bluuebunny/crossref_metadata_2025_split huggingface dataset:
RE-CONCEPTUALIZING SPOUSAL CAREGIVING FROM A DYADIC PERSPECTIVE IN THE U.S.
Authors: Li Yuekang , Liu Huiying , Wang Yi , Morrow-Howell Nancy 
Published: November 2019

Abstract
Existing literature on later-life spousal caregiving tends to focus on one member of the marital dyads, assuming a priori distinction between the caregiver and care-receiver. Theoretically and empirically, this individualistic role-related (caregiver-receiver) approach is inaccurate, as the concept of spousal care intrinsically involves two people within a marital dyad. Therefore, this paper used a social exchange perspective to re-conceptualize spousal caregiving as a dyad-level phenomenon. Using the 2014 wave of the Health and Retirement Study, 6,500 individuals (3,250 couples) aged 65 and above and their spouse were selected. Based on each partner’s need for care, receipt of spousal care, and provision of spousal care, the study identified five distinctive caregiving typologies. Household-level factors such as the availability of other types of informal care were associated with these typologies. This paper offers a broader and more dynamic perspective of the spousal caregiving experiences.
EFFECTS OF ADAPTIVE COMPUTER-BASED COGNITIVE TRAINING ON COMMUNITY-DWELLING ELDERS
Authors: Guo Guifang , Gongzhi Huijuan 
Published: November 2019

Abstract
This quasi-experimental designed study analyzed the effects of adaptive computer-based cognitive training among community-dwelling older adults. A 6-week (5 times/week) program was implemented with an intervention group (Difficulty Adaptive Training) and control group (Difficulty Fixed Training). General cognitive, memory, executive and attention functions were evaluated before (T1), completion (T2), and one month after intervention (T3). Sixty-one participants completed data collection. (1) General cognitive function: improved in both groups at T2, and T3, intervention group had better effect; (2) Memory function: improved in both groups in immediate, short and long-delayed recalls at T2 and T3, and recognition at T2. (3) Executive function: improved in both groups. Time of simple information processing was shortened at T2 and T3 in intervention group, at T3 in control group; TMT response inhibition was shortened at T2 and T3 in both groups. (4) Attention function: digit span forward was improved at T2 in intervention group.
LONGITUDINAL MENTAL HEALTH CONSEQUENCES OF PHYSICAL DISABILITIES: THE MEDIATING ROLE OF PERCEIVED DISCRIMINATION
Authors: Namkung Eun Ha , Carr Deborah 
Published: November 2019

Abstract
Individuals with disabilities have been historically mistreated by discrimination. The detrimental mental health effects of self-reported interpersonal discrimination are well established. However, little empirical attention has been given to the role of perceived discrimination in the adverse mental health outcomes of adults with physical disabilities. This study aims to examine whether daily interpersonal discrimination (i.e., microaggression) mediates the prospective association between having a functional impairment and subsequent changes in the individuals’ mental health outcomes over their midlife and old age. To address this question, this study used data from two waves of a population-based national study, the National Survey of Midlife Development in the United States, covering a 7- to 9-year period (n= 2,503; Mage at baseline = 57, SDage = 11). Physical disability or functional impairment was assessed with items adapted from the SF-36, capturing difficulty with nine activities of daily living. Having functional impairment at the baseline assessment was associated with increases in depressive symptoms and negative affect over the study period. Daily interpersonal discrimination partially mediated this longitudinal association, explaining 7.4% (for depressive symptoms) to 8.1% (for negative affect) of the total effects. Exposure to discrimination and its mental health consequences were also more pronounced at younger ages. Disability-related perceived discrimination is an under-recognized mechanism that is likely to contribute to mental health inequities in later life. Professionals in health and disability policy, research, and practice need to concentrate efforts on developing policy and programs that reduce discrimination experienced by US adults with disabilities.
RACIAL BIAS IN STAFF OPTIMISM ABOUT ADL IMPROVEMENT AMONG NURSING HOME RESIDENTS
Authors: Branco Kenneth J 
Published: November 2019

Abstract
Research on bias in health care has shown disparity in provision of care to and health outcomes of African Americans. Patient optimism was associated with improved physical and psychosocial outcomes, and nurse optimism was correlated with patient perceptions of care. We estimated effects of race using logistic regression, controlling for ADLs, cognitive impairment, and gender on both staff optimism and resident optimism about capacity for improvement in ADLs in a probability sample (n=2604) of nursing home residents who were evaluated with the resident assessment instrument (RAI). We found no difference between African American and White residents’ optimism about their own capacity for improvement. Staff findings were quite different. Staff were most optimistic about the potential of residents who needed ADL assistance OR=1.82; 95% CI [1.42-2.32] over those who were ADL dependent or those who only needed oversight. Most importantly, it was in the oversight category of ADL impairment where the greatest indication of racial prejudice occurred. Staff were much less likely to be optimistic about African American residents (16%) compared to White residents (30%). With all control variables entered, staff were still less willing to be optimistic about African American resident improvement (AOR=0.65; 95% CI [0.44-0.96]. The implications of these findings are troubling. It is unlikely that staff would expend energy on improving the functioning of the African American residents whom they believe cannot improve. Further research is needed on the extent to which prejudice in nursing homes is accompanied by discrimination and how the bias can be overcome.
HIGH-DEDUCTIBLE HEALTH PLANS AND COST OF HEARING AIDS AMONG ADULTS WITH HEARING LOSS: IMPLICATIONS FOR DISPARITIES
Authors: Mahmoudi Elham , Kamdar Neil 
Published: November 2019

Abstract
High-deductible health plans (HDHPs) have shown potential to curb rising healthcare costs. We examined use and cost of hearing aids (HAs), comparing HDHPs with non-HDHPs. Using the 2009-2016 Truven Marketscan claims, we identified adults aged 50-64 who were diagnosed with hearing loss (HL) and whether they used HAs or not (n=1,247,113). We applied multivariable generalized linear models, adjusting for age, gender, hierarchical condition categories (HCCs). To control for potential selection bias, we applied an inverse propensity score weighting. Our outcomes of interest included: (1) utilization and (2) total and out-of-pocket costs of HAs (inflation adjusted to 2016 dollars), comparing HDHPs with non-HDHPs. Number of enrollees in HDHPs increased by 343%, from 1,717 in 2009 to 7,615, in 2016. The percentage of patients who used HA increased from 9.5% (95% CI:0.09-0.10) to 15% (95% CI:0.14-0.15) within non-HDHPs and from 5% (95% CI:0.04-0.06) to 16% (95% CI:0.15-0.17) within HDHPs. The average adjusted cost sharing and total cost of HAs increased by 74% ($85 to $148) and 52% ($589 to $894), respectively, among non-HDHPs; they increased by 80% ($173 to $312) and 91% ($589 to $1,126), respectively, among HDHPs. Average out-of-pocket costs for HAs in HDHPs were twice as much as in non-HDHPs (p &lt;0.0001). Total and out-of-pocket costs for hearing aids were substantially higher among HDHPs compared with non-HDHPs. Many employers have started offering only HDHPs, leaving their employees with no other health insurance option. Higher cost sharing may worsen the existing socioeconomic disparities in access to HAs.
OPPRESSIVE EXPERIENCES AMONG DEAF DIVERSE SENIOR CITIZENS
Authors: Frank Audrey K 
Published: November 2019

Abstract
None of the limited literature on deaf seniors focuses on their experiences of oppression. There is an article that demonstrates that not many mental health professionals have the skills to work with deaf seniors. Obstacles have been noted in the literature among deaf people in general terms of being oppressed with employment, doctors, education, family discrimination, stereotyping, stigmas and cultural conflicts because they are deaf. The obstacles facing deaf seniors had not been specifically explored before this research. The shift attention to deaf seniors is needed in order to make their experiences known and at the same time their lives, values, and strengths need to be understood and recognized. Ninety-one deaf seniors from five states aged between 50 years and 93 years were interviewed to describe their recent experience on oppression. They shared their common experiences on oppression such as lack of communication with their doctors, hearing co-workers, and family members, struggling to get promoted at work, and being left out in the neighborhood. According to the deaf seniors, the community did not acknowledge or accommodate the special needs they had as deaf seniors. Their detailed descriptions provide consistent evidence that supports the importance of cultural awareness for medical and mental health professionals. The professionals are to enhance better understanding of experiences among deaf seniors. This lack of awareness highlights the need for research about deaf seniors’ experiences of oppression and for research on what professionals should know about the special needs of this population.
SILVER FRIEND: A SMART SPEAKER PROJECT TO ASSIST LOW-INCOME OLDER ADULTS LIVING ALONE IN SOUTH KOREA
Authors: Kim Jongwoong 
Published: November 2019

Abstract
Ownership rate of smart speakers in the U.S. reaches 21 percent in late 2018, and the growth of the global market is predicted to explode in the coming years. With this trend, there is an increasing expectation that smart speakers can assist older adults to stay independently in their homes as they age. However, there still is a shortage of empirical studies and evidence that these devices can actually be effective in helping older adults age in place. This paper describes a pilot project, Silver Friend, in South Korea, which utilizes a smart speaker, NUGU, to help low income older adults who live alone remain their homes as actively and safely as possible. The Silver Friend project has largely two goals: 1) reducing the older adults’ loneliness and 2) improving emergency response via the NUGU’s voice recognition and data monitoring system. Initially, the project served 90 older adults who live alone in government-purchased rental housing. This project was a result of a public-private partnership led by a South Korean tech/telecom giant, SK Corporation, practicing its corporate social responsibility. In South Korea, 15 percent of the population is age 65 and older, and 20 percent of them (approximately 1.5 million older adults) are living alone and/or in need of financial assistance. With the ever-expanding global market for smart speakers, this paper focusing on a case in South Korea describes evidence and a potential policy model in utilizing a smart speaker to help achieve the goal of aging in place.
FINDINGS FROM THE ENTOURAGE NOORD PROJECT: CO-CREATING NEW HOUSING MODELS FOR OLDER ADULTS IN BRUSSELS
Authors: Smetcoren An-Sofie , De Donder Liesbeth 
Published: November 2019

Abstract
In response to the challenge of an ageing population and the housing crisis in Brussels, the practice-based project ‘Entour-Age Noord: Inspiring and innovative housing & work’ was launched. A main objective was to develop various innovative and small-scaled housing models for older adults. The new housing models were designed to reinforce quality of life of older people who are ageing in the neighbourhood whilst allowing them to choose the models best suited to their needs and wishes. Given the complexity and multidimensionality, participatory-action research was used and the project was divided into six different ‘work packages’ (WP’s). Within these WP’s, different stakeholders and end users (older people, informal caregivers, neighbourhood residents, Community Land Trust, etc.) were involved during various activities (service design methodology, architectural workshops, inspiring visits, focus groups etc.) in order to co-create the answers. First, based on the results, eight personas (=conceptual models of targeted groups) were developed. Second, stemming from the participants needs and wishes (e.g. desire for more social interaction), architectural and spatial design characteristics were detected (e.g. provide common/shared spaces that stimulate encounter). Based on these personas and spatial characteristics, two prototypes of new housing models were conceptually elaborated on paper and two were operationalized and prepared in practice. The spatial and architectural characteristics are not limited to old age but can be of interest of any age group. Future housing developments could take these suggestions into consideration. Furthermore, experiences, opportunities and pitfalls of a co-creative decision-making process with older adults will be discussed.
THE DUKE INTERAGENCY CARE TEAM: A BRIDGE TO GERIATRIC COMMUNITY RESOURCES
Authors: Kanne Geraldine E , Black Melissa , Disco Marilyn , Mack-Minniefield Rhonda , Halpern David , Upchurch Gina , White Heidi , Heflin Mitchell T 
Published: November 2019

Abstract
The Duke Geriatric Workforce Enhancement Program aims to improve linkages between primary care practices (PCP’s) and community-based organizations by developing an interdisciplinary, community-based team to consult with PCPs, identifying resources to help vulnerable older adults. The Inter-agency Care Team (ICT) includes a nurse practitioner, pharmacists, community resource specialists, geriatricians and geriatrics and advanced practice nursing fellows. PCP’s refer older adults with complex care needs through the EHR for virtual consultation by the ICT. Team members review medical records and call participants and caregivers to obtain permission for the consult, gather information on function, social factors, medical problems, and their perceived needs. The ICT meets to review each case and sends written recommendations to the PCP and patient. To date, the ICT performed consultations for 73 older adults with a mean age of 76 years. 69% were female. 71% were black and 26% white. Frequently identified needs included personal/home safety (74%), medication management (64.3%), food security (63.0%), cognition (49.3%), transportation (38.4%) and advance care planning (31.5%). In the 90 days before consultation, 32.9% of patients had ED visits and 21.9% were hospitalized. In the 90 days after, 24.7% had ED visits and 13.7% were hospitalized. (Differences were not statistically significant.) ICT provided virtual consultation for complex older adults with prevalent social needs and high rates of ED visits and hospitalization. The team worked with PCP’s to connect these patients more directly to community resources. Further study is needed to know rates of adherence with recommendations and true impact on health outcomes.
BUILDING SAFE ROUTES TO AGE IN PLACE THROUGH PARTNERSHIPS WITH AGE-FRIENDLY COMMUNITIES
Authors: Dabelko-Schoeny Holly , Fields Noelle L , Murphy Ian , White Katie , Sheldon Marisa , Ravi Kristen E 
Published: November 2019

Abstract
Participation in active transportation by older persons has been associated with higher quality of life and longevity. Efforts across the United States to increase active transportation (walking, biking and fixed route transportation) by older adults have lacked meaningful input by older adults, are non-theoretical and have had inconclusive results. This paper describes the findings from Phase 1 of the Safe Routes to Age in Place project, a collaboration between Age-Friendly Franklin County, The Ohio State University (OSU) and the University of Texas-Arlington (UT-A), funded by the Ohio Department of Transportation. The aim of the study is to increase the options and safe utilization of active transportation by older persons in three pilot neighborhoods in Franklin County, Ohio utilizing community-based participatory action research strategies with a customized data collection app, MyAmble. The purpose of Phase 1 was to engage city and regional planning students, government officials and older adults to identify “hot spots” in the three pilot neighborhoods. Heat mapping of community data including locations of densely-populated vulnerable older adults, fixed transportation routes, bus stop signage and benches, shared bike stations, bike routes, paratransit routes and pedestrian crash data was completed. Maps were used to identify areas of focus and discussions with municipal leaders and older adult residents further refined target areas to be used in the second phase of the study. Older residents completed walk audits using the MyAmble app and identified issues with sidewalks, crosswalk timers and bus stops. Implications related to age-friendly communities and active transportation are offered.
CHARACTERISTICS AND LIVING ARRANGEMENTS OF CHILDLESS ELDERLY AMERICANS
Authors: Xu Xiao , Liang Jersey , Kim BoRin , Ofstedal Mary Beth , Raymo James 
Published: November 2019

Abstract
Despite a growing number of Americans without children, information on characteristics of childless older adults and their living arrangements is sparse and often outdated. To address this knowledge gap, we examined data from the 2014 Health and Retirement Study (HRS) on childless Americans age ≥65 years (N=760) and compared with childless elders in 2004 HRS (N=830). All analyses accounted for complex sample design of HRS to generate nationally representative estimates. The proportion of elderly Americans without any living biological or step children increased from 8.1% in 2004 to 9.4% in 2014. Compared to childless elders in 2004, those in 2014 were younger (mean age=76.8 years versus 73.8 years, p&lt;0.01) with a higher proportion completing college education (20.7% versus 37.5%, p&lt;0.01) or were cognitively intact (64.6% versus 73.6%, p&lt;0.01). However, childless elders in 2014 had more chronic conditions than those in 2004 (mean=2.5 versus 2.3, p&lt;0.01). The proportion of childless elders living independently (alone or with a spouse) (81.6% in 2004 versus 82.6% in 2014) or living with others (10.0% in 2004 versus 13.5% in 2014) remained relatively stable, whereas the proportion living in nursing homes declined significantly from 8.4% in 2004 to 4.0% in 2014 (adjusted odds ratio [OR]=0.07, p&lt;0.01). A sensitivity analysis limited to childless elders without biological children showed that they accounted for 9.9% of the elderly population in 2004 versus 11.9% in 2014, while other results were generally similar. These findings can help inform long term care needs of childless elders.
GERIATRIC CONDITIONS AND HEALTH CARE UTILIZATION AMONG OLDER ADULTS LIVING IN SUBSIDIZED HOUSING
Authors: Kler Sarah E , Jeon Sun Young , Patel Kanan , Ritchie Christine , Harrison Krista , Thomas Kali S , Brown Rebecca 
Published: November 2019

Abstract
In the US, 1.7 million low income older adults live in subsidized housing. Previous research suggests that subsidized housing residents have poorer health status than older adults in the general community. However, little is known about the prevalence of geriatric conditions. To understand these factors we conducted a retrospective cohort analysis of 11,558 Medicare enrollees ages 65+ who were enrolled in the National Health and Aging Trends Study in 2011 or 2015, including 507 living in subsidized housing and 11,051 in the general community. We compared subsidized housing residents to general community residents across measures of sociodemographics, functional limitations, and geriatric syndromes. We also compared the prevalence of hospitalization, move to a higher level of care, and death within five years. Results suggest that compared to general community residents, subsidized housing residents were more likely to be women (66% vs. 55%, p&lt;0.01), racial/ethnic minorities (50% vs. 18%, p&lt;0.01), and to lack a high school diploma (50% vs. 20%, p&lt;0.01). They also had poorer health status, including higher rates of self-reported functional impairment (difficulty with 2 or more ADLs; 16% vs. 10%, p&lt;0.01), probable dementia (15% vs. 8%, p&lt;0.01), and frailty using the three-level Fried frailty index (55% vs 26%, p&lt;0.01). Subsidized housing residents also had higher rates of hospitalization (29% vs. 22%, p&lt;0.01), move to a higher level of care (4% vs. 3%, p&lt;0.01), and death (10% vs. 7%, p&lt;0.01) compared to community-residing peers. These findings will help inform targeted interventions to improve aging in place for this vulnerable population.
ANTI-AGING PROTEIN CD9 AFFECTS AGE-RELATED HEART FAILURE
Authors: Jonnakuti Sriya T , Ullah Mujib 
Published: November 2019

Abstract
The CD9 is transmembrane protein that plays a critical role in many cellular processes including aging associated cardiac pathologies. The heart function declines in the aged population. Ageing is strongly associated with many age-related conditions such as increased risk of heart failure. If aging can be prevented slowed down or even reversed, heart failure and other signs of aging could be controlled or even cured. It is unknown whether CD9 is cardioprotective. The objective of this study is to investigate whether a decline CD9 levels contributes to aging-related heart failure. Our data shows that CD9-deficient aged mice develop cardiac abnormalities and pathological cardiac hypertrophy, Cardioprotection by CD9 in old mice is followed by the downregulation of SIRT6 in the heart, and CD9 overexpressed exosomes ameliorates cardiac pathologies in treated mice and improves their long-term survival. Additionally, the serum level of CD9 decreased significantly in aged mice. CD9 overexpressed exosomes are cardioprotective and improve cardiac function in aged mice. These exosomes mediate their paracrine effects by attenuating, blood pressure, heart beat, reactive oxygen species and fibrosis. Remarkably, CD9 overexpression reversed fibrosis associated brain natriuretic peptide (BNP), Sirt6, and galectin 3 (Gal-3). These results provide a new perspective on the pathogenesis of cardiomyopathies and open new avenues for treatment of the disease.
SINGLE-CELL TRANSCRIPTOMICS OF AGING MOUSE ISLET REVEALS AGE-RELATED RECRUITMENT OF ISLET-RESIDENT MACROPHAGE
Authors: Nie Jia , Musi Nicolas 
Published: November 2019

Abstract
Type 2 diabetes (T2D) prevalence increases with age. The notion of inevitable progression of T2D has been challenged by reports of remission in some human T2D cases; however, this remission is dependent on islet function reserve. To elucidate the molecular mechanisms driving islet cell dysfunction, it is necessary to understand islet cell composition, diversity, and function throughout the lifespan. We generated a single-cell transcriptomic atlas of healthy islets isolated from young (5 weeks old), middle-aged (12 months old), and older-aged (25 months old) mice. Cell clustering identified 13 initial cell clusters that were further sub-clustered. This single-cell RNAseq profile showed that each cell type/group has different markers and functional characteristics and that age causes a remarkable shift in islet cell composition, diversity, and number. By comparing macrophages from young and old mice, we also found that aged islets contain a higher number of islet-resident macrophages. Overall, this single-cell islet atlas covers nearly all cells in the normal islet and allows a comprehensive exploration of all transcriptional states throughout the lifespan.