deprivation among N=2125 community-dwelling older adults with disabilities. Individuals receiving 40 hours or more of help per week had greater levels of functional impairment and dementia, and more often lived in neighborhoods at the highest quartile of social deprivation compared to those receiving fewer than 20 hours of care (26.8% vs. 21.7%, respectively). Findings have policy implications for targeting LTSS strategies toward addressing inequities in social determinants of health for vulnerable populations.
Home and Neighborhood Context and Fall Risk Among Older Americans
Authors: Okoye Safiyyah , Mulcahy John , Fabius Chanee , Wolff Jennifer 
Published: December 2020

Abstract
Falls result from complex interactions between individuals and their environment and are the leading cause of injuries among older adults. A nascent literature demonstrates an association between neighborhood characteristics and falls. However, available evidence is from small, nonrepresentative samples and generally focuses on individual, home, or neighborhood risk-factors rather than the contribution of all three. We link information from N=6,489 community-dwelling participants in the 2015 National Health and Aging Trends Study with the Social Deprivation Index (SDI), which yields a census-tract-level score of socioeconomic disadvantage, to assess associations between home and neighborhood context and falls in the previous year. Household financial strain was associated with a 31% increased risk of falling, and indoor trip hazards with a 14% increased risk, after adjusting for individual factors and neighborhood SDI (all p &lt;0.05). Findings reflect the interplay between home and neighborhood context and fall-risk, and can inform community-based fall-prevention interventions.
Material Conditions and Well-Being in Old Age: the Role of Contextual Factors at Regional Level
Authors: Myck Michal , Brandt Martina , Garten Claudius , Oczkowska Monika , Schmitz Alina 
Published: December 2020

Abstract
In our Beethoven project “Age-well” we examine the role of regional contextual factors for the relationship between individual wellbeing and material conditions over time, using a unique combination of individual and regional level longitudinal data. The analyses consider a broad range of regional, community-level indicators for two countries, Germany and Poland, both characterised by rapid population ageing and significant regional variation in the standard of living. These variables, including local indicators of economic conditions and public services, are combined with detailed individual-level information on wellbeing from the Survey of Health, Ageing and Retirement in Europe (SHARE). This data match allows us to study the degree to which regional contexts affect the relationship between individual material conditions and wellbeing in later life. Local public services are shown to mediate the importance of individual level resources for wellbeing confirming an important channel through which public policy can improve welfare of older people.
Title II: Improving Grants for States and Community Programs on Aging
Authors: Kuhne Jamie 
Published: December 2020

Abstract
There are several noteworthy changes to the Improving Grants for States and Community Programs on Aging’s portion of the OAA. The reauthorization adds language requiring data collection on the needs of older adults and specifying additional populations on whom to focus outreach efforts, such as survivors of the Holocaust. The reauthorization also expands what States may fund with Supportive Services grants, adding screening for social isolation and traumatic brain injuries. The Act goes on extend Stated the option of funding programs to address both of these issues. The Act also requires the Assistant Secretary to study the supply and demand of home delivered and congregant meals and make recommendations to address the gap. Finally, there is expansion of the section on Caregiving, including a definition of caregiver assessment and the removal of a limit on funds States can use on support services to family caregivers.
State Variability in Assisted Living Regulations, Access, and Outcomes for Persons With Dementia
Authors: Thomas Kali 
Published: December 2020

Abstract
Approximately one million individuals, an estimated40% with a diagnosis of Alzheimer’s disease-related dementias (ADRD), reside in assisted living (AL); yet, little is known about their experience or the quality of care provided in AL. Unlike other forms of long-term care (LTC), the licensing, operating, and enforcement requirements for AL falls to the states, which vary dramatically in their regulatory approaches. The overall objective of this symposium is to examine states’ AL regulatory environments and understand if and how access to AL and the health outcomes of AL residents with ADRD are impacted by states’ regulatory decisions. Presenters will highlight the state variability in the regulation, access, and outcomes of AL residents with ADRD. The first presentation will describe the within and between state differences in regulatory approaches as it relates to dementia care. The second presentation will describe the variation in Medicaid financing of services in AL and its potential impact on access to AL within those states. The third will present geographic disparities in access to specialized dementia care in AL. The fourth presentation will characterize differences in emergency department utilization among AL residents with ADRD across states. Finally, the fifth presenter will report on the effect of establishing or increasing state staffing requirements on outcomes of AL residents with ADRD. Results will ultimately inform policy-makers, organizational leaders, and clinicians as they seek the most effective ways to ensure equal access to AL and optimal outcomes for residents with ADRD. Assisted Living Interest Group Sponsored Symposium.
Geographic Disparities in Access to Specialized Dementia Care
Authors: Cornell Portia , Zhang Wenhan , Smith Lindsey , Fashaw Shekinah , Thomas Kali 
Published: December 2020

Abstract
With novel, previously undescribed data on the availability of dementia-specific assisted living communities (ALs), we analyzed variation among counties in the availability of this important service for persons with dementia. In twenty-one states, we identified 6,961 ALs (16%) with a dementia-specific license/certification. Counties with at least one AL providing dementia-specific care had substantially higher college attainment versus counties that had at least one AL, but no dementia-specific beds: 25% versus 18% (p&lt;0.01). Counties with dementia care also had significantly greater median incomes ($54,000 vs. $46,400), and home values ($159,000 vs. $113,000), lower poverty rates (13.7 percent vs. 16.3 percent), and lower proportions of Black residents (7.8 percent vs. 8.7 percent). Our findings are suggestive of a mismatch in need and availability of residential care options for older adults with ADRD that are also low-income or racial/ethnic minorities. Part of a symposium sponsored by Assisted Living Interest Group.
Privatizing the Welfare State
Authors: Herd Pamela 
Published: December 2020

Abstract
The growth of the private sector in the Medicare and Medicaid programs is a sea change, leading many to argue that the old age welfare state is effectively becoming privatized. I examine these trends, but focus on the consequences for how older adults experience their interactions with government. In particular, I examine how privatization increases administrative burden for beneficiaries. Older adults must navigate hundreds of choices, leading to significant confusion. Most fail to pick policies that maximize their benefits and reduce their cost. This confusion harms beneficiaries. They end up with suboptimal coverage, with increased out of pocket costs and decreased access to care. The confusion, however, generates profits for insurers. Part of a symposium sponsored by the Women's Issues Interest Group.
Getting the Show on the Road! States Amp Up a Life Course Approach to Alzheimer's
Authors: Shean John , French Molly , Beatty Carissa 
Published: December 2020

Abstract
Alzheimer’s and other dementias are chronic conditions that disproportionately impact some populations. The dementia continuum spans decades, so life-course approaches by state health departments (SHDs) are crucial. SHDs’ implementation of the Healthy Brain Initiative Road Map (RM) represents policy/system/environmental actions to improve population-level dementia outcomes. METHODS. Alzheimer’s Association uses online reporting by affiliate chapters to monitor SHDs’ RM implementation. Association staff reviewed data and calculated frequencies by RM action and issue areas. Documentation from SHDs and national partners are supplementary data. RESULTS. Preliminary results from July-December 2019 indicate 34 SHDs were implementing 60 RM actions. Interventions clustered in risk reduction, early detection, workforce competencies, surveillance, and emergency preparedness. RM implementation lagged on access to community supports, attention to caregiving, and workforce supply analyses. A majority of states had multi-faceted initiatives. IMPLICATIONS. SHDs are deploying life-course approaches for dementia. SHD leaders must build towards a full response by expanding RM implementation.
The Intersection of Mental Health, Self-Reported Neurocognitive Functioning, and Education in Older HIV+ Gay Men
Authors: Krause Kristen 
Published: December 2020

Abstract
Older people living with HIV/AIDS (PLWHA) face different mental and neurocognitive challenges related to their health and well-being. Using data from a cross-sectional study (n=250) on older (age 50-69) gay men living with HIV/AIDS in NYC, this study examined the multi-level associations between self-reported neurocognitive functioning, mental health, and key sociodemographics (age, race/ethnicity, financial situation, and education). Findings suggest those who have higher self-reported neurocognitive functioning have higher levels of education, better self-rated health, and lower levels of PTSD and depression (p&lt;0.01). Differences were not observed based on race/ethnicity, financial situation, and age. The overall findings demonstrate educational differences in self-reported cognitive functioning among older HIV+ gay men and highlight the importance of enhancing interventions and policies to promote better cognitive and mental health outcomes. More research is warranted to understand the intersection of education and cognitive performance among other sub-groups of PLWHA to understand whether these findings are consistent.
Socioeconomic Status and Long-Term Care Provision to Parents in Japan
Authors: Ibuka Yoko , Ohtsu Yui 
Published: December 2020

Abstract
Socioeconomic status (SES) is generating considerable interest in terms of health of individuals, but how it is associated with long-term care has not been established yet. We study the relationship between SES and long-term care provision to parents among the Japanese adults using JSTAR. We use the following six measures of SES for the analysis: income, asset, expenditure, living condition, housing condition and education. We find a greater probability of care provision to parents among those in higher SES categories for some SES measures, compared to the lowest category. However, after considering the survival probability of parents, the relationship is reversed and the probability of care provision is found to be greater among lower SES individuals. The association is more pronounced among males. The association is likely to be partly mediated by care needs of parents. These results suggest a higher burden of care disproportionately falls in low SES individuals.
Socioeconomic Inequality in Long-Term Care: A Comparison of Three Time Periods in the Netherlands
Authors: Abbing Jens , Suanet Bianca , van Groenou Marjolein Broese 
Published: December 2020

Abstract
This study aims at investigating to what extent inequalities in the use of formal, informal and privately paid care have changed over time. Data from the Longitudinal Aging Study Amsterdam (LASA) was used from three points in time (1995, 2005 and 2015) that capture distinct periods in the recent development of the Dutch long-term care system. In particular, the reforms of 2007 and 2015 might have impacted care uses. All participants (N = 1810) were living at home and between the age of 75 and 85 at measurement. The results indicate that, adjusted for health and partner status, formal, informal and privately paid care have decreased over time. Socioeconomic differences in informal care use have increased over time, but no change was found for privately paid or formal care use. These findings suggest that changes in the LTC system and long-term care resources in particular benefit lower socioeconomic groups.
The Aging Network and the Older Americans Act Reauthorization
Authors: Gotwals Amy 
Published: December 2020

Abstract
This presentation will cover a range of OAA reauthorization proposals - successes and what was not possible this year. As a leader in the aging network, n4a played a major role in the legislative process, and the discussion will include top priorities for improving the ability of the network to serve older adults with community-based supports and services.
New Pieces for the Older Americans Act Puzzle
Authors: MacPherson Andrew 
Published: December 2020

Abstract
With the passage of the new “Supporting Older Americans Act of 2020,” Congress acknowledged and address several under appreciated issues -the growing social isolation and loneliness of older adults, and the significant role that the aging network does and can play in providing supportive services to older adults with advanced illness (also known as serious illness). This presentation will provide information on these and other pieces of the OAA puzzle.
Understanding Driving as an Everyday Activity: International Perspectives
Authors: Dickerson Anne , Gelinas Isabelle , Choi Moon 
Published: December 2020

Abstract
This international symposium brings together leading occupational therapy researchers from around the world with a shared focus is on evaluating and improving the driving performance of older adults to decrease their crash risk and facilitate their community participation. In this session, five groups of international scholars will share their collective and individual research outcomes for driving as a means of community mobility. The first presentation will outline their collective international, cross-sectional study of 247 older adults from seven countries where the impact of driving on out-of-home mobility was compared. Each presentation that follows will then present results from innovative studies of ways in which to assess and address fitness to drive in older adulthood. Our discussant will summarize the potential expansion of the current work and engage the audience through interactive questions. Transportation and Aging Interest Group Sponsored Symposium.
International Comparison of Older Drivers and Non-Drivers for Activity Access and Quality of Life
Authors: Harries Cilla , Unsworth Carolyn , Vrkljan Brenda , Dickerson Anne 
Published: December 2020

Abstract
Driving is crucial for many people to age in place, as it is the most convenient option, and somtimes the only option for personal transport. This international, cross-sectional, cohort study of older adults (n=246) compared drivers’ and non-drivers’ quality of life and levels of community participation. Following ethical approval, data were collected across seven countries. The EQ-5D-5L was used to measure health related quality of life and a modified version of the Participation in Activities and Places Outside the Home (ACT-OUT) was used to measure community participation (T-ACT-OUT). Drivers accessed more out-of-home activities than non-drivers, suggesting higher community participation among this group. Health related quality of life was generally high among all participants, but slightly higher for drivers (U=3186, z=-2.78, p=.005, r=0.18). These findings resonate with recent evidence, which suggests supporting older drivers to continue to drive for as long as possible provides critical access to their communities (O’Neill et al., 2019). Part of a symposium sponsored by Transportation and Aging Interest Group.
Evaluating Older Drivers in Their Everyday Driving Environments
Authors: Gelinas Isabelle , Mazer Barbara , Chen Yu-Ting , Vrkljan Brenda , Marshall Shawn , Charlton Judith , Koppel Sjaanie 
Published: December 2020

Abstract
Developing tools that accurately detect at-risk driving behaviors is a public-health priority. There is a need for a measure that accurately assesses older drivers’ level of competence on familiar roadways. The objective of this presentation is to describe the development of the procedures and scoring of a new approach, the Electronic Driving Observation Schedule (eDOS), to observe everyday driving in the community. The eDOS was used to record and compare the driving environment and performance of older drivers and low-risk younger drivers during their everyday driving. Older (n=160, &gt;74y) and younger (n=60, 35-64y) drivers completed a 20-30-minute drive from their home to destinations of their choice. Older drivers drove on simpler routes with fewer intersections and lane changes. Both groups made few driving errors, which were mostly low-risk. Younger drivers tended to demonstrate poor driving habits (not signaling, speeding, poor lane position) and compliance with road rules. Part of a symposium sponsored by Transportation and Aging Interest Group.
The Impact of Public Benefits on Low-Income Older Adults’ Financial Well-Being
Authors: Popham Lauren 
Published: December 2020

Abstract
Nineteen percent (13 million) older adults have incomes below 150% of the Federal Poverty Level, leaving them with limited means to afford basic living expenses. Public benefits can help bridge the gap allowing older adults to afford food, home energy, and health expenses. There are studies demonstrating the positive health outcomes associated with public benefits in older adults. It remains unclear how benefits may also improve subjective measures of well-being in older adults. To examine this question, baseline measures of well-being including the CFPB Financial Well-Being Scale were administered to older adults before they enrolled in benefits and again six months after receiving benefits to examine changes in well-being as a result of accessing benefits to help ease some of their financial burdens. Results revealed that older adults experience subjective, psychological improvements from benefits. These findings have implications for the social and behavioral determinants of health in older adults.