bluuebunny/crossref_metadata_2025_split huggingface dataset:
IMMIGRATION, RESILIENCE, AND ORAL-HEALTH-RELATED QUALITY OF LIFE AMONG CHINESE AMERICAN OLDER ADULTS IN HAWAII
Authors: Wu Bei , Pei Yaolin , Zhang Wei 
Published: November 2019

Abstract
Very few studies have compared oral health status between the US-born and foreign-born immigrant older adults. Using data collected among 430 Chinese older adults age 55+ residing in Hawai’i, we examined the association between immigrant status and oral health related quality of life (OHQoL) and the moderating role of resilience in linking the association. Controlling for some key covariates, our study results show that US-born Chinese immigrant older adults had better OHQoL than their foreign born counterparts. Factors such as higher level of education (graduate degree or higher), better self-reported health status and no significant tooth loss were related to better OHQoL. The association between immigrant status and OHQoL was moderated by resilience. Specially, resilience was positively and significantly associated with OHQoL among U.S.-born older adults but not among the foreign-born ones. Our findings indicate the importance of immigration and resilience in shaping oral health outcomes among older Chinese Americans.
THE IMPACT OF DEMENTIA STIGMA IN RECRUITING PARTICIPANTS INTO RESEARCH STUDIES
Authors: Rose Karen , Lopez Ruth Palan 
Published: November 2019

Abstract
Despite efforts to increase awareness and education about Alzheimer’s disease and other dementias, persons with dementia and their family caregivers experience stigma. Dementia related stigma is associated with negative repercussions for those with the disease and their family caregivers. In our prior work, we identified shame as a mechanism by which stigma is enacted and results in isolating and delaying access to supportive services for family caregivers. As such, stigma may influence decisions to participate in research studies. Healthcare providers, friends and family, and society, in general, play roles that further perpetuate stigma in dementia. Best practices from the literature, coupled with our experiences and findings in recruiting persons with dementia and their family caregivers in to research studies will be examined.
THE INFLUENCE OF RECESSION HARDSHIPS ON THE PSYCHOSOCIAL WELL-BEING OF SANDWICHED AND FILIAL CAREGIVERS
Authors: Hodgdon Barbara , Wong Jen D 
Published: November 2019

Abstract
The 2007-2009 U.S. Great Recession impacted the lives of many families, and it has been documented that multigenerational households in the U.S. increased by 10% during this period. Given the vulnerability of providing care to multiple generations, there is a need to examine the influence of recession hardships on sandwiched caregiving and psychosocial well-being in the context of more normative caregiving (e.g., filial caregiving). Informed by the life course perspective, this study assessed the impacts of types of family caregiving (sandwiched and filial caregivers) on psychosocial well-being (e.g., affect, environmental mastery, and social actualization) and the moderating role of recession hardships (e.g., job loss, foreclosure). Sandwiched and filial caregivers (N=127; Mage=53; SD=11.02) from the Refresher Cohort of the Midlife in the United States (MIDUS) Survey provide information on demographics, recession hardships, family caregiving, and well-being. Results from regression analyses showed that sandwiched caregivers exhibited lower levels of positive affect and environmental mastery than filial caregivers. Moderation analyses showed that filial caregivers with lower recession hardships exhibited lower positive affect and social actualization when compared to sandwiched caregivers with lower recession hardships. Filial caregivers with lower recession hardships exhibited lower positive affect and social actualization than sandwiched and filial caregivers with greater recession hardships. These results illustrate the complexity of family caregiving in that providing care to multiple generations does not necessarily translate to lower levels of well-being. Study findings have the potential to inform programs that may promote sandwiched caregivers’ well-being and support filial caregivers navigating financial disruptions.
SENIOR FRIENDLY PACKAGING AND PRODUCT TESTING: FEEDBACK FROM OLDER CONSUMERS
Authors: Hollis-Sawyer Lisa A , O’Neil Alison 
Published: November 2019

Abstract
By 2050, older adults ages 65 or older will account for 83.7 million people in the U.S. population (An Aging Nation: The Older Population in the United States, 2014). It is imperative that products and technologies are designed to accommodate age-related changes that older adults are likely to experience. Given this population surge of older adults, there is a growing interest in identifying consumer products that are usable for older adults or “senior friendly.” Senior-friendly product testing (e.g., Senior Select®) focuses on the usability of various health and consumer products targeted to people with diminishment of any of the following: hearing, vision, taste, touch, smell, mobility & dexterity and /or mental acuity. A usability evaluation study was conducted in three senior living communities located in the Atlanta area. Twenty-nine participants ranged in age from 66 years old to 102 years old. Participants were shown a snack bar product and then asked to use the product themselves to perform a series of prepared tasks. After interacting with the product, participants were asked to share any comments that they had concerning the product. Issues of color contrast between the main packaging and the pull tab, easy of gripping and tearing the wrapper, the labeling of the nutrition information, and the package labeling (should refer to “adult” snack) were reported. Many respondents suggested that senior-friendly package design relates to their health and well-being. Implications toward a wide range of products for older adults of varying ability levels will be discussed.
METABOLITES ASSOCIATED WITH HIGH VERSUS LOW WALKING ABILITY AMONG COMMUNITY-DWELLING OLDER MEN AND WOMEN
Authors: Marron Megan M , Wendell Stacy G , Tseng George C , Boudreau Robert M , Santanasto Adam J , Clish Clary , Zmuda Joseph M , Newman Anne B 
Published: November 2019

Abstract
Low walking ability is highly prevalent with advanced age and associated with a higher risk of major adverse health outcomes. Metabolomics may help better characterize differences among older adults with vastly different walking abilities and provide insight into altered metabolic processes underlying age-related declines in physical functioning. Here, we sought to identify metabolites associated with high versus low walking ability using a nested case-control study of 120 community-dwelling adults ages 79-95 (40% men, 10% black) from the Cardiovascular Health Study (CHS) All Stars study. Participants with high versus low walking ability were matched one-to-one on age, gender, race, and fasting time. Using liquid chromatography-mass spectrometry, 569 metabolites were identified in overnight-fasting plasma. High versus low walking ability was defined as the best versus worst tertile of gait speed (≥0.9 versus &lt;0.7 meters/second) and Walking Ability Index scores (7-9 versus 0-1). Ninety-six metabolites were associated with walking ability extremes (p&lt;0.05, false discovery rate&lt;30%), where 24% were triacylglycerols. Triacylglycerols containing mostly polyunsaturated fatty acids (e.g., omega-3) were higher, whereas those containing mostly saturated/monounsaturated fatty acids were lower among those with high versus low walking ability. Arginine and proline metabolism was a top pathway identified. Body mass index partly explained the association between a subset of metabolites and walking ability extremes. These findings may partly reflect pathways implicating modifiable risk factors including excess dietary lipids and lack of physical activity, which contribute to obesity and cause further alterations in metabolic pathways, potentially leading to age-related declines in walking ability in this cohort.
CULTURAL MOTIVATION TO VOLUNTEER AMONG OLDER JEWISH ADULTS: AN EXPLORATORY STUDY
Authors: O’Dea Eireann , Wister and Andrew 
Published: November 2019

Abstract
The physical, mental, and social benefits for older adults who volunteer are well-documented. Absent from this area of research however, is an understanding of volunteer motivation and experiences among culturally diverse older adults. This study addresses this research gap by exploring the volunteer pathways, motivations, and experiences of Jewish older adults in Vancouver, BC, Canada. The Jewish community is notable for possessing high levels of social capital, indicated by close community ties and the large number of faith and culturally based organizations, including community centres, day schools, seniors’ centres, and family service agencies, which provide many opportunities for older adults to volunteer. Despite this, they remain an understudied population. Semi-structured qualitative interviews were conducted with twenty-one older adult volunteers (age 55+), and two paid volunteer staff in the Jewish community. Theoretical concepts including social capital, generativity, and the life course perspective on aging were used to guide interview questions. Data analysis revealed three themes related to cultural motivation to volunteer: 1.) A desire to support the current and future generations of the Jewish community, 2.) To satisfy the “Jewish ethic” of giving back, and 3.) Experiences of discrimination (anti-Semitism) over the life course. Participants frequently volunteered for organizations that supported the infrastructure of the Jewish community. Findings indicate how cultural experiences and values may influence the decision to volunteer and the types of volunteer roles taken on by older adults. Further, they suggest the ways in which cultural and religious generativity may be expressed through volunteerism, a previously unexplored concept.
INVESTIGATING WALNUT CONSUMPTION AND COGNITIVE HEALTH IN A REPRESENTATIVE SAMPLE OF OLDER U.S. ADULTS
Authors: Bishop Nicholas J , Zuniga Krystle E 
Published: November 2019

Abstract
Population aging increases the need to identify modifiable risk factors of cognitive decline such as nutritional intake. Several nutrients found in walnuts appear to play a neuro-protective role, yet few studies examine whole walnut consumption or draw from representative longitudinal samples. We draw observations from the nationally-representative Health and Retirement Study and Health Care and Nutrition Study to investigate the association between walnut consumption and cognitive trajectories among older US adults. The analytic sample consisted of 6,639 adults age 50 and over in 2013, representing a population of 77,726,682 community-dwelling older adults. Walnut consumption was a categorical measure representing no consumption, moderate consumption (&lt; one serving per week), or high consumption (≥ one serving per week). Indicators of cognitive function representing working memory (immediate and delayed word recall) and global cognitive function (Telephone Interview of Cognitive Status, TICS) were measured at 3 time points (2012, 2014, and 2016). Latent growth models were used to estimate each linear trajectory while adjusting for covariates and complex survey design. Walnut consumption was positively associated with word recall and global mental status at baseline, but was not associated with change over the four year observational window. For example, those with high walnut consumption had baseline TICS scores .89 units greater (SE = .17, p &lt; .001) than those consuming no walnuts. These results indicate that walnut consumption appears to have a positive association with cognitive health, but walnut consumption does not appear to be associated with short-term change in the cognitive outcomes measured.
MINDFULNESS AND COGNITIVE FUNCTION IN PATIENTS WITH COGNITIVE IMPAIRMENT
Authors: Tolea Magdalena I , Park Juyoung , Galvin James 
Published: November 2019

Abstract
Mental health benefits of mindfulness, the attribute of being aware and present in the moment, have long been acknowledged. Mindfulness has also been linked to improved cognitive performance and improvements in AD neuropathology (↓hippocampal atrophy, ↑brain connectivity) in MCI or early-stage AD patients. This study was designed to: investigate the relationship between mindfulness and cognitive function in a patient population with varying degrees of cognitive impairment; identify the specific mindfulness components that provide benefits; and explore differences by sex and disease severity. Patients (N=112; 43% female; 77.0±7.7yrs; 11% cognitively normal, 27% MCI, and 67% dementia) attending a university-based dementia clinic were administered the Applied Mindfulness Process Scale (AMPS) and underwent neuropsychological testing. Cognition was linearly regressed on AMPS with adjustment for age, gender, education, and disease stage, in the entire sample and stratified by sex and stage. In fully adjusted models, higher mindfulness was associated with lower AD8 scores (β=-0.05±0.02(p = 0.003)), better animal naming (AN)(β=0.11±0.04(p = 0.008)), and faster TMA times (β=-0.72±0.32(p=0.025)). All three mindfulness factors (F1=decentering; F2=positive emotional regulation; F3=negative emotional regulation) were significantly linked to AD8, while F3 was not predictive of AN, and F1 was not predictive of TMA. In addition, mindfulness significantly predicted subjective cognitive impairment (SCI)(βF2AD8=-0.18±0.07(p=0.011)) and TMA in men βTMA=-1.14±0.42(p=0.011); βF2TMA=-2.63±1.26(p=0.043); βF3TMA=-2.74±1.12(p=0.019) and dementia patients (βF1AD8=-0.19±0.08(p=0.021); βF2AD8=-0.14±0.07(p=0.044); βTMA=-0.09±0.51(p=0.039)); and AN in women ((βAN=0.12±0.06(p=0.047);βF2AN=0.34±0.16(p=0.036)) and MCI patients (βAN=0.13±0.06, p=0.033; βF3AN=0.36±0.16(p=0.035)). Our findings suggest that effectiveness of mindfulness-based interventions may be enhanced by a focus on emotional regulation and sex- and stage-specific cognitive targets.
SPOUSAL ASSOCIATIONS IN MONTHLY REPORTS OF DISABILITY IN THE PRECIPITATING EVENTS PROJECT
Authors: Monin Joan K , Laws Holly , Gahbauer Evelyne , Murphy Terrence E , Gill Thomas M 
Published: November 2019

Abstract
While many prior studies have evaluated the antecedents and consequences of changes in disability, few have considered the social context. As nearly 60% of older adults currently live with a spouse or intimate partner, it is important to examine spousal influences on disability. This study examined spousal associations in self-reported disability using data from the Precipitating Events Project, an ongoing longitudinal study of 754 initially nondisabled community living adults age 70 and over who have had monthly assessments of functional status since 1999. We hypothesized that one spouse’s level of disability would be associated with increases in the other spouse’s subsequent disability. We used the Actor Partner Interdependence Model (APIM), a statistical modeling framework that accounts for the interdependence in two-person data and tests the associations of both self (actor) and partner influences on outcomes. We used multilevel, longitudinal APIMs to examine lagged associations in spouses’ monthly reports of disability in 13 activities of daily living (e.g., walking a quarter mile, bathing) in the 37 married couples. As hypothesized, one partner’s prior disability level was significantly associated with the other partner’s (the actor’s) subsequent disability level (B = .674, SE = .012, p &lt; .001) after controlling for the actor’s prior disability level. Also, when both couple members had higher levels of prior disability, they were particularly at risk of subsequent increases in disability (B = .016, SE = .003, p &lt; .001). Incorporating partner disability level in modeling individuals’ outcomes provides greater precision in predicting future disability levels.
A SYSTEMATIC REVIEW ON CAREGIVING FOR ABUSIVE FAMILY MEMBERS
Authors: Zhang Qiyi 
Published: November 2019

Abstract
While elder abuse perpetrated by caregivers has raised significant attention in the past 30 years, the well being of and support for caregivers of abusive or previously abusive family members remains little known. This population is large in scope, but greatly neglected in the scientific investigation of elder abuse or domestic violence. This systematic review aims to summarize conceptual discussions and empirical findings from existing peer-reviewed articles to shed light on how to understand, identify, and provide support for this group. I performed a search using MEDLINE, PsycINFO, Cochrane, CINAHL, EMBASE, Ageline, and Social Work Abstract, and examined reference lists of identified articles in the stage of full-text screening. Targeted articles are written in English, peer-reviewed, published between 1989 to 2019, and contribute significant knowledge to the study aims. The search concluded with four conceptual articles and six empirical articles. This review reveals a change in approaches in understanding the living situation of maltreated caregivers: previously an indicator of poor caregiving relationship for predicting caregiving outcomes, now it is increasingly acknowledged as a vulnerable group in need of special attention and support. Empirical studies showed that a significant percentage of caregivers have a history of being abused, and they suffered from worse mental health and responded more poorly to certain coping mechanisms than caregivers without those experiences. Stress and self-esteem were found to be possible mediators. Competing conceptual frameworks on this issue include: 1) abuse versus interpersonal violence; 2) life course perspective; 3) communal model versus exchange model of caregiving.
EXPLORING RACIAL-ETHNICITY DIFFERENCES IN SERVICES USED BY GRANDPARENTS RAISING GRANDCHILDREN
Authors: Shovali Tamar E , Emerson Kerstin G 
Published: November 2019

Abstract
Nearly three million grandparents in the US serve as primary caregivers for their grandchildren. Little research on formal service use and grandfamilies exists for Black and Hispanic populations. To begin to address this gap we conducted exploratory analyses using nationally representative estimates of characteristics and service accessibility of noninstitutionalized children living with grandparents from the 2013 National Survey of Children in Nonparental Care. Our goal was to understand differences in service use as a function of grandfamily race/ethnicity. We specifically explored grandparents’ formal service count, financial services received, confidence in obtaining/using community services, and level of role preparation by race/ethnicity. We calculated descriptive statistics for these service variables for grandparents raising Hispanic, White, Black, and Other identified grandchildren (N = 892). On average, there was a minimal range for the number of formal services used (M range = 5.26 – 5.84, possible = 0 – 10 higher equals more services used), reported number of financial services (M range = 0.71 - 0.78, possible = 0 – 3 higher equals more financial services received), and confidence obtaining/using services (M range = 7.4—7.9, possible = 1 – 9 higher equal more confidence). Most prepared to take on the caregiving role were grandparents of White children (55%) followed by Black (21.6%), Other (12.3%), and Hispanic (11.1%) indicating that although grandparents in this sample report being confident and able to access formal services, grandparents of White children report being feeling more prepared to take on caregiving than grandparents of Black, Hispanic, and Other combined.
IMPLEMENTING A NEW MODEL IN PRIMARY CARE FOR OLDER CANADIANS LIVING WITH FRAILTY
Authors: Elliott Jacobi B , Gould Joanie Sims , Gregg Susie , Tong Catherine , Stolee Paul 
Published: November 2019

Abstract
Primary care may be the best place within the health system to coordinate care for older persons, but at present, it is poorly equipped to do so. Effective models for complex patients require appropriate targeting, patient/caregiver engagement, and care coordination. A large national project aims to co-design and implement a model in primary care that includes risk-stratification, patient engagement and care coordination techniques for older adults. This presentation focuses on the process of implementation in primary care. Grounded in the Consolidated Framework for Implementation Research, researchers worked with nine primary care sites in three Canadian provinces. Project implementation was completed in two phases. Pre-implementation: Interviews with providers (n=25) and older adults (n=8) were conducted to understand current practices and plan for implementation. Implementation: Researchers worked with sites to train staff and support implementation. Monitoring of the implementation process included Interviews with providers (n=20) and field notes. Data were analyzed using directed coding, following the framework. A number of learnings emerged: buy-in was required from the entire team, teams provided meaningful information to guide implementation, contributing to a sense of ownership, and it was important that intervention components were tailored to the needs at each site. Ongoing and frequent discussions with the team was necessary. Scheduling meetings and training sessions for providers was challenging due to the length of time away from direct patient care. A new primary care model for older adults living with frailty was implemented. Lessons from this project will be used to guide future implementation and spread.
MEDICARE IS THE LAST HOLDOUT: EXAMINING THE IMPACT OF MEDICARE POLICY ON OLDER ADULTS’ ACCESS TO MENTAL HEALTH CARE
Authors: Fullen Matthew C , Wiley Jonathan , Morgan Amy , Lawson Gerard , Sharma Jyotsana 
Published: November 2019

Abstract
Medicare is the primary insurance provider for approximately 59 million Americans, and the number of beneficiaries is expected to surpass 80 million by 2030. Currently, Medicare regulations allow psychiatrists, psychologists, clinical social workers, and psychiatric nurses to provide mental health services. These providers were last updated in 1989 with passage of the Omnibus Budget Reconciliation Act of 1989. Since that time, the mental health marketplace has changed dramatically, and Medicare beneficiaries are unable to access care from approximately 200,000 graduate-level mental health professionals with similar training to eligible Medicare providers. There is evidence that this Medicare mental health coverage gap (MMHCG) impacts both providers and beneficiaries. For example, some beneficiaries may begin treatment only to have services interrupted, or stopped altogether, once the provider is no longer able to be reimbursed by Medicare. We surveyed 6,550 members of the American Counseling Association, including 3,815 who identified themselves as practicing counselors. These individuals work in diverse contexts (e.g., community mental health agencies, private practice, and integrated care settings). Survey results indicated that a significant number of practicing counselors turn away or refer Medicare beneficiaries who seek mental health care due to the MMHCG. In-depth interviews were also completed with eight licensed mental health professionals who detailed the challenges they and their clients experienced. Participants perceived a discrepancy between Medicare’s intended aims to promote health and provider restrictions that were confusing and frustrating to navigate. Participants concluded that the MMHCG has a negative impact on older adult clients.