bluuebunny/crossref_metadata_2025_split huggingface dataset:
HOW DOES PARENT-CHILD RELATIONSHIP AFFECT CARE? FOCUSING ON MOTHER-DAUGHTER CAREGIVING
Authors: Baba Ayako 
Published: November 2019

Abstract
OBJECTIVE: Long-term caregiver (child)/care-recipient (parent) relationships have both positive and negative effects on care. However, the mechanism of that impact is unclear. This study aimed to explore how parent–child relationships affect care and which aspects cause those effects. METHOD: Five hundred thirty-four adult children who were caring for or had cared for their parents at home completed the scales of parent–child psychological independence, the acceptance of care, care attitude, and care burden. Data were analyzed using a pass analysis with multiple group structural equation modeling to identify the relationship between parent–child psychological independence, acceptance of care, care attitude, and care burden, and the care dyad difference of the models. RESULT: 1) “Reliable relationship with parent” in parent–child psychological independence affected “resignation” and “understanding actively” in acceptance of care. 2) “Psychological individuation from the parent” in parent–child independence affected all subscales of care attitudes. 3) “Resistance” and “understanding actively” in acceptance of care and “auto-pilot” in care attitude affected care burden. 4) In mother–daughter caregiving, “resistance” and “resignation” had stronger effects on “auto-pilot” whereas “utilization of resource” and “flexible response” in care attitude and “resistance” had weaker effects on care burden. CONCLUSION: The relationship between long-term parent–child relationship and care were revealed. In some points, daughters who were caring for or had cared for their mothers had a different model from other care dyads. These results suggest that child caregivers should be supported mentally in accordance to their difficult points and dyads.
URINARY MARKERS OF OXIDATIVE STRESS CORRESPOND TO INFECTION AND AGING IN WILD CHIMPANZEES
Authors: Thompson Nicole A , Otali Emily , Machanda Zarin , Muller Martin , Wrangham Richard , Emery-Thompson Melissa 
Published: November 2019

Abstract
Oxidative stress (OS) plays a central role in aging and results from a variety of stressors, making it a powerful measure of health and a way to examine phylogenetic variation in life history. However, few urinary OS markers have been examined under field conditions, particularly in primates, and their utility to non-invasively monitor acute vs. chronic conditions is poorly understood. In this study, we examined variation in 5 urinary markers of oxidative damage and protection under 5 validation paradigms in 37 wild, adult chimpanzees living in the Kibale National Park, Uganda. We used 925 urine samples to conduct both cross-sectional and within-individual analyses of responses to acute infection and variation with age. Markers of damage (8-OHdG, F-isoprostanes, MDA-TBARS, and neopterin) and total antioxidant capacity were generally positively correlated with one another. Within individuals, all markers responded to at least one if not both types of acute infection. Markers of damage also varied with age, particularly in individuals near death. Unlike in human and rodent tissues, DNA damage in urine decreased with age, both across and within individuals near death, suggesting a potential decline in DNA repair and/or metabolic rate during senescence. Our results suggest that OS can be measured using field-collected urine and may be useful for both short- and long-term indicators of health. Our results further confirm that using multiple markers and longitudinal sampling within individuals is the most productive approach for studies that seek to determine the role of OS in health and lifespan in long-lived organisms.
POLICY MODIFICATION, CLINICIAN TRAINING, AND ENROLLMENT OF COMMUNITY-DWELLING OLDER ADULTS TO ADOPT A MODEL OF CARE
Authors: Spoelstra Sandra L 
Published: November 2019

Abstract
Partnering with a Medicaid Home and Community Based waiver, we tests implementation strategies on adoption and sustainability of a model of care to support aging-in-place, intervening on individual capabilities and the home environment. Knowledge-to-Action model underpins the 2-arm (usual care + internal facilitation versus additive external facilitation) 3-year randomized (sites) trial statewide using an implementation strategy bundle (relationship/coalition/team building; education; interdisciplinary care/coordination; facilitation; and audit/feedback). Consolidated Framework for Implementation Research guides examining characteristics (site/RN-OT-SW/beneficiary), clinician attitude/self-efficacy, leadership/readiness to implement, and policy on adoption and sustainability; and intervention impact on beneficiary outcomes. Linear models will be used to analyze fidelity, Poisson and bootstrapping gage adoption, sustainability, fidelity, and level of facilitation. Champions (internal facilitators/supervisors; N=57) were engaged and 33.3% (n=19) completed online training (1.5 hours; 7.0 [SD 2.3] understood role; 6.8 [SD 1.8] would use training: 1-10 [lo-hi]); 100% (N=19) attended monthly coalition-building meetings. RN-OT-SWs were recruited (mail); 608 of 685 (88.8%) consented and completed online education (5.5 hours; Certified). Policymakers included quality incentives in contracts (10/1/2019) with sites for &gt;95% certified RN-OT-SWs. Beneficiaries (N=12,000) were recruited (mail); 5% (n=608) did not participate (16.1% [n=98] poor cognition; 11.5% [n=70] nursing home/assisted living; 7.1% [n=43] no needs; 5.9% [n=36] too sick; 5.2% [n=32] many caregivers; 5.1% [n=31] inability to improve]; no English/hospitalized/other). Stages of Implementation Completion and fidelity data (September/October) will be reported. Adoption of models of care to support aging-in-place in Medicaid settings are a challenge, and this research harnesses a network (university/policymaker/supervisors/waiver sites-clinicians/beneficiaries) to improve care for vulnerable older adults.
30-DAY READMISSION IN PATIENTS WITH CARDIOVASCULAR DISEASE: DO PATIENTS KNOW THEIR RISK BEFORE DISCHARGE?
Authors: Xu Hanzhang , Farmer Heather R , Granger Bradi , Dupre Matthew 
Published: November 2019

Abstract
Cardiovascular disease (CVD) is the leading cause of disability and death in the United States, and older adults with CVD are at a high risk of readmission after discharge. This study examined whether patients’ perceived risk of readmission at discharge was associated with actual 30-day readmissions in patients with CVD. A standardized survey and electronic health records (EHR) were used to collect sociodemographic, psychosocial, behavioral, and clinical data on patients admitted to the Duke Heart Center (n=730). Prior to discharge, patients were asked their perceived likelihood of returning to the hospital for an unplanned/emergency visit within 30-days. Logistic regression models were used to examine all-cause 30-day readmission among patients who perceived low versus high readmission risk. Nearly 1-in-3 patients (31.4%) perceived high-risk of readmission at the time of discharge. Life stressors, poor self-rated health, and ADL limitations were associated with perceptions of high-risk. Patients who perceived high-risk had significantly higher subsequent readmissions compared with low-risk (23.3% vs. 15.6% p=0.016). Among patients who perceived low-risk of readmission, those who were widowed, had inadequate health literacy, and reported difficulty accessing care exhibited a higher likelihood of being readmitted. In those perceiving a high-risk, nonwhites and those with poor self-rated health, difficulty accessing care, and prior hospitalizations in the past year were significantly more likely to be readmitted. These findings have important implications for identifying CVD patients at high risk of readmission within 30 days after discharge, particularly older adults who may lack adequate resources (e.g., social support, literacy, access to care).
HEALTHY AGEING FOR ALL? SOCIOECONOMIC CHANGES OVER TIME IN DISABILITY-FREE AND INDEPENDENT LIFE EXPECTANCIES
Authors: Bennett Holly Q , Matthews Fiona E , Robinson Louise , Corner Lynne , Kingston A , Jagger Carol 
Published: November 2019

Abstract
Background: Previous research using cross-sectional data shows widening inequalities in disability-free life expectancy (DFLE) by socioeconomic status (SES) in the UK. We aimed to understand the underlying transitions of DFLE and years dependency free (DepFLE) using longitudinal data from the Cognitive Function and Ageing Studies (CFAS I and CFAS II). Methods: Two large population based studies of those aged 65+ in three centres (Newcastle, Nottingham, Cambridgeshire) interviewed at baseline in 1991 (CFAS I) and 2011 (CFAS II) with follow up two years later. Disability was measured using difficulty in activities of daily living (ADL), and dependency by time between help required for ADLs. SES was based on area deprivation categorised into study specific tertiles. Transitions between disability or dependency states and death were modelled using Interpolated Markov Chain software. Results: Between 1991 and 2011, DFLE and disabled life expectancy (DLE) at age 65 increased for men in every SES group, with men being less likely to become disabled or die, and more likely to recover, in 2011 than 1991 across SES groups. For the most disadvantaged women, DFLE was similar, and DLE increased, whilst for the remaining women DFLE increased and DLE was similar. For women probability of recovery increased and probability of death from disability decreased but probability of becoming disabled decreased only for the most advantaged. DepFLE patterns across time were similar but more pronounced. Conclusion: Preventive measures should focus on reducing the disability and dependency onset in the most disadvantaged to ensure inequalities do not widen further.
DEATH ANXIETY AND FINANCIAL DECISION-MAKING IN AGING: A STUDY FROM THE HUMAN CONNECTOME PROJECT AGING (HCP-A)
Authors: Ly Timothy K , Diaz-Santos Mirella , Campbell Liam , Caldera Marcela , Kuhn Taylor , Bookheimer Susan 
Published: November 2019

Abstract
While research addressing late-life death anxiety (the fear of death or the dying process) has focused on end-of-life care decision-making, few have studied the effect of late-life death anxiety on financial decision-making. This is particularly relevant to financial decision-making as older adults are more vulnerable to fraud and deception. The aim of this study was to determine how age and death anxiety affect financial decision-making in a sample of older adults of 60-93 years of age (N = 102), who participated in the HCP-A project at UCLA. To study this relationship, we used a delayed reward discounting task to model financial decision-making, where higher rates of discounting indicate a greater preference for immediate, smaller monetary rewards and lower rates of discounting indicate more future-oriented planning. To account for age-related cognitive decline, cognitive functioning was assessed using the NIH Toolbox. We hypothesized that the presence of death anxiety will increase discounting of future rewards in older adults. Results from a univariate ANOVA showed an interaction between age, death anxiety, and delayed reward discounting. Specifically, older adults with self-reported death anxiety showed greater preference for immediate, smaller monetary rewards. By controlling for cognition, these findings suggest that death anxiety moderates decision-making in late-life adults and may add to our understanding of why older adults are more susceptible to financial abuse. These results suggest a need to consider death anxiety as a moderating variable when developing and implementing policies and services that are geared towards older adults.
THE EFFECTS OF SOCIAL NETWORK ON RESILIENCE OF COMMUNITY-DWELLING OLDER ADULTS LIVING ALONE
Authors: Park Sangmi , Kim Tae Hui , Choi Soyeon , Lee Kyuwon , Jung Jisoo , Hong Myounghee 
Published: November 2019

Abstract
Resilience is one of the components for successful aging and is related to wellbeing in late life. Studies have shown that older people living alone have low resilience. However, most of these studies were mainly conducted on unhealthy participants. The aim of this study is to examine the factors that contribute to resilience of healthy older adults living alone. Older people living alone who are not subject to public health care service provided to the economically or physically challenged or depressed people were recruited. Data collected from 295 participants were used to conduct hierarchical multiple regression analyses, controlling demographic characteristics, level of cognitive and physical functions, and emotional status. A self-reported questionnaire, UCLA Loneliness Scale, Lubben Social Network Scale(LSNS), and Multidimensional Individual and Interpersonal Resilience Measure(MIIRM) were used to measure study variables. A hierarchical model accounted for 48.8% of the variance in resilience. In model 1(demographics), the religion(β=.178, p&lt;.001) and the perceived economic status(β=-.176, p&lt;.001) variables were significantly related to resilience. The subjective health(β=-.109, p=.038) in model 2(level of function) and the loneliness(β=-.379, p&lt;.001) in model 3(emotional status) had a significant effect on resilience. In model 4, the size(β=-.115, p=.029) and the frequency(β=.160, p=.003) of social networks significantly predicted resilience. The results showed that protecting older adults’ social networks could lead to promote their health and wellbeing. What can be inferred from this finding is that even though the members are small, the social network they often have contact with is important for the resilience of older adults living alone.
HEAVY ALCOHOL CONSUMPTION IN MIDLIFE IS ASSOCIATED WITH ACCELERATED BRAIN AGING SIX YEARS LATER
Authors: Slayday Riki E , Franz Carol E , Hatton Sean N , McEvoy Linda K , Lyons Michael J , Kremen William S 
Published: November 2019

Abstract
Excessive alcohol consumption is associated with cognitive decline, exacerbated brain atrophy, and dementia in older adults, but associations with midlife brain health are less well understood. We hypothesized that heavy drinkers would have older-looking brains in late midlife. We examined alcohol consumption at mean age 56 (range 51-59) in 364 men from the Vietnam Era Twin Study of Aging (VETSA) and their predicted brain age at mean age 62 (range 56-67). We created five midlife alcohol consumption groups based on drinks consumed over the past two weeks: never, former, light (1-14), moderate (15-28), and heavy (&gt;28). Participants underwent structural magnetic resonance imaging at mean age 62. Predicted brain age was measured using the Brain-Age Regression Analysis and Computation Utility software (BARACUS). Models adjusted for age, scanner, race/ethnicity, SES, smoking, health, depressive symptoms, alcohol dependence, general cognitive ability at age 20, and non-independence of twins within pairs. Heavy drinkers had a significantly older predicted than chronological brain age (M= 5.93, SE= 0.88) compared to each of the other four groups (p’s &lt; 0.05). There were no significant differences among the never (M= 2.88, SE= 0.98), former (M= 2.76, SE= 0.74), light (M= 3.00, SE= 0.94), or moderate (M= 5.93, SE= 0.88) consumption groups. Heavy alcohol consumption at age 56 was associated with an approximately 3-year greater predicted brain age difference at age 62. There was no evidence of protective effects of light/moderate drinking over non-drinking. The neurotoxic effects of excessive alcohol may exacerbate brain aging in late midlife.
LIVING-APART-TOGETHER RELATIONSHIPS: EXPLORING OLDER ADULT BLACK WOMEN’S PERSPECTIVES ON CAREGIVING EXCHANGES
Authors: Hicks Nytasia 
Published: November 2019

Abstract
Recent research suggests that the preference for living-apart-together (LAT) relationships, where individuals are committed to one another but reside in separate households, has increased among older adults. However, older adult LAT couples prefer not to exchange care to maintain autonomy. In this study, we examine future expectations of spousal caregiving exchanges among older adult black women in LAT relationships. Eleven black women ages 60-74 (married and unmarried) completed two semi-structured phone interviews about future spousal caregiving expectations as to receiving and providing emotional, financial, and physical support. Regarding providing spousal care, findings from this qualitative descriptive study suggest that participants were consistent in their intent to provide emotional support, yet divided in visualizing themselves providing both financial and physical support for a spouse. As to receiving care from a spouse, participants envisioned their spouses providing emotional support, but responses were inconsistent on the expectation of spouses providing financial and physical support. Participants anticipate receiving emotional and physical support from their adult children and/or close family members instead of spouses. Autonomy, level of commitment, and the exchange of health information were also identified as core concepts. This study has implications for applications to different intimate relationships regarding living arrangements, to professionals supporting caregiving families, and to further studies of family gerontology.
LOSS, SLEEP, AND HEART RATE VARIABILITY: GENDER DIFFERENCES
Authors: Chai Hye Won , Jester Dylan J , Lee Soomi , Joo Susanna 
Published: November 2019

Abstract
Death of a significant other is consistently found to have a detrimental effect on cardiovascular functioning, and such relationship may be stronger when loss is accompanied by low-quality sleep. Using data from the Biomarker project of Midlife in the United States study (n=1,310), we examined whether quality-of-sleep has an additive effect on the relationship between loss and heart rate variability (HRV). Loss was measured as losing someone close within a year of data collection, and was categorized based on the respondents’ relationship with the deceased. Relationship was categorized as: immediate family, relative, and friend. Quality-of-sleep was measured using the Pittsburgh Sleep Quality scale. Results showed that the associations among loss, sleep, and HRV differed by gender. For women, losing an immediate family was associated with worse HRV and this did not differ by quality-of-sleep. For men, death of an immediate family was associated with worse HRV only among those with poorer quality sleep. These results suggest that low-quality sleep may indicate psychophysical vulnerability for men who experienced loss, which may relate to their lower capacity for physiological adaptation.
USE OF A HOME SYMPTOM MANAGEMENT ZONE TOOL IN GERIATRIC PATIENTS UNDERGOING CANCER TREATMENT
Authors: Baker Mary F , Shockey Debra 
Published: November 2019

Abstract
Adult oncology practices are caring for a growing number of older adults with cancer. Evidence suggests that patients with cancer have higher emergency department (ED) utilization, particularly in patients 65 years of age and older and in those whose symptoms are poorly controlled. The ED is not the most appropriate nor most cost-effective option for addressing urgent care needs of patients undergoing cancer treatment. This quality improvement project is being conducted in a community medical oncology practice during usual cancer treatment education. Older adult patients starting or changing cancer treatment are presented with a zone tool (green-yellow-red) to inform decision-making at home regarding level of severity of current symptoms and recommended actions (e.g., you are stable, you need to call the office, you need to go immediately to the ED). The tool has been distributed to 28 patients with a goal of at least 30 by 9/20/19. Outcome measures include the number of ED visits in the intervention group compared to a pre-intervention sample of older adults from the same medical oncology office. Other outcome measures are acceptability of zone tool among clinical staff and patients. Preliminary data suggest suggest acceptability among staff and patients; and ease of use among clinical staff. Tracking of visits to the ED in the sample population and surveys of patients and staff are ongoing through October 2019.
VALIDATION OF A BRIEF SCREEN TO IDENTIFY PERSONS WITH DEMENTIA AT RISK FOR BEHAVIORAL DISTURBANCE
Authors: Evans Tracy L , Amspoker Amber , Kunik Mark E , Shrestha Srijana 
Published: November 2019

Abstract
Per current guidelines, clinical assessment of persons with dementia (PWD) should include potential causes of behavioral and psychiatric problems including pain, depression, and caregiver-patient relationship quality. Many validated assessment tools are available; however, administering a battery of instruments is not practical in most clinical settings. Objectives of this secondary analysis are to 1) evaluate the construct validity of brief screens (1-3 questions each) for pain, depression, and relationship strain by examining their associations with validated measures (Geriatric Depression Scale, Modified Philadelphia Pain Scale, Zarit Burden Interview, Mutuality Scale) and medication use and 2) evaluate the predictive validity of each individual screen and the screens as a set (number positive) by examining their associations with frequency of disruptive behaviors on the Revised Memory and Behavior Problem Checklist. PWDs (n=228) were included in the original trial if the PWD or the caregiver endorsed one or more of the three screens. There was evidence of good convergent and discriminate validity for each individual screen (p’s &lt; 0.01). Although only the relationship screen was individually associated with frequency of disruptive behaviors (p &lt; 0.00010), the total number of screens endorsed was positively associated with this frequency (F (2,225) = 5.50, p = 0.005). In this sample, the brief screening questions showed good construct and predictive validity. Further studies are needed to determine if they can be used to identify patients with depression, pain, and/or caregiver-patient relationship problems in the clinical setting.
AGE, SEX, AND FRAILTY INFLUENCE AGE-DEPENDENT CHANGES IN VENTRICULAR STRUCTURE AND FUNCTION IN C57BL/6 MICE
Authors: Howlett Susan E , Kane Alice , Bisset Elise , Keller Kaitlyn 
Published: November 2019

Abstract
The heart undergoes maladaptive changes during aging that set the stage for cardiovascular diseases, but frail older individuals are most likely to develop such diseases. We investigated the impact of frailty on left ventricular (LV) remodeling in male and female mice (aged 9-23 mos). Ventricular function/structure and frailty were assessed with echocardiography (Vevo 2100) and a frailty index (FI) tool. Fractional shortening (systolic function) increased with age (9 vs 23 mos) in males (27.7±2.6 vs 38.4±1.6%; p&lt;0.05) and females (26.9±1.4 vs 32.5±1.8%; p&lt;0.05); similar results were seen with ejection fraction. Conversely, E/A ratios (diastolic function) declined with age in males (1.9±0.1 vs 1.3±0.1; p&lt;0.05) and females (2.1±0.3 vs 1.6±0.1; p&lt;0.05). LV mass and LV internal diameter (diastole) increased with age in females but not in males, while intraventricular septum (diastole) increased in males only. As age-dependent changes were heterogeneous, we stratified the data by FI scores. Interestingly, fractional shortening (r=0.52; p=0.006) and ejection fraction (r=0.52; p&lt;0.0001) were graded by FI score, but only in males. By contrast, LV mass was graded by frailty, but only in females (r=0.55; p&lt;0.0001). Thus, diastolic function declines with age in both sexes while systolic function actually increases. Aging females display increased LV mass and LV dilation whereas older males exhibit septal thickening. These maladaptive changes are graded by frailty, suggesting that cardiac aging is prominent in those with poor overall health. Age, sex and frailty influence cardiac aging, which may predispose frail older men and women to develop different cardiovascular diseases as they age.