bluuebunny/crossref_metadata_2025_split huggingface dataset:
Considering LTSS Through the Lenses of Social Construction of Target Populations: Theory and Neoliberalism
Authors: Buckley Tommy , Cox Carole , Doron Israel (Issi) 
Published: December 2020

Abstract
The global increase of the older population has led to a greater demand for long term support services (LTSS) that address their rights and needs for care. However, policies among countries remain diverse with varying options, services, and recognition of human rights. This study applies the Social Construction of Target Population (SCTP) theory which relates to the perception of older adults and Neoliberalism, a political theory associated with policies of economic privatization, deregulation, and free market activity to the analysis of LTSS systems. As an example, in the United States, the concept of Successful Aging, conflicts with the need for LTSS while present Neoliberal policies that stress minimal government intervention and regulation contribute to little support for any comprehensive LTSS policy. This paper reviews existing policies in 7 countries, representing diverse regions, cultures, and political systems as a means of understanding the relationship of SCTP and Neoliberalism to LTSS. Highlighting the roles that these theories may play can assist in understanding and developing systems that meet the rights and health care needs of older adults.
Cortisol Responses to a Laboratory Challenge: The Moderating Role of Cognitive Performance
Authors: Grimm Elise , Agrigoroaei Stefan 
Published: December 2020

Abstract
Recent theoretical and empirical studies have considered higher cognitive performance as a protective factor with respect to reactivity, recovery and habituation to acute stressors. The goal of our study was to examine the individual role of inhibition, working memory, processing speed, reasoning, and category fluency in the regulation of the cortisol response to a laboratory challenge. Younger, middle-aged, and older participants (N =109, aged 22-84, M=55.90, SD=16.35) were invited to a laboratory session comprising a driving simulation and a set of cognitive tasks. At least one week in advance, baseline cognitive performance was measured using the Brief Test of Adult Cognition by Telephone (BTACT). Throughout the lab session, five saliva samples were taken, which allowed for the computation of a global measure of cortisol release (area under the curve (AUC)). Cortisol AUC was regressed on the individual BTACT cognitive tests, while controlling for age, sex, education, body mass index, physical activity, and time since awakening. The results revealed that inhibition and working memory significantly accounted for the cortisol response. These associations remained significant when other factors such as smoking, caffeine consumption, and medication use were included as covariates. The contributions of reasoning and speed of processing approached significance. Our findings contribute to the emerging evidence that cognitive functioning modulates stress responses to acute stressors. The findings are discussed in the context of cognitive interventions with transfers and implications for stress processes and healthy aging.
Developmental Trajectory of Theory-of-Mind Decline in Older Adults
Authors: Yow W Quin , Li Xiaoqian , Lee Jiawen 
Published: December 2020

Abstract
Theory-of-Mind (ToM) is critical to individual social competence and mental health across the lifespan (Frith, 2008). Though it is often discussed as one broad construct, ToM abilities can be viewed as following a developmental trajectory: from early emotion recognition and gaze following to more advanced inferences about others’ beliefs, perspectives, and intentions (Hutchins et al., 2012). Despite current literature suggesting that ToM abilities may be impaired in late adulthood, there is no consensus regarding whether ToM abilities are differentially affected by age. In this study, we examined younger adults (N=18, aged 19-30) and older adults (N=13, aged 58-76) on their ToM competence across three levels of ToM abilities: Early-ToM (e.g., recognizing a happy face), Basic-ToM (e.g., perspective-taking and false-belief reasoning), and Advanced-ToM (e.g., inferring second-order emotion and false belief). All participants completed a Theory-of-Mind Task Battery consisting of three subscales that assessed the three levels of ToM, where participants viewed vignettes and answered questions about the protagonists’ feelings and beliefs. Overall, younger adults outperformed older adults on the battery, F(1,29)=7.34, p=.011. However, a significant interaction between age and ToM levels (p=.010) revealed that Early and Advanced ToM (ps&gt;.25) were not as affected by age as Basic ToM (p=.007). Older adults have difficulty in inferring others’ perspectives/beliefs while their attributions of emotion and higher-order false beliefs are relatively preserved compared to the younger adults. These findings provide important insights into the impact of age on various levels of ToM and could help inform early detection of ToM decline in normal aging.
Is Volunteering an Equalizer? A Quasi-Experimental Study Using Propensity Score Analysis
Authors: Kim Seoyoun , Halvorsen Cal 
Published: December 2020

Abstract
Formal volunteering in later life has been extolled as beneficial for both physical and mental health. However, research points to potential selection bias, in that older adults with key advantages, such as higher wealth, are more likely to volunteer and reap its benefits. As such, we test two competing propositions: Volunteering may act as an equalizer if it benefits the health of the least wealthy the most, or it may further exacerbate disparities if it benefits the health of the wealthiest the most. To that end, we analyzed data from the 2012 and 2014 waves of the Health and Retirement Study (N≈15,000). First, we used relevant covariates (e.g., sociodemographic characteristics, informal volunteering, and health) in 2012 to predict volunteering in 2014, developing the propensity score weights from these results. We then performed several regression analyses to assess the influence of volunteering on self-reported health and depressive symptoms among the general population (ATE) and volunteers themselves (ATT), while comparing the findings for the highest and lowest wealth quintiles. We found that volunteering enhanced self-reported health and reduced depressive symptoms. Further, those in the highest quintile experienced significantly fewer depressive symptoms from volunteering while those in the lowest quintile did not, albeit with no significant differences between the two coefficients. The study enhances the nuanced understanding of volunteering and health while suggesting that unmeasured factors felt strongest among the least wealthy—such as financial distress, discrimination, or lack of organizational support—may attenuate the benefits of voluntary activity.
Neural Inhibition Task Elicits Age-Associated Changes in Prefrontal Cerebral Oxygenation
Authors: Salzman Talia , Rahman Tabassum , Polskaia Nadia , St-Amant Gabrielle , Vallejo Diana Tobón , Lajoie Yves , Fraser Sarah 
Published: December 2020

Abstract
Certain cognitive tasks, such as those involving inhibition, can influence an older adult’s dual-tasking ability more than others. This study aimed to manipulate cognitive task difficulty to evaluate age-associated differences in brain activity and behaviour during walking. Nineteen younger (M=21.3, SD=3.9) and 20 older (M=71.8, SD=6.4) adults completed four cognitive-auditory tasks: simple reaction time (SRT; processing speed), Go-no-Go (GNG; neural inhibition), N-back (NBK; working memory) and Double number sequence (DNS; working memory) with or without self-paced walking. Trials took place under single cognitive (SC), single motor (SM) and dual-task (walking with a cognitive task; DT) conditions. Throughout each condition, cerebral oxygenation changes (ΔHbO2) in the prefrontal cortex were acquired using functional near-infrared spectroscopy (fNIRS). Behavioural measures including response time (ms), accuracy (%) and gait speed (m/s) were also calculated. Repeated measures ANOVAs revealed that OAs exhibited greater ΔHbO2 than YAs in the left hemisphere during the GNG inhibition task (p = 0.04). Activation in the right hemisphere also increased compared to the left during DNS DT (p = 0.05). Response times increased with increasing task difficulty and YAs were faster than OAs during NBK SC (p = 0.09). Neural findings revealed age-associated changes in prefrontal activation at the GNG inhibition difficulty level. Behavioural results indicated poorer performance with increasing task difficulty including slower response times in OAs. Moreover, gait speed and accuracy only decreased within task and difficulty. Therefore, understanding the neural and behavioural changes across task difficulty may help monitor cognitive decline and distinguish normal aging from disease states.
Implementation Approaches to Strengthen a Food Insecurity Intervention for Older Adults in an Emergency Department
Authors: Aylward Aileen , Platts-Mills Timothy , Wardlow Liane , Sullivan Conor , Anderson Jessa Engelberg , Morris Andrea 
Published: December 2020

Abstract
Food insecurity is prevalent among older adults, negatively impacts health, and may increase healthcare utilization. Emergency Departments (ED) are an important site of care for older adults. However, the feasibility of screening for food insecurity in EDs is unknown. We assessed the feasibility of implementing a screening and referral process to identify and address food insecurity among older adults in the ED and then monitored progress to overcome barriers to implementation. We developed a semi-structured interview (SSI) guide using the Consolidated Framework for Implementation Research. Prior to implementation, ED staff with diverse clinical backgrounds participated in SSIs. SSIs were analyzed using rapid analysis. Before and during implementation, we engaged hospital leadership to refine the screening and referral process. During implementation, we identified barriers through periodic reflections with staff, observing screenings, and reviewing Electronic Medical Record (EMR) data. Staff agreed that food insecure older adults would benefit from community services. Nursing Assistants (NA) were identified as key implementers. ED leaders expressed concerns about regulatory compliance, EMR integration, and NA scope of work, which were addressed. During implementation, barriers included competing priorities, lack of knowledge, and discomfort with the topic of food insecurity. Stakeholder input and reviewing EMR data led to adaptations including modifying criteria for referral and embedding training into NA orientation. Leadership and staff supported food insecurity interventions but identified several concerns. Steps to facilitate implementation included identifying staff to screen, EMR integration, and building staff efficacy. Reviewing screening data and soliciting stakeholder feedback enabled ongoing adaptations that strengthened implementation.
Feeling Older and Constrained: Synergistic Influences of Control Beliefs and Subjective Age on Cognition
Authors: Cerino Eric , O’Brien Erica , Almeida David 
Published: December 2020

Abstract
Control beliefs are important correlates of cognitive health and aging. In addition, how old or young one feels is a self-perception of aging that may play a role in understanding control-cognition associations. We explored whether subjective age moderates associations among control beliefs and cognitive performance using data from the third wave of the national Midlife in the United States study. The analytic sample comprised of 2,621 adults aged 39–93 (Mage=64.06, SD=11.15; 55.51% female) that completed measures of control (mastery, perceived constraints), subjective age (how old you feel most of the time), and cognition (executive function, episodic memory) via telephone administration. Hierarchical regression analyses were conducted to examine whether mastery, perceived constraints, and subjective age were associated with cognitive performance, adjusting for chronological age, gender, education, marital status, and self-rated health. For executive function, there was a significant perceived constraints by subjective age interaction. Higher levels of perceived constraints were associated with worse executive function (Est.=-0.05, SE=0.01, p&lt;.001), and this association was amplified among those with relatively older subjective ages (Est.-0.10, SE=0.02, p&lt;.001). For episodic memory, higher levels of perceived constraints were associated with worse performance (Est.=-0.07, SE=0.03, p&lt;.001), while reporting a more youthful subjective age was associated with better performance (Est.-0.10, SE=0.02, p&lt;.001). Mastery was not associated with either cognitive domain (ps&gt;.05). Results suggest that perceiving constraints in life may confer greatest risk to cognitive performance among adults who feel older than their actual age, whereas perceiving a more youthful subjective age may be more facilitative.
Higher Ed as a Leveler: How Early Life and Higher Education Shape Resilience and Health in Adulthood
Authors: Bruefach Tyler , Carr Dawn 
Published: December 2020

Abstract
Growing evidence shows that individuals who have high levels of psychological resilience maintain higher levels of physical and psychological health in later life. Individuals cultivate psychological resilience over the life course, yet little research has explored its mechanistic effects on health during midlife. One source of resilience may be formal education, which is a well-established determinant of health in adulthood. Resilience might be one reason for this robust association, as education helps individuals develop greater psychological resources in adulthood. On the other hand, having a college degree also increases access to other health-promoting resources that can be leveraged over the life course, such as better-paying and higher-quality jobs. Using data drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health), the current paper examines: 1) how early-life factors shape psychological resilience in early adulthood (24-32 years); and 2) the effects of early adulthood resilience on the association between education and health in mid-life (36-44 years). Results show that psychological resilience and college education have significant direct effects on health in midlife, net of health in early adulthood. However, first-generation college graduates cultivate more psychological resilience from their educational attainment than do those with college-educated parents. That is, higher education serves as a leveler for health gaps in midlife for those with fewer resources available in early life by bolstering resilience. These results provide important insights about how early life factors play an important role in shaping successful aging processes.
Perceived Social Integration Predicts Engagement and Responsiveness to Positive Events: Test of Age Moderation
Authors: Klaiber Patrick , Almeida David , Sin Nancy 
Published: December 2020

Abstract
Social Integration has important implications for health and well-being during adulthood. Being socially integrated might be an important resource that helps people to regularly engage in daily positive events. With older age, this resource might become increasingly important. However, being well socially integrated might also mean that people are certain that they experience more positive events in the future and thus, respond with less positive affect to any given positive event. We examined perceived social integration as a predictor of engagement and responsiveness to positive events using data from the National Study of Daily Experiences 2. 1904 adults (Mean age = 56.25, min = 33, max = 84) reported their daily positive affect and daily positive events during 8 consecutive days of telephone interviews. Perceived social integration was assessed at baseline. Adults higher in social integration experienced daily positive events more frequently (b = 0.01, SE = 0.003, p &lt; .001), but showed less of an increase in positive affect on days with more-than-usual positive events (b = -0.003, SE = 0.001, p = .030). These models controlled for the Big Five personality traits, purpose in life, demographic variables and same-day occurrence of stressors. Age did not moderate the present associations. The present findings imply that social integration might be an important contributor to experiencing more positive events across adulthood. Being better socially integrated might also lead to responding with less positive emotions to any given positive event.
Evaluating a Mobile-Health-Enhanced Behavioral Lifestyle Intervention for Frailty in Diabetes: A Feasibility Study
Authors: Jiwani Rozmin , Wang Jing , Li Chengdong , Espinoza Sara 
Published: December 2020

Abstract
Type 2 diabetes (T2D) and overweight are significant predictors of frailty in older adults. There are no widely accepted intervention strategies for frailty. The Look AHEAD (Action for Health in Diabetes) trial demonstrated the efficacy of behavioral lifestyle intervention on weight loss and glycemic control in overweight older adults with T2D. It is unknown whether this intervention can prevent/delay frailty in older adults. We designed a feasibility study examining the effect of a behavioral lifestyle intervention enhanced with mobile technology (Fitbit) for self-monitoring of diet and physical activity on frailty and T2D outcomes over 6 months in overweight older adults diagnosed with T2D. Forty older adults were randomized to receive either 10 group sessions vs. one condensed session plus monthly phone calls for 6 months. In this analysis, we are reporting on Fitbit wear adherence and weight changes on the 20 participants in the group session for the first 6 group sessions. The study sample was aged 72.3±6.4 years; 62% female; 52% Hispanic; BMI 33.7±5.9 kg/m2; hemoglobin A1c 7.2%; frailty score 1.1±1.0 kg/m2. Thirteen (65%) are pre-frail, 6 (30%) are non-frail, and 1 (5%) is frail (using Fried criteria). Their weight (lbs.) changed from session 1 (210.2±42.5) to session 6 (196.8±44.2). Ten participants wore Fitbit every day between sessions, averaged at 92±12%. The preliminary evaluation showed the feasibility of using Fitbit to promote self-monitoring adherence in a behavioral lifestyle intervention and a positive trend for weight loss. Evaluating intervention effect on frailty at 6 months will provide us further insights.
Home-Based Exercise Program With Telephone Coaching: A Feasibility Study
Authors: Gulley Emma , Verghese Joe , Ayers Emmeline , Verghese Tanya , Ambrose Anne Felicia 
Published: December 2020

Abstract
Exercise is crucial to maintain mobility, reduce falls and delay functional decline in older adults, but effective implementation strategies are lacking. Self-directed home-based exercise therapy is recommended by clinicians to overcome barriers such as cost, travel and availability. However, non-adherence is a major challenge due to lack of motivation, real time feedback or social support. To overcome these barriers, we conducted a feasibility study to evaluate a home-based exercise program with telephone coaching to improve mobility in frail older adults. Four non-demented, frail community-dwelling older adults were taught one of two exercise routines at our research center. The first involved complex exercises with internal and external cueing techniques that have been associated with neuroplasticity in previous studies (N=3). The second was a lesser cognitively demanding control program that included aerobic, balance and strengthening exercises (N=1). One week later, the participants were asked to repeat the exercises in their own home. The research assistant coached the patient over the telephone. A board-certified physiatrist was present during the home session to monitor adherence and fidelity to the protocol as well as address safety. The study produced qualitative findings regarding recruitment strategies, exercise feasibility, and other logistical issues relating to participant understanding, safety, and monitoring. Based on direct observation of participants at home, safety assessment protocols, instructions, and exercises were all refined. Building on this data, we plan to design a clinical trial to evaluate the impact of complex exercises designed to promote neuroplasticity and reduce cognitive and motoric decline in older adults.
Physical Activity, Diabetes, and Heart Conditions Among Native Hawaiian and Other Pacific Islander Older Adults
Authors: Lee Yeonjung (Jane) , Terada Tyran 
Published: December 2020

Abstract
The Native Hawaiian and Other Pacific Islander (NHOPI) older adult population remains understudied and are disproportionately affected by diabetes and heart conditions. Research has shown that participating in physical activity is a protective factor for many of the health conditions experienced by older adults. Yet, the link between physical activity, diabetes, and heart conditions among the NHOPI older adult population is limited. The purpose of this study is to identify the characteristics of NHOPI older adults and to explore the association between physical activity levels and diabetes/heart conditions. Methods and findings Using data from the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS), which is considered to have a representative sample of NHOPI, the study explores the associations between physical activity and diabetes/heart conditions. A total of 1,045 older adults ages 50 years and older were included for analyses. Weighted multivariate analyses with multiple imputation techniques were used. The NHPI NHIS is the first federal survey focusing on the NHOPI population of the United States with rich information on health. Results and Implications Those with who were engaged in a sufficient physical activity had lower odds of having diabetes or heart conditions than their counterparts without physical activity while controlling for other sociodemographic characteristics. Findings highlight the importance of physical activity promotion intervention in preventing cardiovascular disease. Research and practice addressing health disparities and cardiovascular conditions should leverage efforts to provide culturally relevant physical activity types and resources to NHOPI older adults.
Companionship With Family, Friends, and Neighbors in Later Life
Authors: Sugawara Ikuko , Takayama Midori , Ishioka Yoshiko 
Published: December 2020

Abstract
Companionship with close others are known to have a significant positive effect on our well-being in later years of life. At the same time, it is known that the frequency of meeting and chatting with others, an indicator of companionship, declines as we age. In this study we explore the situation of companionship among older-old and oldest-old people. The focus of this study on understanding how the aging process affects the experience of companionship and how people adapt to the loss of companionship. Semi-structured, in-depth interviews with 43 people aged 75 and older living in urban communities in Kawasaki, Japan. Participants were asked about everyday interactions with close others and feelings they experienced at the time. Interviews were transcribed and analyzed qualitatively. Chatting, going out for lunch or dinner, and going shopping were examples of activities older Japanese enjoyed with close others. Almost all respondents mentioned the loss of their old friends and siblings. They also mentioned that the decline in their physical and cognitive health, as well as that of their companions hindered shared activities they used to enjoy. They cherished positive interactions with others, although the frequency declined. Some respondents intentionally made new companions in the physical proximity, but it was hard to compensate for the loss of old companions with new one. These findings suggest that the value of companionship remains or even increase as we age. It would be important to identify environmental or social factors that may prevent the loss of companionship among older adults.