bluuebunny/crossref_metadata_2025_split huggingface dataset:
Daily Emotional Well-Being and Cardiometabolic Syndrome in Adulthood: The Role of Sleep Deficiency
Authors: Chai Hye Won , Joo Susanna , Lee Sun Ah , Almeida David 
Published: December 2020

Abstract
Previous studies note daily emotional well-being and sleep duration as significant correlates of cardiovascular health including cardiometabolic syndrome. However, not much is known about the interactive effects of emotional well-being and sleep. Expanding upon current research, this study examined whether sleep deficiency, defined as having on average &lt;7 hours of sleep a day, moderated the associations between daily emotional well-being and cardiometabolic syndrome. Data was drawn from the Midlife in the United States Biomarker Project and the National Study of Daily Experiences (N = 1,163; Mean age = 53.3). Results showed significant interaction effects- higher negative affect was associated with worse cardiometabolic syndrome and higher positive affect was associated with better cardiometabolic syndrome only among those with deficient sleep. Such association was stronger for older adults compared to young adults. These findings suggest that individuals with insufficient sleep are more affected by health-related benefits and costs of daily emotional experiences.
Why Biopsychosocial Determinants Matter: Is Age Just a Number?
Authors: Steptoe Andrew 
Published: December 2020

Abstract
Aging is a physiological and dynamic process enduring time, which is influenced by various underlying mechanisms occurring within the biological, psychological and social spheres. We investigated biopsychosocial determinants of subsequent health and mortality in the English Longitudinal Study of Ageing (ELSA) (Steptoe). Cognitive impairment and dementia, particularly Alzheimer’s disease (AD), represent significant challenges to individuals, families and healthcare. We found an indication of socioeconomic differentials influencing the mediating biological and psychological pathways in relation to subsequent cognitive health, which was ascertained with a latent g factor across various cognitive domains in the Harmonised Cognitive Assessment Protocol in ELSA (Cadar). We also identified an interplay between socioeconomic markers and genetic factors influencing the time of dementia and Alzheimer’s disease (AD) diagnosis in individuals from the English Longitudinal Study of Ageing, particularly in those with a polygenetic predisposition to AD (Ajnakina). Within the same cohort, we found that participants who transitioned into a single household due to divorce or bereavement had a higher risk of mortality (Abell). The adverse health outcomes associated with loneliness are well documented, but less is known in terms of hospitalization and accessing health care. In the Healthy Ageing in Scotland (HAGIS), we found an increased hospitalization for older individuals reporting higher loneliness (Douglas); and various loneliness patterns in relation to age, gender, marital status and socioeconomic status in participants from first wave of the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) (Neville). Our findings highlight the imperative need for policy interventions and tailored strategies.
Overview of the English Longitudinal Study of Ageing
Authors: Steptoe Andrew 
Published: December 2020

Abstract
The English Longitudinal Study of Ageing (ELSA) is a unique and rich resource of information on the health, social, wellbeing and economic circumstances of the English population aged 50 and older. The current sample contains data from up to nine waves of data collection covering a period of seventeen years (2002-2019). The multidisciplinary and longitudinal nature of the data allows the examination of complex relationships and causal processes. The survey data are designed to investigate a broad set of topics to help understand the ageing process. These include predictors of well-being, health trajectories, disability and healthy life expectancy, the determinants of economic position in older age, the links between socioeconomic status, physical health and functioning, cognition and mental health, the nature and timing of retirement and post-retirement labor market activity, household and family structure, social networks and social supports; patterns, determinants and consequences of social, civic and cultural participation.
Breaking the Silence Associated With Death and Dying: New Directions in End-of-Life Research
Authors: Stemen Sara , Lichtenberg Peter 
Published: December 2020

Abstract
Conversations surrounding end-of-life care and bereavement continue to remain relatively silenced within gerontology and the general population. The purpose of this symposium is to break the silence associated with death, dying, and bereavement by sharing emerging perspectives and interventions related to end-of-life experiences. This symposium features four presentations that examine bereavement and end-of-life care from the viewpoints of individuals, families, practitioners, and researchers. Carr provides a comprehensive overview of the current state of research regarding death, dying, and bereavement - mapping out how current technological and demographic shifts have changed the nature of end-of-life experiences. Stemen presents an illustrative case study that examines how cause of death (e.g., chronic illness, suicide) shapes grief and subsequent social relationships for surviving individuals. Utz explores conversations that occur between families and professionals embedded within the hospice system, showcasing reactions from families who experienced live discharge from hospice services. Last, Ogle sheds light on the roles taken on by state tested nursing assistants (STNAs) in end-of-life care as well as the training and education they receive and need on end-of-life issues. Lichtenberg, our discussant, will tie these emerging perspectives together in order to initiate an important dialogue with attendees regarding the actions needed to break the silence associated with death and dying so that we can better serve individuals, families, and professionals.
Social Support and Depressive Outcomes in Older Adults: An Analysis of the Health and Retirement Study
Authors: Tucker Julia , Bishop Nicholas 
Published: December 2020

Abstract
Given population aging and impact of both spousal and social support on the health of older adults, the protective role of social support amongst recently bereaved older adults represents an important area of research. The aim of this study is to identify the relationship between recent widowhood and change in depressive symptoms in older adults, and how social support moderates this association. Utilizing observations from the nationally representative Health and Retirement Study, the analytic sample consisted of 2,890 adults age 50 and over who were partnered or married in 2012. Depression was measured using the Center for Epidemiological Studies Depression scale short form (CESD-8). Positive social support was measured as perceived social support from family, friends, and children. Widowhood was a dichotomous measure indicating mortality of spouse between 2012 and 2014. Autoregressive multiple regression was used to determine if widowhood was associated with change in depression from 2012-2104 and whether positive social support moderated this relationship. Widowhood was associated with an increase in depressive symptoms from 2012-2014 (b=0.967, SE=0.145, p &lt;.001) and social support was negatively associated with change in depression (b=-0.021, SE=0.004, p &lt;.001). Social support appeared to moderate the association between widowhood and change in depression (b=0.068, SE=0.026, p =.010), though widowed older adults with higher social support appear to have more rapid increase in depression than those with lower social support. These preliminary findings and implications for supporting bereaved older adults will be discussed.
Association Between Self-Reported Health and Dementia Symptoms Among People With Dementia and Their Caregivers
Authors: Jutkowitz Eric , Mendez Mauricio Lopez , Iskandar Rowan , Pizzi Laura 
Published: December 2020

Abstract
People living with dementia (PwD) can often reliably self-report their health; yet, there are limited data on their and their primary caregiver’s self-reported overall health (excellent, very good, good, fair, and poor). We used data from the Aging, Demographics, and Memory Study (2001-2009) to quantify the association between PwD’s cognitive impairment (Mini-mental State Exam), physical limitations (scale [0-10] of activities of daily living), and behaviors (scale [0-12] of behavioral symptoms on the Neuropsychiatric Inventory Questionnaire) and self-reported health. We estimated two ordered logistic regressions estimating: 1) PwD’s self-reported health (analyzed n=308); 2) primary caregiver’s self-reported health (analyzed n=135; 173 PwD did not have primary caregiver in the survey). We controlled for the PwD demographics, chronic conditions, and if they lived in the community. The regression estimating caregiver’s self-reported health also controlled for the caregiver’s relationship to the PwD, and whether the caregiver lived with the PwD. PwD’s self-reported health was lower (4% excellent; 16% very good; 22% good; 30% fair; 30% poor) than caregivers (14% excellent; 27% very good; 32% good; 23% fair; 4% poor). For PwD, one-additional physical limitation, but not cognition or behavior, was associated with 1.15 (95%CI: 1.01,1.30) times greater odds of self-reporting poor health compared to all other categories. For caregivers, one-additional behavior, but not cognition or physical limitations, was associated with 1.17 (95%CI: 1.01,1.37) times greater odds of self-reporting poor health. For PwD, interventions targeting physical limitations may increase self-reported health, but for caregivers, interventions targeting behavioral symptoms may increase self-reported health.
Exploring the Stress and Strengths Arising From the Complexities Existing Within Grandfamilies
Authors: Tompkins Catherine , Zic Alice , Carlson Ellie , Purvis Ali , Yancura Loriena , Nadorff Danielle 
Published: December 2020

Abstract
The opioid crisis and other social problems continue to increase the number of grandparent-headed households in the U.S. There are challenges and benefits that result from grandparents parenting their grandchildren. Grandparents often report the joy in watching their grandchildren grow but also report on the complexities that may lead to stress. Two-hundred forty-one grandparents were recruited using Qualtrics’ Online Panel Service. In addition to a standardized perceived stress scale and demographic questions, participants responded to open-ended questions related to the benefits and challenges of residing within a grandparent-headed household. This presentation focuses on comparing demographics, perceived stress, benefits and challenges of 108 current grandparent caregivers to 133 grandparents who were no longer the head of household at the time of the survey. Grandparents who currently were raising their grandchildren had a higher perceived stress score (p=.03) compared to grandparents who had raised their grandchildren in the past. An exploration of the demographic variances and responses to the open-ended questions, will begin to explain this statistically significant difference in reported stress. An additional complexity arising for a subsample of 10 current grandparents raising grandchildren, included simultaneously caregiving for an older adult relative. It is imperative to study the complexities existing within grandfamilies, from the perspectives and experiences of the grandparent caregiver, and develop interventions to reduce stress and increase the grandparents’ ability to cope with situational, emotional and relationship changes.
Family Caregiver Assessment in Primary Care: A Nationwide Survey
Authors: Riffin Catherine , Wolff Jennifer , Maisano Julianna , Lee Sylvia , Pillemer Karl 
Published: December 2020

Abstract
Family caregivers play an important role in the healthcare of older adults, but their circumstances, needs, and risks are often unknown to medical professionals. Standardizing how caregivers’ needs are assessed in healthcare delivery can help clinicians design care plans that take caregivers’ capabilities into account and provide targeted recommendations for caregiver support. Despite the potential of caregiver assessment, little is known about its use in primary care practice. The present study surveyed a national random sample of 1,000 U.S. primary care clinicians (physicians, nurses, social workers) to characterize current practices, barriers, and facilitators of caregiver assessment. A total of 231 completed responses were received. A minority of respondents (11%) reported that their practice or clinic had a standardized procedure for caregiver assessment; one in ten (10%) reported that they had personally conducted a caregiver assessment using a standardized instrument in the past year. The most common barriers to caregiver assessment were lack of time (65%), inability to have private discussions with caregivers (36%), lack of access to referral options (30%), inadequate reimbursement (30%), and reluctance of caregivers to discuss their needs (30%). The most frequently endorsed facilitators to aid future implementation included better availability of referral options (77%), easier referral mechanisms (67%), co-location of mental health specialists, care managers, or social workers (65%), and training in how to address caregiver issues (61%). Findings are discussed within the context of emerging healthcare policies and practice initiatives designed to promote caregiver assessment in health care settings.
Long-Term Care Market Trend and Patterns of Caregiving in the United States
Authors: Basu Rashmita 
Published: December 2020

Abstract
Objectives: The current study aims to: 1) identify patterns of the use of long-term care services and supports (LTSS) among community-dwelling individuals; 2) examine if the changes in supply of formal care predict the use of informal care (IC). Methods: Linking the market supply of formal LTSS to individual level Health and Retirement Survey data from (N=7,781), descriptive and regression analysis were performed. Results: Supply of formal home and residential LTSS indicates a stronger upward trend. More than 90% of people used IC and 40% received both informal and formal help. People aged under 60 years, IC from spouse dominates but then falls sharply and an adult child becomes the primary source. More than 20% reported unmet needs. Regression analysis indicates that the formal home care supply significantly predicts the likelihood of using IC. But the rate and intensity of unpaid IC use among individuals aged 85 or older is low and that of paid formal care use are highest. We find that about 20% of care recipients experienced at least one unmet need with ADL assistance in our sample. The prevalence of an unmet need sharply decreases as individuals receive care from multiple caregivers (including paid professionals) but receiving care from too many caregivers contributes to higher unmet ADL needs. Discussion: The findings suggest opportunities to create a holistic system of care for people needing LTSS.
SAVE-CLC: An Intervention to Reduce Suicide Risk in Veterans Who Discharge From VA Nursing Homes
Authors: Simons Kelsey , Luci Katherine , Hagemann Lauren , Jacobs Lindsey , Bower Emily , Eichorst Morgan , Hilgeman Michelle 
Published: December 2020

Abstract
Prior research has established transitions into and out of nursing homes as periods of suicide risk for older adults. Deaths by suicide were found to be 2.4 times as likely among Veterans within six months of discharge from US Veterans Health Administration (VA) nursing homes when compared with gender and age-matched Veterans from the general VA patient population (McCarthy, Szymanski, Karlin, & Katz, 2013). Despite these trends, suicide prevention interventions implemented during nursing home and post-acute care transitions, including those taking place from Centers for Medicare and Medicaid Services regulated nursing homes, are lacking. Suicide Awareness for Veterans Exiting the Community Living Center (SAVE-CLC) was piloted as a quality improvement intervention to reduce suicide risk for older Veterans discharging from VA nursing homes. VA clinicians from three sites provided a friendly contact by phone after discharge (n = 66) to screen for depression, facilitate a strengths-based discussion about service needs, and provide service referrals. Compared to a group of patients discharged prior to the start of the intervention (matched on location, age range, and Care Assessment Need scores), SAVE-CLC patients received more depression screening within 30 days after discharge (chi square = 38.7, p &lt; .001) and were seen more quickly for mental health care (t = 3.1, p = .005) when indicated. Implications for suicide prevention with older Veterans and for the general population of older adults receiving short stay services in US nursing homes will be addressed.
An Innovative Mental Health Model for Treating Culturally Diverse Older Adults
Authors: Abramson Tobi , Berman Jacquelin , Gates Madison 
Published: December 2020

Abstract
The mental health needs of older adults are largely unmet, a finding even more prevalent within culturally diverse older adult populations. Added to this is the high rate of social isolation. Research has indicated increased connection to mental health services when services are embedded within physical health care settings. For those attending community centers, 85% indicate that they are socially isolated, 68% indicate they are lonely, and 53% have a mental health need (compared to 20% nationally). The need for innovative programming is evident. When examining the needs of diverse older adults, it is increasingly important that new and innovative approaches address social isolation, loneliness, and mental health problems experienced by this cohort. Utilizing this knowledge an innovative model of embedding and integrating mental health services, provided by bilingual and bicultural clinicians, into congregate sites (older adult centers) was implemented. Those that participated were mainly female (72.1%), 68.5% English-speaking, 14.5% Spanish-speaking, 13.6% Chinese-speaking and 3.4% other. Spanish-speakers had more depression than English-speakers and both had more depression than Chinese-speakers. English and Spanish-speakers reported more social isolation and Chinese-speakers compared were more likely to participate in engagement. Chinese-speakers were less likely to be in clinical services with a positive screen compared to English-speakers. Overall, 75% engaged in treatment; 37.3% and 41% showed a 3-month improvement of depression and anxiety, respectively. This presentation focuses on the innovative components of this model, how to engage diverse older adults to utilize treatment, steps needed for replication, and policy implications around integrated mental health treatment.
Social Isolation and Hospitalization Risk Factors Among Community-Dwelling Older Adults
Authors: Pomeroy J Mary Louise , Gimm Gilbert 
Published: December 2020

Abstract
PURPOSE: This study examines psychosocial risk factors associated with hospitalization among community-dwelling older adults in the United States. METHODS: Using two waves of the National Health and Aging Trends Study from 2011 and 2015, we conducted descriptive and multivariate analyses of individual-level data from a nationally representative sample of 8,003 Medicare beneficiaries ages 65 and older. Associations between hospitalization and risk factors including social isolation, depression, and anxiety were assessed. Covariates included gender, race/ethnicity, age, region, insurance type, falls, and comorbidities. RESULTS: Overall, about 20.9% of older adults reported a hospitalization within the past year and 22.2% were socially isolated. The odds of hospitalization were higher for socially isolated adults (OR 1.17; p = .02), for depressed adults (OR 1.25; p = .01), and for individuals with anxiety (OR 1.25; p = .02). Individuals living in the Western region had lower odds of hospitalization (OR 0.71; p = .001), whereas men (OR 1.13; p = .03), those requiring assistance with activities of daily living (OR 1.48; p &lt; .001), and those having one (OR 1.41; p = .03) or more (OR 3.05; p &lt; .001) chronic health conditions had higher odds of hospitalization. CONCLUSION: Social isolation, depression, and anxiety represent significant psychosocial risk factors for hospitalization among community-dwelling older adults in the United States. Efforts to reduce health care costs and improve health outcomes for older adults should explore ways to strengthen social integration and improve mental health.
The Role of Geographical Differences and Discrimination in the Cognitive Health of Older Blacks
Authors: Johnson Kimson , Sol Ketlyne , Sprague Briana , Cadet Tamara , Munoz Elizabeth , Webster Noah 
Published: December 2020

Abstract
Where you live in old age matters in the United States in terms of access to health care and potential exposure to discrimination. This is especially important for non-Hispanic Blacks. Everyday experiences of discrimination are known to “get under the skin” but to date few studies have examined if associations between discrimination and cognitive health differ by region and urbanicity. This study aims to fill this gap. Data are from the 2012 and 2014 waves of the Health and Retirement Study (HRS) (N =2,347). Non-Hispanic Blacks over age 51 with complete data on the Everyday Discrimination Scale in either 2012 or 2014 and cognition, residential location were included in the analysis. Regression models included covariates for age, gender, education and examined interactive effects of everyday discrimination, region, and urbanicity on episodic memory in a nationally representative sample of non-Hispanic older Black adults in the U.S. Descriptive analyses revealed that the majority lived in Southern regions and in non-urban areas. Respondents also reported experiencing discrimination a few times a year. Regression analyses indicated that experiencing more everyday discrimination was significantly associated with lower episodic memory when living in urban areas. Among Blacks, the discrimination-episodic memory link did not significantly vary across U.S. regional contexts. Findings highlight the importance of socio-environmental factors in shaping how stressful experiences such as everyday discrimination are linked to cognitive health in later life. Future research should focus on the development of focused upstream interventions that are responsive to racial disparities in cognitive health in urban areas.