bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Affecting Subjective Well-Being Among Older Adults in India
Authors: Banerjee Kasturi , Baker Tamara 
Published: December 2020

Abstract
India has a rapidly expanding aging population whose unique mental health needs remain largely unexplored. Existent preliminary data however, show a significant association between life satisfaction and depressive symptoms within this population. Yet, little is known regarding the specific social and behavioral factors that may influence this relationship. Using data from the Longitudinal Aging Study in India (LASI) Pilot survey, the current study aimed to examine demographic and psychosocial factors associated with life satisfaction and subjective well-being among older adults 45+ years of age in the Indian states of Punjab, Rajasthan, Kerala and Karnataka. Results from the multivariate analyses indicated that age, household resources, neighborhood safety, religion, literacy status and participation in social activities are significantly associated with life satisfaction. Belonging to a southern state (β=.156; p&lt;0.001), being financial provider status (β=-.073; p&lt;0.001) and not being a care provider (β=.105; p&lt;0.01) were significant predictors of greater life satisfaction. These findings are consistent with previous exploration of state level disparities regarding accessible resources and quality of life, and similarly the need to better understand the role of financial difficulties and care-giving burden among this population. These findings suggest the need to use qualitative assessment that explores the role additional factors such as social engagement and perceived neighborhood support have on this population’s subjective well-being; thereby shaping public policy, focus resources, and form the foundation of intervention programs.
Gender, Race, and Immigrant Status: Intersecting Implications for Health in Middle and Later Life
Authors: Penning Margaret , Chappell Neena , Browning Sean , Kadlec Helena 
Published: December 2020

Abstract
Although the negative implications of gender, race and immigrant inequalities for health and well-being in the middle and later years of life are well-documented, there is a lack of research addressing their combined implications as well as the mechanisms linking them to various health-related outcomes. Yet, as intersectionality theory reminds us, the consequences of gender, race, immigrant and other inequalities for physical and mental health outcomes must be understood in terms of these overlapping social identities. Moreover, linking intersectionality to stress process theory provides us with an explanation of the mechanisms potentially linking intersecting structural inequalities to health outcomes. This paper draws on data from the Canadian Longitudinal Study on Aging (CLSA - N=51,338) to assess the additive and interactive implications of gender, race and immigrant status for physical and mental health outcomes, together with the mediating effects of primary and secondary stressors on these outcomes. The results of a series of weighted least squares regression analyses suggest that immigrant status interacts with race and/or gender to influence health outcomes. Socioeconomic and other stressors also play a role in linking these intersecting structural inequalities to health outcomes. Overall, our findings provide initial support for the value of linking intersectionality and stress process frameworks for an understanding of the health implications of structural inequalities in middle and later life.
Too Many Treats or Not Enough to Eat? The Impact of Custodial Grandparents on Food Security and Nutrition
Authors: Nadorff Danielle , Mathews Rahel 
Published: December 2020

Abstract
In the US, 28.5% of seniors are obese, with a BMI of 30 plus. The prevalence of obesity for children is also an alarming 17%, making it one of the primary public health burdens. According to the socio-ecological model, a child’s weight status can be influenced by factors related to parenting style, family, and the community. The literature reflects a significant emphasis focusing on children and their parents. However, according to the US Census, 7.5 million grandchildren are living with their grandparents, with about 1/3 of these residing in skipped-generation households. There are essential age-related differences in food preparation and eating behaviors between middle-aged and older grandparents and younger adult parents that may influence their children’s eating behaviors. Grandparents may provide a positive feeding environment, including role-modeling healthy food intake, teaching children about nutrition, and involving them in mealtimes and cooking, monitoring and encouraging children to eat nutritious foods, especially vegetables and regularly serving vegetables. However, grandparents have also reported providing energy-dense and nutrient-poor food and drinks and used food as a reward or gift. The current study aims to investigate the influence of caregiver type (grandparents only, parents only, or multigenerational households) on children’s nutrition, food security, and BMI. One-way ANCOVAs controlling for SES found that grandparent-headed households had children with more deficient diet and higher BMIs, but also less food insecurity. These results indicate that age-related changes in caregiver type are an important predictor of children’s nutritional health. Details and clinical implications will be discussed.
A Pilot Study of the Effects of Formal Service on Japanese Family Caregivers’ Daily Fluctuation of Stress
Authors: Abe Koji 
Published: December 2020

Abstract
Purpose: Recent studies report daily fluctuations in stress among family caregivers of older individuals with dementia. Several studies focused on daily stressors or behavioral and psychological symptoms of dementia and use of adult day services. Most previous studies on daily fluctuations of caregivers’ stress have used a daily diary approach. This approach involves creating multiple daily reports, making it possible to examine between-person differences and within-person processes of change. However, only few studies used this approach for family caregivers in Asian countries. Therefore, this study examines the applicability of a daily diary approach for Japanese family caregivers and the effects of formal care services on their stress and depression. Methods: Participants were 13 family caregivers of individuals with dementia using formal care services in a rural area in Japan. They were assessed through self-administered questionnaires including use or nonuse of formal care services, caregiving stressors (DASC-8), depressive symptoms (K-6), and caregiving stress for 7 days. Generalized linear mixed models (GLMM) with data nested within persons were used to examine the effects of formal services on stress and depression. Results: For the GLMM procedure, this study used caregiving stressors and stress variables as fixed effects and participants as random effects. Results indicated that use of formal services significantly lowered caregivers’ stress and depression. Conclusion: The findings demonstrate the applicability of a daily diary approach and the effectiveness of formal services on the stress of Japanese family caregivers.
Early- to Late-Life Environmental Factors and Late-Life Global Cognition: The SONIC study
Authors: Ishioka Yoshiko , Gondo Yasuyuki , Masui Yukie , Nakagawa Takeshi , Ogawa Madoka , Inagaki Hiroki , Yasumoto Saori , Ishizaki Tatsuro 
Published: December 2020

Abstract
Life environment across the life course—such as engagement in late-life leisure activity (LA), primary occupation, and early-life education—have been reported to be associated with better late-life cognitive outcomes. However, few studies have included all these factors from the past to the present due to the time-consuming procedure to measure all factors. This study examined (1) whether late-life LA is associated with better late-life cognition, after considering other life environments and (2) whether occupation, education, and childhood intelligence quotient have indirect effects on the late-life cognition through late-life LA. We used baseline data from the groups of 70- and 80-year-olds in the SONIC study (N = 1721 ). Global cognition was measured using the Montreal Cognitive Assessment. As for LA, participants were asked for yes/no answers to questions regarding their engagement in 158 activities. A latent factor representing LA was used in the analyses. We retrospectively evaluated the complexity of work with data, people, and things. As early-life environments, education and language and arithmetic abilities during elementary school were included in the analyses. Age and gender were controlled. A structural equation model showed that late-life LA was significantly associated with higher global cognition, even after controlling for all past factors (RMSEA = .050, GFI = .973, AGFI = .947). Sobel tests showed significant indirect effects of occupation, education, and childhood abilities on cognitive function. Results were robust across age and gender. It is suggested that engagement in LA explains individual differences in late-life cognitive function.
Evidence for an Age-Related Positivity Effect in Metacognitive Confidence Judgments
Authors: Sanders Edie , Berry Jane 
Published: December 2020

Abstract
We examined age differences in metacognitive monitoring of emotionally-valenced stimuli. If older adults (OAs) are more focused on emotionally meaningful goals in late life (Carstensen, 2006), then they should demonstrate attentional and memory biases for positive stimuli over neutral and negative stimuli and, arguably, these cognitive biases should be reflected in their metacognitive judgments of learning. Judgments of learning (JOLs) for memory of positive, negative, and neutral words were collected. Younger adults (YAs) aged 18-23 years and OAs aged 65-90 years (N = 85) studied words in each valence category and made immediate JOLs, followed by a two-alternative forced choice (2AFC) recognition memory task. Analyses of JOLs revealed evidence for a positivity effect (Mather & Carstensen, 2005) in metacognitive confidence for OAs and an emotional salience effect in YAs (Tauber & Dunlosky, 2012; Zimmerman & Kelley, 2010). Predictably, YAs recognized more words than OAs, but valence did not affect number of words recognized and valence did not moderate age differences in recognition memory (p = .055). Memory monitoring as measured by resolution accuracy was equivalent in YAs and OAs (Hertzog & Dunlosky, 2011). Positive affect was higher and negative affect was lower in OAs relative to YAs (Gallant, Spaniol, & Yang, 2019), lending additional evidence to an orientation toward the positive in older adulthood. These results are novel in that they demonstrate an age-related positivity effect that extends beyond the domains of memory and emotion to the domain of metacognitive aging. Discussion will focus on theoretical, methodological, and applied implications.
Information Avoidance in Decision Making: Do the Reasons Vary by Age?
Authors: Deng Stephanie , Nolte Julia , Loeckenhoff Corinna 
Published: December 2020

Abstract
Older adults make up the majority of the U.S. patient population and age differences in information avoidance have potential implications for their ability to participate in informed medical decision making. Meta-analytic evidence suggests that older adults seek less information before making a decision than younger adults do (Mata & Nunes, 2010). However, age differences in explicit information avoidance have yet to be quantified. We hypothesized that older adults would avoid decision-relevant information more strongly than younger adults do. We also examined the self-reported reasons for information avoidance and hypothesized that older adults would express more concern about unwanted information influencing their affect (Reed & Carstensen, 2012) and decision preferences (Mather, 2006), both of which are known predictors of information avoidance (Woolley & Risen, 2018). To test these assumptions, we conducted a pre-registered online study involving three different health-related decision scenarios. For each scenario, an adult lifespan sample (N=195, Mage=52.95, 50% female, 71% non-Hispanic White) chose to either receive or avoid information. Responses were highly correlated across scenarios and results were pooled into a single avoidance measure. Analyses indicated that concerns about consequences for decision preferences positively predicted decision avoidance (p&lt;.001), whereas concerns about consequences for affect did not (p=.079). Contrary to predictions, older age was not significantly associated with information avoidance (p=.827). Further, self-reported concerns about the influence of unwanted information on affect and decision preferences were negatively associated with age (ps&lt;.001). This suggests that interventions to foster pre-decisional information seeking should be tailored to the target age group.
Confirmatory Factor Analysis of the Geriatric Depression Scale to Measure Apathy in Older Adults
Authors: Ceide Mirnova , Cantor Aviva , Verghese Joe , Lounsbury David 
Published: December 2020

Abstract
Apathy is a psychological syndrome characterized by lack of motivation, interest, flattening of affect and social withdrawal; which has been associated with cognitive and functional decline in community dwelling older adults. Many of these associations have been investigated using subscales of depression tools, with varying sensitivity and specificity. The objective of this study was to develop an apathy measurement model, which distinguishes depression and apathy, using the Geriatric Depression Scale Long Form (GDS). We conducted an exploratory factor analysis (EFA) in a memory clinic cohort (N=81) who completed the GDS. Based on the EFA results, we ran a confirmatory factor analysis (CFA) in a community dwelling cohort of older adults (≥65 years old) enrolled in the Central Control of Mobility in Aging study (CCMA) and computed factor scores in both cohorts. CFA of the GDS in the CCMA cohort (N=538) yielded 3 factors: Depression (14 items; Cronbach’s α=0.77), Apathy (10 items; Cronbach’s α=0.63), and Cognitive concern (4 items; Cronbach’s α=0.546). In linear regression models, adjusted for age and gender, the memory clinic cohort had significantly higher Apathy factor scores (β = .18, t(618) = 4.49, p &lt; .001) factor scores compared to the CCMA cohort.Our findings suggest that the CFA derived apathy score is a reliable and valid tool to distinguish apathy from depression in older adults. This novel measurement model can be employed in both clinic and research populations to investigate the role of apathy in cognitive decline.
Depressive Symptom Profile Transitions From Midlife to Late Life in the Wisconsin Longitudinal Study
Authors: Carr Kyle 
Published: December 2020

Abstract
Late-life depression is a significant public health problem among the growing elderly population in the United States. Structural social capital has previously been associated with lowering depressive symptoms in later life, but these results have been inconsistent. However, few studies have investigated this association when investigating different subtypes of depression. The current study used data from the Wisconsin Longitudinal Study (WLS) of 3,197 respondents to examine how structural social capital influences baseline depression statuses and transitions in these depression statuses. Latent class and latent transition analysis (LCA/LTA) were used to identify latent statuses at two time points in the WLS – 1992 and 2011 – as well as transitions between those statuses. Four depression statuses were identified at both time points: Very Depressed, Depressed and Lonely, Agitated and Restless, and Not Depressed. Gender, self-rated health, total assets, structural social capital measures, and polygenic score for depression were all predictors of baseline depression statuses. Transitions between depression statuses were associated with two forms of structural social capital – social support and social involvement. These findings add to the increasing number of studies investigating subtypes of depression in older adults as well as to scholars examining the association between structural social capital and depressive symptoms. Results suggest possible social and behavioral factors policymakers can use to identify risk of depression in mid-life and areas of intervention to improve depressive symptoms for aging adults.
Subjective and Functional Health Literacy Screening in Geriatric Primary Care
Authors: Albright Amy , Dragan Deanna , Halli-Tierney Anne , Carroll Dana , Allen Rebecca 
Published: December 2020

Abstract
The aim of the current study is to provide comprehensive health care to older adults by assessing physical and mental health in a geriatric primary care setting, including evaluation of both subjective and functional health literacy. Health literacy is vital to understanding medical information and making subsequent decisions based on this information. Knowledge of patient health literacy may be particularly important for care providers, as it can provide guidance on how to best communicate with the patient (Nouri & Rudd, 2015). It may be particularly important to monitor health literacy within older adults, as several studies (e.g., Kobayashi et al., 2015) have shown that health literacy decreases with mild cognitive impairment. Approximately 250 patients (mean age = 76; 74% female; 16% African American) attending an interdisciplinary geriatrics clinic in West Alabama have been recruited to take part in a variety of behavioral health screenings. The current study assessed subjective health literacy using questions developed by Chew, Bradley, and Boyko (2004) and functional health literacy using the Newest Vital Sign (Weiss et al., 2005). While there was a significant correlation between subjective and functional health literacy (r = .43, p &lt; .001), 81% of patients reported adequate subjective health literacy, while only 41% demonstrated adequate health literacy on a functional screening measure. Based on these findings, self-reported health literacy may not necessarily be reflective of performance on more functional measures. Given the potential consequences of overestimating health literacy, this represents a serious barrier to patient care.
Assessment of a Potential UTI–Using Videos to Analyze a Simulated Nursing Home Experience
Authors: Owen Donna , Ashcraft Alyce , Johnson Kyle , Song Huaxin 
Published: December 2020

Abstract
In the past, urinary tract infections (UTIs) have been attributed to poor hygiene, the natural course of aging, an unfortunate corollary of nursing home (NH) residence, and a condition routinely treated empirically with antibiotics. Recent UTI management consensus statements foretell a very different future and support the need to consider all UTIs in the NH as complex infections. Improving assessment capabilities of the NH nurse workforce is essential for improving quality of care. This study aimed to determine how, using simulation, licensed vocational nurses (LVNs) integrated a mobile decision-support app (MDS-app) into assessment of a NH resident with a potential UTI. The MDS-app directed the LVN to examine or question the resident (mannequin) to identify signs and symptoms developed as part of a simulated clinical scenario. MDS-app items were based on UTI practice guidelines. A descriptive, participant observation design (video-taped) was used with ten practicing LVNs. An observation checklist was used to examine audiovisual recordings and included frequency of verbal interaction (17.9+/-7.2), and eye contact (10.6+/-4.1). Participants (47%) were “glued to” the MDS-app without making resident eye contact or touching residents during the assessment. 60% of participants deviated from the app to ascertain urine odor and color; irrelevant symptoms for UTI diagnosis. Assessments required 11.20 (+/-4.67) minutes to complete. The MDS-app provided LVNs with needed focus on data driven by guidelines and not individual LVN preferences. Training LVNs should focus on integration of communication, assessment skills, and MDS-app use for evidence-based data collection as a basis for UTI treatment decisions.
Characterizing Mealtime Verbal Interactions Among Nursing Home Staff and Residents With Dementia
Authors: Liu Wen , Williams Kristine , Batchelor Melissa , Perkhounkova Yelena , Hein Maria 
Published: December 2020

Abstract
Mealtime difficulties are common in residents with dementia, leading to negative outcomes. Interaction with staff are critical to engage residents in eating. This study characterized dyadic verbal interactions (descriptive statistics), and relationships among verbal behaviors and between verbal behaviors and individual characteristics (bivariate analyses). This secondary analysis of 110 videotaped mealtime observations involved 25 residents and 29 staff (42 unique dyads) in 9 nursing homes (NH). Verbal behaviors (utterances) were coded using the Cue Utilization and Engagement in Dementia mealtime video-coding scheme, addressing 8 positive behaviors and 4 negative behaviors. Staff spoke three times more frequently (76.5%) than residents (23.5%). Nearly all staff utterances were positive (99.2%). 85.1% of residents’ utterances were positive and 14.9% negative. Staff positive utterances were associated with staff negative utterances (p=.02), and resident positive (p&lt;.001) and negative (p&lt;.001) utterances. Staff negative utterances were associated with resident negative utterances (p=.02), but not with resident positive utterances (p=.39). Resident positive and negative utterances were associated (p&lt;.001). Staff positive utterances were associated with staff race (p=.01), and resident age (p=.01), dementia stage (p&lt;.001), and eating function (p&lt;.001). Resident positive utterances were associated with years staff worked as caregivers (p=.02) and in the current NH (p=.01), resident age (p=.04), comorbidity (p=.04), dementia stage (p=.01), and eating function (p=.003). Resident negative utterances were associated with dementia stage (p=.01). Dyadic mealtime interactions were dynamic, interactive and complex. Multiple resident and staff characteristics were related to mealtime verbal interactions. Findings may inform development of individualized, person-centered mealtime care interventions.