bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementation of the FL-REACH Caregiver Intervention: Translation in an Outpatient Memory Disorders Clinic
Authors: Wharton Tracy , Paulson Daniel , James Nicholas , Laird Rosemary , Campos Barbara Mendez , Shepherd Gayle 
Published: December 2020

Abstract
The REACH II intervention is the gold-standard in dementia caregiver interventions. The FL-REACH translation is a novel adaptation offered in both English and Spanish to an outpatient memory disorder clinic at an urban, Southeastern healthcare system. This pre-post feasibility trial involves 6 sessions (4 in person at the clinic and 2 by phone) with the identified caregiver and any other family who wish to attend, which may also include the person living with dementia. The program is focused on early stage post-diagnosis, and is structured around building rapport, empowering families to build support networks, and teaching skills and knowledge-based material. Twenty four of the 60-participant target sample have consented to participate in this ongoing study. Change on the Preparedness for Caregiving Scale is significant (t=3.03, p=.001, Cohen’s d=2.49). Means for the Zarit Burden 12-item scale went from 24.5 to 13.17 (t=-6.65, p=.03, Cohen’s d=3.53). Access by care recipients to dangerous objects decreased (67% to 14%). Confidence in ability to use behavioral strategies in caregiving increased from 8% at baseline to 72% at study completion. Satisfaction surveys indicate high satisfaction with all elements of the intervention. These outcomes are consistent with existing data regarding utility of the REACH framework and reflect feasibility of delivering an adapted program model in an outpatient clinic environment. A future randomized controlled trial should examine whether early intervention and training reduces utilization of emergency care over time and improves quality of life for families.
Challenging and Dismantling Ageist Attitudes, Beliefs, and Behaviors Through Intergenerational Programs
Authors: Rogers-Jarrell Tia , Meisner Brad 
Published: December 2020

Abstract
Age stereotypes are complex and multifaceted: individuals can demonstrate and embody numerous and varied positive and negative stereotypes. Therefore, solutions to combat age stereotypes must also be complex and multifaceted. Additionally, both social and physical forms of age segregation are common in our society. This causes fewer and fewer opportunities for younger and older people to interact. Intergroup Contact Theory suggests age stereotypes can be reduced through increased intergenerational contact. One way to encourage contact between younger and older populations is through intergenerational programming. However, there is a lack of literature investigating the effects of intergenerational programs on perceptions of aging. The purpose of this paper was to critically review and explore literature on intergenerational programs to understand how they influence age stereotypes and ageist attitudes. The available literature suggests that intergenerational programs involving young children (ages 4-8), adolescents (ages 11-18), or emerging adults (ages 19-26) interacting with older adults (ages 65+) can significantly reduce age stereotypes towards older adults. Additionally, older adults (ages 65+) negative beliefs and attitudes towards younger people (ages 4-26) can also be deconstructed after participation in intergenerational programs. Intergenerational programs act to break down age barriers and promote connections and understandings between generations. These programs challenge the belief that older and younger people should live and participate in spaces that are separate from one another. Providing opportunities for younger and older people to participate in intergenerational programs is one way to promote respectful relationships and enhance the quality of life and health of all generations.
Changes in Neighborhood-Level Socioeconomic Disadvantage and Older Americans’ Cognitive Functioning
Authors: Settels Jason , Leist Anja 
Published: December 2020

Abstract
Most studies of later life cognitive functioning have focused on individual-level variables. While some studies have examined neighborhood-level variables as influences upon older adults’ cognitive functioning, this scholarship has neglected to consider neighborhoods in a dynamic context. The present study helps fill this research gap by considering how changing extents of neighborhood-level socioeconomic disadvantage cause changes in older residents’ cognitive functioning. We employ waves 2 (2010-2011) and 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP) as our source of individual-level variables and the American Community Survey as our source of neighborhood-level variables. Our analytical sample includes 1,989 respondents who participated in both waves and were 50 to 90 years in age at wave 2 of the NSHAP. Through structural equation modelling, we find that rising neighborhood-level socioeconomic disadvantage significantly decreases older residents’ cognitive functioning, both without and after controlling for baseline neighborhood-level socioeconomic disadvantage and cognitive functioning. Furthermore, approximately 7.2% of this effect is mediated through decreases in the sizes of networks of close confidants, and roughly 8.5% of this effect occurs through increased depressive symptoms. Our findings suggest that older adults’ cognitive decline can be slowed down or prevented through improvements in their living environments. In particular, policies and programs that improve living spaces while also facilitating older residents’ development of close and supportive confidant ties are likely to be particularly effective. Our study encourages further research on how neighborhood dynamics affect older persons’ cognitive functioning.
Addressing Under-Detection in Minimum Data Set Behavioral Measures Using NIH Stage III/IV Embedded Trial Design
Authors: McCreedy Ellen , Gutman Roee , Rudolph James , Baier Rosa , Thomas Kali , Dvorchak Faye , Ogarek Jessica , Mor Vincent 
Published: December 2020

Abstract
Using the National Institutes of Health (NIH) Stage Model framework, we are conducting a Stage III/IV embedded trial to evaluate the effects of personalized music on agitated behaviors in nursing home (NH) residents with dementia under two research conditions--less pragmatic, more researcher involvement (Stage III) and more pragmatic, less researcher involvement (Stage IV). We are conducting a three-year trial in 81 NHs, with 27 NHs receiving the intervention per year. Behavior frequency is assessed via resident MDS assessments, staff interviews, and direct observations of residents. During the first year, researchers interview NH staff and observe residents with dementia in 54 randomly selected NHs (27 treatment and 27 control, parallel design). MDS assessments are available for all 81 NHs throughout the three-year study (stepped-wedge design). In the 54 NHs in the parallel design, we compare staff interview and NH-conducted resident assessments and, using multiple imputation methods, we impute staff interview data for eligible residents of all 81 NHs in order to estimate the effect of the intervention under the step-wedge design. There are four key features of this trial: 1) combination of parallel and stepped-wedge designs; 2) equilibrating researcher-collected behavior data to NH-collected behavior data to impute research-collected behavior data for some residents; and 3) simulated resident selection process in control facilities to improve comparisons of effects across treatment groups. This design has the potential to shorten the research timeline by iteratively assessing real-world efficacy and large-scale effectiveness. Our design will inform pragmatic testing of other interventions with limited efficacy evidence.
Functional Neural Underpinnings of Increased Falls Risk
Authors: Ai Meishan , Hsu Chun-Liang , Liu-Ambrose Teresa 
Published: December 2020

Abstract
Impaired cognition, especially in the domain of executive functions, is a major risk factor for falls in older adults. However, the underlying neural mechanism of the association between cognitive function and falls risk remains unclear. The current study compared the performance on mobility and cognitive assessments, and brain activation under Stroop task between fallers (&gt;=2 falls in the past year) and non-fallers (0 or 1 fall in the past year). We found that during the incongruent condition of Stroop task, higher activation in precuneous, frontal and temporal areas was observed in fallers, while they showed comparable task performance as non-fallers. In addition, the contrast between congruent and incongruent conditions showed fallers exhibited increased activation in middle frontal region (z&gt;1.7, P&lt;0.05). Further, through mediation analysis, our data revealed that brain activation in temporal and frontal-paracingulate regions mediated the relationship between Montreal Cognitive Assessment and number of falls (confidence interval = 95%), after controlling for age and sex. Overall, our findings suggested that lower neural efficiency may be an underlying mechanism by which cognitive function is associated with falls risk.
Loss of ARNT Limits Improvement in Physiological Performance Following Aerobic Exercise in Aging
Authors: Endo Yori , Zhang Yuteng , Li Bin , MacArthur Michael , Sinha Indranil 
Published: December 2020

Abstract
Hypoxia signaling is essential for angiogenesis and metabolic regulation during exercise. Our previous study has demonstrated an age-related loss of ARNT resulting in limited muscle regeneration. To explore the role of hypoxia signaling in physiological performance in relation to aging, we generated a mouse model with skeletal muscle-specific knockout of ARNT (ARNT mKO). ARNT mKO and ARNT WT mice were subjected to a sedentary activity or treadmill running exercise regime at an increasing speed of 8-12 m/min for 40 minutes, three times weekly over the course of 8 weeks. ARNT levels was 3-fold lower in old mice compared to young. The exercised WT mice exhibited 52% greater increase over the sedentary group in exercise endurance as measured by the maximum running distance (490.92±154.28 vs 237.76±135.19m, p＜0.01). In contrast, ARNT mKO mice did not benefit from exercise (231.85±198.61 vs 167.27±136.56m, p=0.41). The maximum running speed was severely restricted in the trained ARNT mKO mice versus WT (16±1.63 m/min vs 26.67±2.45 m/min, p＜0.001). Cross-sectional area of myofibers increased significantly following exercise in WT mice (2270 vs 2960 □m2, p=0,015) indicating muscle hypertrophic response, while no change was observed in the ARNT mKO group (2101 vs 2378□m2, p=0,21). Further, exercise increased femoral artery blood flow by 41% in ARNT WT mice, but not in ARNT mKO mice (898.96±52.33 vs 802.86±48.43, p=0.20). These data suggest that ARNT is essential for physiological response to exercise
P300 Amplitude in Relation to Age, Neuropsychological Performance, and Genetic Risk for Alzheimer’s Disease
Authors: Sheffler Julia , Hajcak Greg , Vied Cynthia , Meynadasy Melissa , Mach Russell 
Published: December 2020

Abstract
The P300 event-related potential (ERP) is associated with aging and risk for Alzhiemer’s disease (AD) and mild cognitive impairment (MCI). Our study sought to replicate previous findings regarding P300 amplitude, age, and neuropsychological outcomes. We also sought to fill gaps in the literature by assessing associations in a primarily healthy sample of older adults (aged 60-75) and through use of comprehensive assessment procedures for ERPs, neuropsychological outcomes, and a genetic risk score (i.e., BDNF, APOE, and PSEN1 mutations). Approximately 25% of our total sample (N=72) met criteria for possible or probable mild cognitive impairment. We assessed whether the P300 elicited by auditory (oddball) and visual (go/nogo) paradigms were associated with performance across neuropsychological tests commonly used in clinical settings, which include cognitive domains of semantic, episodic, and visual memory, executive functioning, language (confrontation naming), abstract reasoning (visual and verbal), and attention. Further, we examined associations between P300 and multiple genetic risks for AD. Our findings demonstrated differences in outcomes between audio and visual tasks of P300, with visual tasks tending to show stronger relationships with neuropsychological and genetic factors. Neuropsychological measures of memory and executive functioning were most closely related to visual P300 amplitude. P300 amplitude was also significantly associated with a genetic risk score for AD, despite the sample generally performing in the normal range on most neuropsychological tasks. Overall, our study has implications for use of the P300 for early detection of risk for AD and for improving our understanding of the P300 as a cognitive biomarker.
Canadian Consensus Conference on Psychological and Non-Pharmacological Interventions for Dementia
Authors: Sheets Debra , Clare Linda , Sivananthan Saskia , Vedel Isabelle , Liu-Ambrose Teresa , Brodaty Henry , Mann Jim , McAiney Carrie 
Published: December 2020

Abstract
Psychological and non-pharmacological interventions that could have a positive effect on outcomes important to persons living with dementia are essential to identify given the the limited efficacy of dementia medications and the diverse needs of persons living. In 2019, for the first time the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD) created a working group to develop recommendations related to a broad range of psychosocial and non-pharmacological interventions exist, typically aimed at improving cognition, symptoms, or well-being, as well as improving caregiver well-being and coping. The recommendations, primarily intended for primary care physicians, may also allow clinicians, organizations, and communities and help to better meet the needs of people living with dementia and their caregivers. A group of 11 experts, including persons living with dementia and informal caregivers, as well as clinicians and researchers from various organizations both nationally and internationally were invited to participate. A rapid review of meta-analyses and literature reviews on psychological and non-pharmacological interventions was conducted. The synthesized results were submitted for a consensus building approach using a Delphi method, involving a panel of more than 50 Canadian participants. Recommendations with a positive vote of 80% or more were considered to have reached consensus. All proposed recommendations reached consensus using the Delphi process. Details of the recommendations are presented. Five recommendations are made: group or individual physical exercise, group cognitive stimulation therapy, psychoeducational interventions for caregivers, dementia friendly organizations/communities, and case management.
Nurse Visits, Site of Care, and Hospitalization Among Hospice Patients With Dementia
Authors: Luth Elizabeth , Russell David , Prigerson Holly , Bowles Kathryn , Ryvicker Miriam 
Published: December 2020

Abstract
Persons with dementia comprise up to 50% of hospice patients and face an increased risk of burdensome, disruptive, and costly discharge from hospice due to hospitalization. The relationship between timing, dose and site of hospice care provided, all modifiable factors, and risk of hospitalization is poorly understood. We use a retrospective cohort analysis of 2,692 electronic health records of hospice patients with dementia who received care from a large hospice agency in New York City between 2013-2017 to determine the relationship between hospice service delivery (e.g., number and timing of nurse visits, home vs. facility-based) and risk of hospitalization (vs death). We control for demographic and clinical characteristics of patients. 9.36% of patients with dementia were hospitalized. Hospice service delivery factors were significantly associated with risk of hospitalization. Each additional nurse visit was associated with a 5% decrease in risk of hospitalization (AOR: 0.95, 95% CI: 0.92-0.98). Each additional day between last nurse visit and discharge was associated with a 7% increase in risk of hospitalization (AOR: 1.07, 95% CI: 1.04-1.11). Home hospice was associated with 97% higher odds of hospitalization (AOR: 1.97, 95% CI: 1.19-2.09). Hospice patients with dementia who receive services at home, receive fewer nursing visits, and have increased time between nursing visits are at increased risk for hospitalization. Research is needed to determine if increasing the number and timing of nursing visits can reduce risk of hospitalization in this population.
Implementing Changing Talk Online Training: A Pragmatic Trial to Improve Dementia Care Communication in NHs
Authors: Coleman Carissa , Williams Kristine , Perkhounkova Yelena , Hein Maria , Beachy Tim , Shaw Clarissa 
Published: December 2020

Abstract
The Changing Talk (CHAT) training effectively reduces elderspeak and subsequent behavioral challenges in residents with dementia in nursing homes. The Changing Talk: Online (CHATO) training was developed to increase staff access to education using a new online format. A pilot test was conducted to confirm the feasibility and effects of CHATO on training outcomes. In the initial nursing home, twenty-three direct care staff members in a small Midwestern nursing home enrolled in the course including 12 CNAs, 4 RNs, 2 LPNs, 2 CMAs, 1 Dietary Aide, 1 Social Worker, and 1 in Transportation. Two forms of a 13-item scenario-based test to measure knowledge gain were developed and tested. Of the 23 staff, 18 (78%) completed the post-test and 83% of completers achieved a post-test score of 70% or greater. Scores on the test improved from M=69% correct (SD=11.7) at pretest to 86% correct (SD=10.6) on posttest demonstrating knowledge gain (p=.024). Participants improved their recognition of elderspeak (21%) and person-centered communication (24%) in a video vignette and 86% self-reported improvement in their abilities to recognize ineffective communication and to apply more effective communication strategies in practice. A randomized control trial enrolled staff (N=187) in eight additional nursing homes. Preliminary results confirm improvements in test scores from M=70.6% correct (SD=15.8) at pretest to 77.2% correct (SD=14.1) on posttest and increased elderspeak recognition (p=.004). Relationships between nursing home characteristics, implementation strategies, and culture change measured by the Artifacts of Culture Change Tool and their relationship to communication outcomes will be presented.
Improving Dementia Capability Among Law Enforcement: Evaluation of Dementia Education Training in San Diego County
Authors: Powers Sara , Orsulic-Jeras Silvia , Empeno Jessica , Lagasca Regina , Abrams Amy , Barker Sarina , McDaniel Rebecca , Hanna Marcie 
Published: December 2020

Abstract
As the number of Alzheimer’s disease and related dementia (ADRD) cases grow, first responders will have more frequent interactions with individuals living with ADRD within the community. Recognizing the lack of dementia training among first responders and through the support of an Administration for Community Living grant, Alzheimer’s San Diego partnered with local law enforcement to support and educate first responders on local ADRD resources, referral systems for families and caregivers, and disease-related information, in hopes of building stronger dementia capable services within San Diego County. To date, 249 first responders have participated in dementia education trainings and completed the related evaluations that aimed to understand their experiences with and knowledge of dementia. On average, participants were 44.74 years old (SD=18.45) and served 8.72 years (SD=7.99) on their job. Majority were male (n=189), had some college education (n=94), and identified as White/Caucasian (n=105) or Hispanic/Latino (n=92). Although objective knowledge (as measured by a shortened version of the Alzheimer’s Disease Knowledge Scale [ADKS]) did not significantly differ from pre- to post-test, participants’ perceived subjective knowledge about dementia significantly increased from pre-test (M=1.17, SD=0.77) to post-test (M=1.89, SD=0.66); t(141)=10.56, p&lt;.001. Encouragingly, participants who reported receiving prior training on dementia had significantly higher ADKS scores at both pre- and post-test compared to those who did not have prior training. Results highlight the need for ongoing dementia-related training for law enforcement and the importance of evaluation requirements. Discussion will focus on policy implications and how communities can support dementia capability among first responders.
Initial Results From an Everyday Memory and Metacognitive Intervention for Older Adults
Authors: Pearman Ann , Hertzog Christopher , Lustig Emily , Hughes MacKenzie 
Published: December 2020

Abstract
We report results from a new intervention study implementing an Everyday Memory and Metacognitive Intervention (EMMI). This intervention trains older adults on self-regulatory procedures for achieving everyday life goals by implementing a metacognitive perspective where participants learn mindful control over life tasks that place demands on planning and memory (e.g., learning new names and managing prospective memory demands). Fifty-three participants, age range 65 to 83, were assigned to either the EMMI treatment group (n = 32, mean age = 70.13, SD = 3.2) or a waitlist control group (n = 21, mean age = 71.76, SD = 4.7). Individuals with probable memory impairments, as indexed by low MOCA scores, were excluded from the study. Outcomes included daily diary reports of everyday memory errors and a prospective memory telephone task. EMMI participants had fewer reported memory errors per day (M = 0.42) than controls (M = 0.64), one-tailed p = .03. EMMI participants also performed better than controls on the telephone task outcome variables: total number of phone calls completed and mean absolute deviation of call times from scheduled times for successfully completed calls (ps&lt;.001). Subjective outcomes, including personal memory beliefs, life satisfaction, and perceived stress, showed greater pretest-posttest improvement in the EMMI group compared to the control group. This study is a successful initial demonstration of the efficacy of our intervention for improving everyday cognition in older adults and highlights the possibility of improving success in memory-demanding everyday life contexts, thereby contributing to resilient aging in an older population.