bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social Participation Across Midlife and Later Life: Evidence From the Silent Generation
Authors: Vogelsang Eric 
Published: December 2020

Abstract
Despite the well-established benefits of social participation for individuals and communities, little is known about how it varies throughout the life course. Drawing upon data collected between 1957 and 2011 by the Wisconsin Longitudinal Study (22,023 observations from a cohort of 6,627), this study provides four valuable results. One, I find evidence of five distinct social participation trajectories between the ages of 35 and 71; the majority of which demonstrate social disengagement over time. Two, these participation declines are primarily attributable to changes in meeting friends and group exercise activity. Three, the most pronounced activity differences separating those in more favorable and unfavorable participation trajectories are cultural event attendance and voluntary group membership. Lastly, I identify particular high school activities that are associated with social participation decades later. In total, these results highlight heterogeneity among different types of social activities, and underscore the possible consequences of membership decisions made in early adulthood.
Feasibility and Acceptability of App-Based Mindfulness-Meditation Training for Older Adults
Authors: Mahlo Leeann , Windsor Tim 
Published: December 2020

Abstract
Few studies have focused on the utility of mindfulness-meditation for well-being in older adults. This study aimed to investigate the feasibility and acceptability of an app-based mindfulness-meditation program for community-based older adults. A convenience sample of 46 participants aged between 63 and 81 (M = 70.85, SD = 4.70) was recruited from the community. Participants were invited to engage with a 30-day app-based mindfulness-meditation program for 10-minutes daily on their smartphones. Each meditation session comprised focusing on the breath, mentally scanning the body, monitoring the mind’s activity, and cultivating a nonjudgmental attitude toward experience. Participants completed psychosocial questionnaires at baseline, day 10, and day 30. On average, participants completed 25 sessions and almost 4 hours of application use across the 30-days. Results of linear mixed effects models showed significant improvements in positive affect, negative affect, and life satisfaction across the study interval, but no meaningful change in total or facet-level mindfulness or perceived stress. Furthermore, relative to high levels of smartphone efficacy, low smartphone efficacy was associated with higher perceived stress and negative affect, and less life satisfaction at baseline; and steeper improvements on these outcomes across the study interval. Results indicated that, on average, older adults found app-based mindfulness-meditation training interesting, enjoyable, valuable, and useful. The findings provide preliminary support for the feasibility and acceptability of an app-based mindfulness-meditation program with community-based older adults and demonstrate potential benefits for well-being. Furthermore, older adults’ perceptions of smartphone competency may play an important role in the outcomes of app-based programs.
Recruitment of Hard-to-Reach Older Adults in Technology-Based Mental Health Services Studies: Lessons Learned
Authors: Lai Patrick Ho Lam , Xiang Xiaoling , Sun Yihang , Himle Joseph 
Published: December 2020

Abstract
Homebound older adults are a hard-to-reach population with a high burden of depression and face substantial access barriers to mental health treatments. Internet-based psychotherapy is a promising strategy to address this persistent treatment gap, but older adults are severely underrepresented in internet-based psychotherapy trials. One challenge to advance this area of research and practice is the recruitment and retention of homebound older adults in clinical trials. Previous research has discussed the challenges of recruiting older adults in behavioral interventions and offered useful recommendations. However, recruiting homebound older adults, who face substantial mobility barriers, poses additional challenges not fully addressed in the literature. The expectation of using technology adds another layer of difficulty. In this presentation, we will discuss our group’s experiences working with community partners to recruit and retain homebound older adults for a study on technology-based mental health treatment. We partnered with home care agencies, senior apartment buildings, and Meals-on-Wheels and experimented with a few different ways to recruit study participants. Issues related to accessibility, trust, and stigma emerged as important considerations when designing recruitment strategies and materials. The discussion will be an integration of our experiences and a review of previous literature on the challenges and recommendations for recruiting older adults in mental health services research.
Relationship Status, Social Interactions, and Conversations in Late Life
Authors: Ng Yee To , Huo Meng , Zhang Shiyang , Fingerman Karen 
Published: December 2020

Abstract
Studies suggest spending more time interacting with and talking to others is associated with better well-being. Older adults with partners (e.g., married, cohabitated) may spend more time with their romantic partners and rely on them for support, whereas older adults without partners (e.g., widowed, divorced, never married) may have a greater reliance on other family members (e.g., grown children, siblings) and non-kin (e.g., friends). Yet, we know little about how older adults’ relationship status affects their time spending alone or with other social partners, and the frequency of conversation throughout the day. Adults aged 65+ (N = 313) completed an interview about their relationship status and social partners. They then reported social encounters in ecological momentary assessments every 3 hours for 5 to 6 days. Participants also wore Electronically Activated Recorders which captured snippets of their conversation throughout the day. Older adults with partners reported 85% of time was with their romantic partners. Multilevel models revealed that compared to older adults with partners, older adults without partners were more likely to spend time alone and have encounters with friends throughout the day. Older adults without partners also engaged in fewer conversations throughout the day. Further, older adults without partners talked significantly more when they encountered friends than did older adults with partners. Findings suggest that friends are important in older adults’ social networks particularly for those who do not have romantic partners. Daily contact with social partners facilitates conversations and that could have implications for emotional or cognitive health.
Volunteering and Friendship in Later Life: Does Gender Moderate the Relationship?
Authors: Lim Emily , Peng Changmin , Burr Jeffrey 
Published: December 2020

Abstract
Friendship, which is an essential part of social life and beneficial to individuals’ well-being, plays a crucial role in maintaining social connectedness in late life. Volunteering is an avenue for older adults to stay socially engaged, and also provides older adults the opportunity to meet and make new friends. A limited literature suggests that volunteering may be associated with friendship, but many studies are limited by reliance on small, non-probability samples and overly simplistic analytic approaches. The literature is also unclear with respect to how volunteering behaviors relate to specific characteristics of friendships and whether there are gender differences underlying these relationships. Using the 2014 wave of the Health and Retirement Study (N=5,306), this study investigates the association between volunteering characteristics (i.e., volunteer status and hours) and friendship characteristics (i.e., the number of close friends, friendship quality, and contact frequency) among community-dwelling older adults. We also examine whether gender moderated these relationships. Results from linear regression analyses indicate that volunteer status and the number of volunteer hours were positively associated with each dimension of friendship. Also, the positive association between volunteering at 1–99 hours, 100–199 hours, and 200 hours or more and number of close friends, friendship quality, and contact frequency were stronger for older women than for older men. Findings demonstrated that volunteering is integral in shaping late-life friendships. The differential benefits of volunteering between older men and women also suggest that volunteering might be more critical for older women’s friendships.
Home Hospice Versus Other Places of Death and Caregiver Stresses
Authors: Luth Elizabeth , Prigerson Holly 
Published: December 2020

Abstract
As of 2017, more individuals in the U.S. die at home than in any other location. Hospice care was designed to provide support for people who are dying and their families. However, dying persons may have rapidly emerging needs that home hospice does not immediately meet, thereby, exposing family members to be “first responders.” Thus, home death may result in distress and burden for dying individuals’ family members, even when hospice is involved. This study uses multivariable regression analysis to explore the relationship between place of death and stressful end-of-life experiences in a sample of 185 patients with advanced cancer. We also analyze which end-of-life experiences are associated with death location. Compared to home hospice death, we found dying in a hospital was associated with fewer caregiver exposures to, and reports of fearfulness and helplessness in response to, stressful end-of-life events. Compared to home hospice death, hospital death was associated with decreased frequency of choking, falls, confusion/delirium, and feeling the patient has had enough. It was also associated with less fearfulness about choking and falls and less hopelessness about falls, the patient having enough, and thinking the patient was dead. Our results suggest home death with hospice care, often involves undesirable experiences that result in more caregiver fear and helplessness than dying in a hospital without hospice care. Research is needed to understand how to best support family members through stressful end-of-life experiences even when supported by home hospice services.
Religiosity, Cognition, and Engagement in Advance Care Planning Among Older Adults
Authors: Chunga Richard , Stokes Jeffrey , Dugan Beth 
Published: December 2020

Abstract
Advance care planning (ACP) is an important process of discussion and documentation that may help older adults receive the end-of-life care they prefer. Although existing literature predominantly finds greater self-reported religiosity to decrease the rates of ACP, a clear consensus is not yet evident. Data from 3,182 adults aged 55 and older participating in the 2012 wave of the Health and Retirement Study were used to investigate this association and examine the moderating role of cognition. Participants reporting at least one of two ACP behaviors (written instructions and assigning a health care proxy) were categorized as formal planning only, engaging in only informal discussions was categorized as informal planning, and those who completed both or none were categorized accordingly. Cognition was measured using self-reported memory change over the last two years and with objective cognitive testing scores. Using multinomial logistic regression, three forms of ACP behaviors were regressed on a religiosity/spirituality scale, the two cognition measures, and demographic and psychosocial covariates. Greater religiosity was associated with a lower likelihood of engaging in both plans compared to none (OR=0.91, 95%CI=0.84-0.97), however this effect was no longer significant with the inclusion of race. Higher cognitive scores were associated with greater odds of engaging in informal-only (OR=1.07, 95%CI=1.04-1.10) and both plans (OR=1.04, 95%CI=1.01-1.06); subjective memory change was not associated with ACP. Neither cognitive measure significantly moderated the negative association of religiosity on ACP, suggesting that the awareness of worsening memory does not undermine the tendency to avoid planning among the highly religious.
Systematic Review of Grief Interventions
Authors: Ricken Nicole , Kim Alice , Khaled Mona , Corner Geoff , Beam Christopher 
Published: December 2020

Abstract
Grief interventions address pain and suffering in response to the death of a significant other. Evidence-based grief psychotherapies treat normative grief to symptoms of persistent complex bereavement disorder, the latter of which is characterized by difficulty accepting the loss and persistent yearning for the decedent. We reviewed published randomized controlled trials (RCT) of grief-focused psychotherapies to test two hypotheses. First, participants receiving grief-focused psychotherapies should demonstrate decline of grief symptoms from pre- to post-intervention. Second, participants receiving grief-focused psychotherapies should demonstrate lower grief symptoms post-intervention than participants receiving control treatments. Published studies were identified using academic search engines (Web of Science, PsycInfo, and Google Scholar) and by reviewing reference sections of published RCTs. Twelve published RCTs were identified. Effect sizes (Hodges’ g) and confidence intervals were calculated. Results support our first hypothesis and partially support our second hypothesis. Grief-related symptoms declined from pre- to post-intervention (g ranged from -0.39 to -2.51), with all studies reporting statistically significant effects. When comparing post-intervention differences in grief-focused psychotherapies versus control groups, effects were more variable (g ranged from -2.40 to 3.02), with seven studies demonstrating greater improvement among grief intervention recipients than control treatment recipients. Grief interventions appear to be effective for reducing grief-related symptoms pre- to post-intervention. However, they were only more effective than control treatments in just over half of published RCTs. While grief interventions were more effective, point estimate ranges are wide, suggesting that treatment effectiveness probably depends on factors other than the treatments themselves.
Concept Analysis of Aging With Disability in Adults
Authors: Park Seeun 
Published: December 2020

Abstract
People with long-standing physical disabilities are living longer than at any time in history, owing to advancements in medical science, rehabilitation, and social systems. Approximately 12–15 million people in the U.S. are aging with long-standing disabilities that were acquired before age 40 years. This population is forecast to grow, resulting in a subset within the aging community. More research is needed to increase understanding of successful aging with disabilities, the pathways of aging with disability, and unique characteristics of the aging process. The purpose was to define and clarify the conceptual meaning of aging with disability, identify its attributes, antecedents, and consequences, and explore the significance and implications of the concept in nursing. Rodgers’ evolutionary method of concept analysis was used. Three databases, CINAHL, PubMed, and PsycINFO were used to retrieve literature. Inclusion criteria were publication year from 2001 to 2019, peer-reviewed academic journals, and English-language. Exclusion criteria included other than physical disability such as developmental, learning, or intellectual disability, focus on the aging process of people without disability, the main topic on the perspectives of caregivers or health care providers. Thirty-five articles met inclusion criteria. The analysis identified three antecedents (e.g., contributing barriers), three attributes (e.g., premature aging), and three consequences (e.g., accommodation needs). An understanding of the antecedents, attributes, and consequences of aging with disabilities will enhance quality of care including effective prevention and communication. Findings will guide researchers in developing a framework or theory to increase understanding of aging in individuals who acquired disability early in life.
Factors Associated With Perceived Stress Among Dementia Caregivers With Poor Sleep
Authors: Song Yeonsu , Papazyan Anna , Kelly Monica , Choi Sarah , Fung Constance , McCurry Susan , Alessi Cathy , Martin Jennifer 
Published: December 2020

Abstract
Poor sleep among family caregivers of individuals with dementia is associated with higher levels of caregiver stress. Modifiable factors that increase risk of stress among caregivers with poor sleep are targets for intervention. This analysis aimed to identify factors associated with greater caregiver stress among caregivers with poor sleep. Baseline data from an ongoing trial of a dyadic sleep intervention program for individuals with dementia and their caregivers with poor sleep quality (defined by Pittsburgh Sleep Quality Index total score &gt; 5; N=21 dyads; mean age 70.8± 11.1 for caregivers, 80.5± 8.3 for care-recipients) were analyzed. Caregiving factors included Zarit Burden Index (ZBI) and SF-12 Short Form Health Survey (SF-12v2). Care-recipient factors included Mini-Mental State Examination (MMSE) and Revised Memory and Behavior Problems Checklist (RMBPC). Stress was measured with the Perceived Stress Scale (PSS). Analyses included Pearson correlations and t-tests. Caring for multiple care-recipients (n=5: 24.8±2.7) was associated with higher (worse) PSS scores than caring for one care-recipient only (n=16: 19.6±3.7, p=0.011). Caregivers with higher PSS also had a significantly higher ZBI score (r=0.53, p=0.015), higher distress related to care-recipient behaviors on the RMBPC (r=0.57, p=0.009) and worse mental health on the SF-12v2 (r= -0.47, p=0.037). PSS was not associated with care-recipient MMSE. These findings suggest that caregivers with poor sleep who care for multiple care-recipients may be at higher risk of stress. This work also identified potential targets (e.g., caregiver burden, mental health, distress related to care-recipient behavior) for reducing stress in this population.
Personality and Sleep Health: Do Lifestyle Habits Play a Role?
Authors: Deason Karley , Mu Christina , Lee Soomi 
Published: December 2020

Abstract
The health behavior model proposes that healthy/unhealthy behaviors may play a role in the relationship between personality and health. Previous research shows that personality traits are linked to sleep, however, few studies have considered the moderating role of unhealthy behaviors in the personality—sleep relationship. The current study investigated the associations between specific personality traits and sleep and whether the associations were moderated by unhealthy behaviors. Participants were 61 oncology nurses (Mage=35.39, SDage=11.73). They responded to a background survey that assessed the big five personality traits and engagement in unhealthy behaviors (i.e., exercise, smoking, fast food and alcohol consumption). For two weeks, ecological momentary assessments captured daily variability in sleep (i.e., quality, sufficiency, onset latency, insomnia, duration). A series of multilevel models was used. After controlling for sociodemographics and work shift, higher conscientiousness was associated with greater sleep sufficiency (B=0.31, p&lt;.05) and lower odds of having insomnia symptoms (OR=0.24, p&lt;.05). Moreover, higher agreeableness was associated with longer sleep duration (B= 0.51, p&lt;.05) and lower odds of insomnia symptoms (OR=0.29, p&lt;.05). Other personality domains were not associated with sleep, however, extraversion interacted with unhealthy behaviors to be associated with sleep. Those who were more extraverted reported lower odds of insomnia and better sleep sufficiency; these associations were significant only for those with less unhealthy behaviors. Findings suggest that conscientiousness and agreeableness were associated with sleep health. The interaction between extraversion and unhealthy behaviors suggests that reducing unhealthy behaviors may be beneficial to improving sleep in individuals with certain personality traits.
Rural-Urban Differences in Survival and Nursing Home Use Among Medicare Beneficiaries Diagnosed With Dementia
Authors: Rahman Momotazur , White Elizabeth , Thomas Kali , Jutkowitz Eric 
Published: December 2020

Abstract
There is poor understanding as to how survival and healthcare utilization vary among older adults living with Alzheimer’s disease and related dementias (ADRD) in rural versus urban areas of the United States. This prospective cohort study used 2008-2015 Medicare claims linked with nursing home and home health assessment data to describe differences in survival and healthcare utilization in the six years following a new ADRD diagnosis between rural and urban populations. The sample consisted of 1,203,897 Medicare fee-for-service beneficiaries who were diagnosed with ADRD in 2008 or 2009. 77% (n=921,853) resided in metropolitan counties, 14% (n=162,857) in micropolitan counties, and 10% (n=119,187) in rural counties. Rural residents were on average about six months younger than metropolitan residents at diagnosis. Metropolitan residents survived a mean of 1211 days after diagnosis. Adjusting for individual characteristics, beneficiaries in rural and micropolitan counties survived 29.2 fewer days (95% CI -34.0,-24.4) and 31.9 fewer days (95% CI -36.1,-27.7) than metropolitan residents, respectively. Compared to metropolitan residents, rural residents spent 59.8 more days (95% CI 56.7, 63.0) in nursing homes. We found similar patterns in nursing home use for micropolitan vs. metropolitan residents, though the magnitude of the differences was smaller. Differences between groups became more pronounced the greater the time from diagnosis. These findings demonstrate that urban-dwelling older adults with ADRD are significantly more likely to remain in the community and less likely to use nursing homes than individuals in rural and micropolitan counties, particularly in later disease stages.
Creative Cities Creating Connections: Fostering Cross-Age Interaction Through Leisure
Authors: Douglas Rachel , Barrett Anne 
Published: December 2020

Abstract
Older and younger people interact infrequently in most social realms – a pattern stemming from institutional, cultural, and spatial age segregation. Increasing cross-age interaction offers promise as a strategy for not only enhancing social connections but also reducing ageist attitudes. We argue that a social realm with untapped potential for creating these connections is leisure, particularly within creative cities. To explore this possibility, our study examines cross-age interactions in Key West, Florida – a leisure-oriented city that promotes creativity through its social and built environment. Using participant-observation and interview data (n=126) from 2017 to 2019, we examined leisure experiences of tourists and residents, aged 23 to 83. Findings indicate that creative cultural contexts can counter ageist attitudes by promoting cross-age interaction. Data analysis revealed three processes encouraging these shifts – promoting diversity and acceptance, enhancing older adults’ participation, and nurturing intergenerational bonds. Ongoing cross-age interactions were fostered through the island’s welcoming philosophy and encouragement of out-group acceptance and diversity. They were further fostered by the island’s wide array of leisure activities and proximity of shared spaces that enabled older adults to readily pursue leisure with younger people. Cross-age ties also were promoted by the island’s focus on family-friendly leisure experiences. Our research highlights the potential of creative cities to promote age integration, and reduce ageism, through its cultural practices within leisure spaces.