bluuebunny/crossref_metadata_2025_split huggingface dataset:
NOVEL BIOMARKERS OF BIOLOGICAL AGE IN THE HEALTH AND RETIREMENT STUDY
Authors: Thyagarajan Bharat , Levine Morgan E 
Published: November 2019

Abstract
This symposium presents early results on epigenetic, transcriptomic and other aging biomarkers such as telomere length and mitochondrial DNA copy number from the Health and Retirement Study that allows a detailed examination of the biological pathways through which socioeconomic conditions influence the human aging process. In 2016 HRS collected 6 tubes of blood from people who completed the 2016 interview, had been in the sample at the prior wave and were not in a nursing home (n=9,973) to maintain a nationally-representative sample. These blood samples were analyzed for novel biomarkers of aging that included global methylation arrays, whole transcriptome sequencing, telomere length and mitochondrial DNA copy number among other biomarkers that were shown to be related to both social and economic circumstances and health outcomes at older ages. This level of integration of biological data to address social disparities hasn’t been accomplished before on a large nationally-representative sample of Americans and will provide a unique opportunity to understand the biological mechanisms through which social disparities affect human health. The symposium will describe the utility of measuring novel age related biomarkers in a nationally representative population study such as HRS and the potential research opportunities that can be pursued using this publicly available resource. It will provide an overview of the measurement and distribution of epigenetic, transcriptomic and telomere length and mitochondrial DNA copy number as novel aging biomarkers. It will also describe the utility of these biomarkers in further understanding the biological underpinnings of socioeconomic differences in health and mortality.
IADL DIFFICULTY AND MORTALITY IN ACTIVE: IMPLICATIONS FOR TRANSFER OF COGNITIVE TRAINING
Authors: Gross Alden L , Clay Olivio , Felix Cynthia , Unverzagt Fred , Marsiske Michael , Coe Norma 
Published: November 2019

Abstract
Objectives: Our goals were to externally scale an IADL difficulty scale to the more recognizable Functional Activities Questionnaire (FAQ), and test whether cognitive training attenuates the relationship between IADL difficulty and mortality. Method: We leveraged externally available FAQ data from NACC to scale questions about IADL activities administered in ACTIVE (N=2,802) using item response theory. We modeled time to death as a function of IADL difficulty in ACTIVE using survival analysis, testing whether ACTIVE intervention group status modified the association between FAQ and mortality. Results: IADL difficulty in ACTIVE, scaled to the FAQ, was associated with a higher risk of death (Hazard Ratio, HR, 1.01, 95% Confidence Interval, CI: 1.001, 1.02). The relationship did not differ by ACTIVE intervention status. Discussion: Cognitive training does not modify the relationship between IADL difficulty and mortality, consistent with a hypothesis that proposed relationships between cognitive ability and IADL difficulty are correlational, not causal.
ACTUARIAL CRITERIA FOR MCI DIAGNOSIS IN ACTIVE: IMPLICATIONS OF ADJUSTMENT FOR RACE
Authors: Thomas Kelsey , Cook Sarah , Unverzagt Fred , Bondi Mark W , Marsiske Michael 
Published: November 2019

Abstract
This study examined the baseline prevalence of mild cognitive impairment (MCI) in the ACTIVE study using actuarial criteria for MCI. Participants (n=2763; 26% Black) were classified as probable MCI cases if they had two observed test scores within the same cognitive domain (memory, reasoning, speed) that were &gt;1SD below a demographically-adjusted expected score (based on the regression weights of a “robust” normal control group). Each score was adjusted using two approaches: Method 1 adjusted for age, sex, and education; Method 2 also adjusted for race. The estimated prevalence of MCI was 33.5% (n=925) in Method 1 and 32.1% (n=887) in Method 2. Adjusting for race reduced the proportion of Black participants classified as probable MCI from 42.3% to 34.9%. Future work will examine whether adjustment for social determinants of health (e.g., education quality, neighborhood/healthcare access) might further improve the utility of this classification method in diverse samples.
LONG-TERM BENEFITS OF REASONING TRAINING: A PREDICTED DIFFERENCE APPROACH
Authors: Marsiske Michael 
Published: November 2019

Abstract
In 928 ACTIVE participants, we investigated predictors of exceptional reasoning performance ten years post-enrollment. Participants had been randomized into a training arm (memory, reasoning, or speed of processing) or a no-contact control group. Each participant received an age- and education adjusted expected normative trajectory on a reasoning composite score, derived from the untrained control group. They were then classified as within- (n=467, 50%), above- (n=285, 31%), or below-normative expectation (n=176, 19%) ten years post-training. At a p&lt;.001 significance criterion, reasoning training (b=, 0.632, OR =1.88) and younger age (b=-0.048/year, OR = 1.05) were associated with 10-year above-normative expectations. No other baseline factors considered (other training arms, education, cardiovascular risk, life space, mobility, locus of control, morale, motivation) predicted ten year status, nor did they interact with training arm. Reasoning training appears to have produced long term alterations in reasoning trajectory for many participants.
DEATH OF A CHILD AND MORTALITY RISK OVER THE LIFE COURSE: RACIAL DISADVANTAGE IN THE U.S.
Authors: Donnelly Rachel , Umberson Debra , Hummer Robert , Garcia Michael 
Published: November 2019

Abstract
Numerous studies show that bereavement, including bereavement following the death of a minor child, increases mortality risk in white populations. The death of a child prior to midlife has received much less attention. Moreover, recent research shows that black Americans are substantially more likely to lose a child compared to white Americans, but this racial disadvantage is largely unexplored. Losing a child is a traumatic event that may activate biopsychosocial and behavioral risk factors that add to mortality risk. We analyze longitudinal data from the Health and Retirement Study (1992-2014) to assess the association of child loss prior to midlife with mortality risk in mid to later life, and the possible biopsychosocial and behavioral covariates linking child death to mortality. The analytic sample includes 20,489 non-Hispanic white respondents and 5,328 non-Hispanic black respondents who have ever given birth to or fathered at least one child. Findings suggest that that the death of a child prior to midlife is associated with increased mortality risk, net of sociodemographic controls. Psychological (e.g., depressive symptoms), behavioral (e.g., alcohol use, smoking), and social (e.g., income, marital status) factors explain this heightened mortality risk. Although the heightened mortality risk for child loss is similar for black and white parents, black parents experience a greater disadvantage as they are almost twice as likely as white parents to lose a child prior to midlife. Child loss and the resulting health risks disproportionately burden black families, functioning as a unique source of disadvantage for black Americans.
RACIAL SIMILARITIES AND DIFFERENCES IN FUTURE CARE PLANNING
Authors: Peterson Natasha L , Lee Jeong Eun 
Published: November 2019

Abstract
Recent population trends for the United States show substantial increases in racial diversity as well as an increase in the older adult demographic. Accordingly, the expansion in minority older adults suggests the importance of recognizing how race affects future care planning (FCP) in late life. The aim of this paper is to investigate the racial similarities and differences in planning behavior and intentions related to end-of-life care planning. This study utilized data from the Future Care Planning intervention based on the initial assessment with 237 older adults in rural Iowa (Mage= 75.93, SD=11.14) with 73 non-White participants. Results indicated that both Whites and non-Whites had similar levels of intentions in terms of future care. However, non-Whites were less likely than Whites to engage in multiple areas of FCP including planning behavior and preparing for end-of-life (F=23.957, p&lt;.000). These findings suggest a need for more targeted FCP assessments and interventions across race groups in rural contexts.
STRENGTHENING FAMILY CAREGIVING THROUGH INNOVATIVE TECHNOLOGY SOLUTIONS
Authors: Lindeman David , Kim Katherine K 
Published: November 2019

Abstract
Technology has the potential to enhance the repertoire of tools for family caregiving to address the complexities of caring for older adults. There are examples of technology-enabled interventions helping older adults remain independent and safe in their home; easing the financial, physical, and psychological challenges of family caregiving; assisting in the management of chronic illness; improving socialization and support; offering information and resources on a “just in time” basis; and improving the quality of care and quality of life for both older adults and their family caregivers. This session will review eight evidence-based, technology-enabled solutions for family caregivers, including technology solutions that address medication adherence, falls prevention, personal emergency response, remote monitoring, telehealth, dementia tracking, social engagement, and care training. Key drivers for successful application of these interventions (e.g., technology, analytics, user experience design) as well as barriers to scaling (e.g., accessibility, affordability, regulation) will be reviewed.
EVIDENCE-DRIVEN PROGRAMS IN THE HEALTHCARE SETTING: HOW CAREGIVERS CAN BENEFIT
Authors: Jensen Christine J , Jensen Christine J 
Published: November 2019

Abstract
How do family caregivers who interface with the healthcare system benefit from evidence-driven programs designed to support them? Education, training, and care coordination programs have all been found to significantly improve the well- being of caregivers. These programs include Operation Family Caregiver; Caring For You, Caring For Me; BRI Care Consultation; the New York University Caregiver Intervention; and patient and family advisory councils. Healthcare systems that host, translate and scale these programs make them more readily accessible for patients and their families, staff, and the larger community. Further, there is legislation, including the CARE Act, which recognizes the key role a family caregiver provides as a partner in their love one’s care. The CARE Act, now enacted in 36 states, states that family caregivers must be identified in the medical record and provided with the necessary resources to be able to care for their loved one after a hospital stay.
IMPLEMENTATION OF A MINDFULNESS BASED DEMENTIA-CARE PROGRAM WITHIN A HEALTHCARE SYSTEM
Authors: Hanson Leah , Kashyap Bhavani , Barclay Michelle P 
Published: November 2019

Abstract
The stress associated with caring for a loved one with Alzheimer’s disease or a related dementia can negatively affect mental and physical health. Mindfulness-based stress reduction (MBSR), teaching caregivers to focus on the present moment with non-judgmental awareness, has been shown to improve overall mental health, reduce perceived stress, and decrease depression. At HealthPartners, we implemented the Mindfulness Based Dementia-Care (MBDC) program, an 8-week program designed for family caregivers for those living with dementia. MBDC combines teaching of MBSR skills along with essential education for this chronic disease. Participants attend a 1-hour orientation session, 2-hour classes each week for 8 weeks, at-home practice between classes, and a 6-hour Saturday retreat. Secure electronic surveys are administered at baseline, program completion and follow-up for evaluation of the program. We will discuss barriers and learnings of implementation as well as preliminary results from the evaluation.
THE IMPORTANCE OF THE LONG-TERM CARE WORKFORCE ON QUALITY OUTCOMES FOR INDIVIDUALS RECEIVING SERVICES
Authors: Schwartz Lindsay , Degenholtz Howard , York Amy M 
Published: November 2019

Abstract
A strong, supported long-term care (LTC) workforce is vital to quality outcomes of individuals receiving LTC. With the sector facing issues around recruitment and retention, it is important to understand factors impacting the workforce. This symposium includes four presentations, a mix of both quantitative and qualitative research. First, Scales and colleagues will provide an overview of the workforce crisis using extensive policy analysis of home and community-based services (HCBS) in the US. Factors impacting the HCBS direct care workforce (DCW), including training, supply and demand, models of care and compensation, will be addressed. Next, Carder et al. will compare workforce recommendations from the 2003 Assisted Living Workgroup (ALW) report to current regulations. Many states have incorporated recommendations including criminal background checks and training while few have required staff performance evaluations and policies to improve retention. Morgan et al. examine AL residents’ care convoys’ impact on resident outcomes utilizing data from interviews with AL staff, external health care professionals, residents and family members (n=219). Policies, practices, work overload, time constraints, lack of training and turnover impacted DCW involvement in care convoys. Bender et al. analyze data from 14 DCWs and 16 executive directors from 4 ALs to examine how staff implement and understands end-of-life care policies and procedures. Limited training and communication around death present opportunities for improvement to support DCWs experiencing grief and bereavement. The discussant will address the importance of workforce as part of the network providing quality of care and improving quality of life of individuals receiving LTC.
BUILDING COHESIVE CONVOYS: IMPROVING STABILITY AND PREPAREDNESS OF DIRECT CARE WORKERS IN ASSISTED LIVING
Authors: Morgan Jennifer C , Burgess Elisabeth , Barmon Christina , Kemp Candace L 
Published: November 2019

Abstract
Person-centered collaborative care arrangements that empower residents, families, and care partners require supports for resident and their “care convoys”—the evolving collection of individuals who provide formal and informal care. Direct care workers (DCWs) are essential in supporting resident needs within the complex and dynamic environment of assisted living. The stability and preparedness of this workforce is central to improving quality of life for residents. This paper identifies key factors influencing the integration of DCWs in the convoys and explore supportive employment practices to strengthen the convoy. This analysis uses data from a 5-year mixed-method qualitative study of eight assisted living communities. Time pressures, AL policies and practices, work overload, lack of training, and turnover impact whether direct care workers are empowered as full members of the care convoy. Supportive employment practices (e.g. training, onboarding, career opportunities, rewards and recognition) are discussed as potential solutions for building consensus and collaboration.
A VOICE-INTERACTION-MEDIATED SMART HOME TO SUPPORT AGING IN PLACE: A NEW PARADIGM TO ENGAGE WITH HEALTH-RELATED DATA
Authors: Choi Yong K , Thompson Hilaire J , Demiris George 
Published: November 2019

Abstract
Current tools for health management such as personal health records (PHR), mobile applications, and wearable devices rely on conventional interfaces such as keyboard and mouse with screens for reading information. More recently, Internet-of-things (IoT) voice-activated smart speakers and embedded Artificial Intelligence (AI) assistants have emerged that may provide an effective user interaction platform to support healthy aging, creating a hands-free, conversational way to access and share health related data. We conducted an exploratory study with nineteen older adults (65+) who chose to evaluate a smart speaker for a 2-month as part of a larger IoT feasibility study. Three interview sessions were conducted to gather attitudes towards this technology. Participants provided feedback on future improvements or desirable features for health maintenance. A content analysis was performed to extract common themes. In general, participants expressed a positive experience with the voice interface and discussed its potential as an integral tool for their home health management. Based on these findings, we propose a voice interaction smart home platform to support healthy aging. This platform provides an intuitive voice user interface to execute commands to access, record, and query data from IoT sensors, a PHR and a hospital EHR. For example, the voice interaction platform will help individuals to dynamically explore their own health data thus eliminating manual and tedious searching of PHR data. We demonstrate how this platform can potentially improve usability issues including difficulties navigating charts and entering or retrieving health data using conventional interfaces. Finally, we highlight ethical and technical considerations.
BETTER LIVING THROUGH TECH: TECHNOLOGY-MEDIATED RECREATION AND LONG-TERM CARE FACILITY RESIDENTS’ QUALITY OF LIFE
Authors: McMahan Ethan A , Godoy Marion , Awosanya Abiola , Winningham Robert , Vilmorin Charles De , McMahon Meaghan 
Published: November 2019

Abstract
Empirical research on long-term care facility resident engagement has consistently indicated that increased engagement is associated with more positive clinical outcomes and increased quality of life. The current study adds to this existing literature by documenting the positive effects of technologically-mediated recreational programing on quality of life and medication usage in aged residents living in long-term care facilities. Technologically-mediated recreational programming was defined as recreational programming that was developed, implemented, and /or monitored using software platforms dedicated specifically for these types of activities. This study utilized a longitudinal design and was part of a larger project examining quality of life in older adults. A sample of 272 residents from three long-term care facilities in Toronto, Ontario participated in this project. Resident quality of life was assessed at multiple time points across a span of approximately 12 months, and resident engagement in recreational programming was monitored continuously during this twelve-month period. Quality of life was measured using the Resident Assessment Instrument Minimum Data Set Version 2.0. Number of pharmacological medication prescriptions received during the twelve-month study period was also assessed. Descriptive analyses indicated that, in general, resident functioning tended to decrease over time. However, when controlling for age, gender, and baseline measures of resident functioning, engagement in technologically-mediated recreational programming was positively associated with several indicators of quality of life. The current findings thus indicate that engagement in technology-mediated recreational programming is associated with increased quality of life of residents in long-term care facilities.
BUILDING A CONTINUOUS DEMENTIA MANAGEMENT MODEL IN COMMUNITIES OF SHANGHAI
Authors: Li Xia , Qiu Qi , Yang Yinghua , Sun Ling , Jiang MinJun , Gu chunling , Cui Ming , Lin Xiang 
Published: November 2019

Abstract
Over 10 million people with Alzheimer’s disease or related dementias (ADRD) live in China. In Shanghai, the prevalence of ADRD is about 3-4% among aged 60 or older, and approximately 70-85% have never been diagnosed. This study reported the pilot testing results of a dementia management model launched by Shanghai Mental Health Center to build dementia friendly communities. The dementia management model links screening, diagnosis, care planning, treatment, and services, to improve dementia literacy and standard diagnosis rate. About 3,786 senior residents were screened using the AD 8 and MoCA scales. The cognitively intact group was suggested for annual check-up, while at -risk groups were referred to formal diagnosis and intervention. About 125 older adults with a mild cognitive impairment diagnosis were provided referrals for cognitive training, and 109 diagnosed with dementia were provided medical and social interventions. This management model adds to dementia awareness and education.
CREATING DEMENTIA-FRIENDLY COMMUNITIES IN CENTRAL FLORIDA IN THE UNITED STATES
Authors: Wharton Tracy , Paulson Daniel , Wagner Courtney 
Published: November 2019

Abstract
The Dementia Care & Cure Initiative in Florida is a statewide movement to advance dementia friendly communities. With 25% of the state over the age of 65, Florida has one of the highest rates of dementia in the nation. The taskforce based in Orlando involves a partnership of representatives from social service agencies, law enforcement, healthcare providers, and research partners, as well as consumers. The task force commissioned a series of five focus groups with 43 consumers. These focus groups produced short and long-term recommendations, identifying such issues as needed training for emergency personnel and law enforcement, improving inter-provider communication, and providing culturally competent programming for a diverse region. The taskforce has been planning with the Mayor’s office and law enforcement to initiate training and support for community engagement, and planning for implementation of these goals. Recommendations from the groups and from the taskforce to community leaders will be discussed.
BUILDING DEMENTIA-FRIENDLY COMMUNITY IN MICHIGAN: THE EXPERIENCES OF BATTLE CREEK
Authors: Fales Karla 
Published: November 2019

Abstract
Alzheimer’s disease is now the 6th leading cause of death in Calhoun County – a mostly rural county of 156,000 people in southwest Michigan. In 2017, a cross-sector collaborative launched Dementia Friendly Battle Creek led by CareWell Services Area Agency on Aging. This study focuses on evaluation of the progress and outcomes of this initiative. The goal is to create a community that features high awareness of dementia, coordinated systems of care, and an environment that promotes dignity and engagement of PWD. Using participatory community planning, three Pillars of Impact were developed: Awareness, Coordination, and Environment. More than 500 people have engaged in the effort through trainings, educational programs, expanded supportive services, and the creation of integrated pathways of care for PWD. Additionally, more than $100,000 has been leveraged to support the effort. Challenges included sustaining momentum & gaining buy-in from local municipalities and health care providers.
HEARING LOSS AND HEALTH CARE SATISFACTION
Authors: Reed Nicholas , Reed Nicholas , Willink Amber , Deal Jennifer , lin Frank R 
Published: November 2019

Abstract
Hearing loss (HL) impacts two-thirds of adults over 70 years and affects patient-provider communication which could limit satisfaction. We used two cross-sectional cohorts, The Atherosclerosis Risk in Communities Study (ARIC, n=250) and the Medicare Current Beneficiaries Survey (MCBS, n=12,311) to examine the relationship between HL (subjective and objective measures) and self-report satisfaction with quality of health care using multivariable-adjusted logistic regression. In ARIC, there was an interaction between HL and age such that HL had a greater impact on odds of dissatisfaction as age increased. In an 85-year-old, for every 10 dB increase in HL, the odds of being dissatisfied increased 1.33 (95% Confidence Interval [CI]:0.96-1.83). In MCBS, compared to participants with no trouble hearing, those with a lot of trouble hearing had 1.7 times the odds ( 95% CI = 1.150-2.623) of being dissatisfied. This has implications for patient-centered care planning given that Medicare ties reimbursement to patient-reported satisfaction.