bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age and Daily Positive Events Moderate the Link Between Depressive Symptoms and Inflammation
Authors: Wen Jin , Almeida David , Sin Nancy 
Published: December 2020

Abstract
Inflammation is a pathway underlying numerous aging-related conditions. Depression is related to elevated inflammation, whereas daily positive events have been linked to lower inflammation; these psychological experiences may interact with age to predict inflammation. The purpose of this study was to examine whether daily positive events moderate the association between depressive symptoms and inflammation in an adult lifespan sample. A sample of 343 adults ages 25-75 (55% women, 83% white) in the Midlife in the United States Refresher Study completed daily diary interviews for 8 evenings about their daily positive events. Depressive symptoms were assessed with the 20-item Center for Epidemiological Studies Depression scale, and blood samples were assayed for inflammatory markers interleukin-6 (IL-6) and C-reactive protein (CRP). On average, depression scores ranged from 0 to 44 (mean = 9.31, SD = 7.80), and participants reported 1.25 (SD = .70) positive events per day (range = 0–5). Depressive symptoms and daily positive events were separately associated with higher and lower log IL-6 and CRP, respectively. Depressive symptoms, daily positive events, and age interacted such that daily positive events predicted lower IL-6 (but not CRP) among midlife and older adults who reported lower depressive symptoms, whereas positive events were not related to inflammation among younger adults. Thus, these findings suggest that the protective association between daily positive events and inflammation was blunted when depressive symptoms were elevated and for younger adults. This work has implications for understanding age variations in the role of positive experiences in depression and inflammation.
East and West Ethnography in Adult Day Services: Lessons From Taiwan and the United States
Authors: Liou Chih-ling , Salari Sonia 
Published: December 2020

Abstract
Adult Day Services (ADS), an alternative to institutionalization, offer daytime programs for those with physical and/or cognitive impairments. ADS have grown rapidly in Taiwan and the U.S., to improve quality of life (QOL) and provide respite for caregivers. ADS researchers have focused primarily on caregiver outcomes, with less emphasis on consumers. Our study is among the first to examine these issues in a cross-cultural context. Surveys are insufficient for ADS attendees, since many have diminished capacity. We use ethnographic methods to more fully understand the life of clients in ADS in two countries. The focus is on clients and staff, while including the physical and social environments. Data were collected over 820 hours of observation and 77 interviews with key ADS stakeholders, including clients, for insider perspective. Comparisons between the two countries, found that infantilization (e.g., baby-talk, child-oriented activities and decor) occurred in all 10 settings to varying degrees and outcomes were shaped by culture. In Taiwan, infantilization embedded within a cultural tradition of respecting elders and exhibited as a parent-child role reversal, where staff played the adult-child role. Their over-helping and over-controlling were aimed to ‘benefit’ clients, who were seen as incompetent aging parents. In the U.S., infantilization resembled a primary school environment with elementary décor. Aides used baby-talk and ‘taught’ compulsory child-oriented songs and games. This effect was exacerbated when preschool-aged children were added, and all generations were treated similarly. Results can be translated to implement age-appropriate care environments across cultures to improve QOL in ADS.
Goals-of-Care Consult and Future Costs, Acute Care and Hospice Use in Matched Cohorts of African Americans and Whites
Authors: Starr Lauren , Ulrich Connie , Appel Scott , Junker Paul , O’Connor Nina , Meghani Salimah 
Published: December 2020

Abstract
African Americans receive less hospice care and more aggressive end-of-life care than Whites. Little is known about how palliative care consultation to discuss goals-of-care (“PCC”) is associated with future acute care utilization and costs, or hospice use, by race. To compare future acute care costs and utilization and discharge to hospice between propensity-matched cohorts of African Americans with and without PCC, and Whites with and without PCC, we conducted a secondary analysis of 35,154 seriously-ill African American and White adults who had PCC at a high-acuity hospital and were discharged 2014-2016. We found no significant difference between African Americans with or without PCC in mean future acute care costs ($11,651 vs. $15,050, P=0.09), 30-day readmissions (P=0.58), future hospital days (P=0.34), future ICU admission (P=0.25), or future ICU days (P=0.30), but found greater discharge to hospice among African Americans with PCC (36.5% vs. 2.4%, P&lt;0.0001). We found significant differences between Whites with PCC vs. without PCC in mean future acute care costs ($8,095 vs. $16,799, P&lt;0.001), 30-day readmissions (10.2% vs. 16.7%, P&lt;0.0001), future days hospitalized (3.7 vs. 6.3 days, P&lt;0.0001), and discharge to hospice (42.7% vs. 3.0%, P&lt;0.0001). Results suggest PCC decreases future acute care costs and utilization in Whites and, directionally but not significantly, in African Americans; and increases discharge to hospice in both races (15-fold in African Americans, 14-fold in Whites). Research is needed to understand how PCC supports end-of-life decision-making and hospice use across races and how systems and policies can enable effective goals-of-care consultations across settings.
Age-Related Variation in Cardiovascular Risk Associated With Red Cell Distribution Width
Authors: Dalton Jarrod , Zidar David , Al-Kindi Sadeer , Krieger Nikolas I , Perzynski Adam 
Published: December 2020

Abstract
We previously showed that routine indicators of immune-hematologic function are strongly associated with all-cause and cardiovascular mortality, especially among older adults, in whom traditional atherosclerotic cardiovascular disease (ASCVD) risk factors predict poorly. The objective of this study was to quantify differences in the relationship between red cell distribution width (RDW) and 5-year risk of ASCVD events (stroke, myocardial infarction or cardiovascular death) as a function of age and the area deprivation index (ADI). We analyzed electronic health records of 76287 Cuyahoga County, Ohio residents who were over age 40 and who visited Cleveland Clinic Health System and/or MetroHealth System in two consecutive years between 2005 and 2015, the latter of which served as the index/baseline. Multivariable Cox regression was used, adjusting for sex, race/ethnicity, diabetes, systolic blood pressure and antihypertensive use. Generally, RDW levels in disadvantaged neighborhoods corresponded to people 15-20 years older from affluent neighborhoods. In a main-effects-only model, we found higher ASCVD event rates associated with age (hazard ratio [95% confidence interval] per 10 year increment: 1.34 [1.32–1.35]), ADI (top vs. bottom quintile: 1.30 [1.24–1.36]) and RDW (&gt;16% vs ≤13%: 2.03 [1.94–2.12]). Age and RDW exhibited a synergistic interaction (χ2 = 17.7 on 2 df, p&lt;0.001), with slightly larger RDW effects associated with increasing age, while evidence of differential RDW effects across ADI quintiles was weak (χ2 = 12.9 on 8 df, p=0.11). We conclude that RDW effects on ASCVD event risk are large, independent from traditional ASCVD risk factors and increase with advancing age.
Assessment of Appropriateness of Cardiovascular Preventive Medication in Adults ≥ 75 years
Authors: van der Ploeg Milly , Poortvliet Rosalinde , Gussekloo Jacobijn , Drewes Yvonne 
Published: December 2020

Abstract
Physicians are confronted with dilemma’s on cardiovascular preventive medication for older people with complex health problems. With accumulation of diseases, limitations and shortening life expectancy, questions arise for whom cardiovascular preventive treatment is still appropriate (the expected benefits of treatment exceeds the negative consequences by a sufficiently wide margin resulting that treatment is worth doing). There is a need for more guidance in clinical situations. With the RAND/UCLA appropriateness method (RUAM), we investigated the appropriateness of cardiovascular preventive medication in adults ≥ 75 years. The RUAM is a systematic, formalized method, to combine available scientific evidence with the collective judgment of experts. Fourteen interdisciplinary panelists (9 physicians representing 6 medical disciplines, 1 medical ethics expert, 1 pharmacist and 3 older adults [lay man]), discussed and rated the appropriateness of starting and stopping of three medication groups (cholesterol lowering, blood pressure lowering and thrombocyte aggregation inhibitors) for different clinical scenarios (combinations of cardiovascular history, systolic blood pressure, complexity of health problems, age, life-expectancy, side-effects). Depending on the medication group, different patterns of appropriateness judgments across the clinical scenarios were found. In general, absence of cardiovascular disease, presence of complex health problems, a short life-expectancy or hindering side-effects were important factors to judge cardiovascular preventive medication as inappropriate. Results were summarized into colored reading maps. These findings can offer more guidance in clinical decision making about cardiovascular preventive treatment for adults ≥ 75 years.
The Model of Empathic Pain Assessment and Treatment in Persons With Dementia
Authors: Starr Lauren , Magan Kristin Corey 
Published: December 2020

Abstract
There are 5.8 million people with Alzheimer’s dementia in the United States—81% are 75 years or older. Although half of persons with dementia regularly experience pain, their pain is underrecognized and undertreated, partly because clinicians experience challenges assessing pain in persons with dementia who cannot self-report. Evidence suggests clinician empathy is involved in pain assessment and treatment. Conceptual models guiding Alzheimer’s research are lacking in the literature. To create an interdisciplinary, evidence-based model for understanding clinical empathy’s relationship with the assessment and treatment of pain in persons with advanced dementia, we conducted a literature review of relevant manuscripts from 2000-2019 across disciplines and countries, emphasizing dementia studies and research conducted in the last decade. After performing quality appraisal using the Oxford Centre for Evidence-based Medicine’s levels of evidence, we synthesized findings from 38 qualifying studies and developed a new conceptual model driven by observation of behaviors indicating pain in persons with dementia unable to self-report. The model represents the cognitive, affective, ethical, and behavioral components of clinical empathy involved in assessing and treating pain, relevant patient outcomes, and contextual factors influencing empathy and outcomes; and provides a framework for testing clinical empathy interventions to improve adverse outcomes in persons with advanced dementia. Understanding the relationship between clinician empathy and the assessment/treatment of pain in persons with dementia may improve care quality and help reduce pain behaviors in this population. This model may be used to inform pain research in persons with dementia and develop clinical interventions and clinician education programs.
Unpacking “OK, Boomer”: Using Lifespan Concepts to Ease Intergenerational Conflict
Authors: Graf Allyson , Bartlett Robin 
Published: December 2020

Abstract
With the “OK, Boomer” media exchange in late 2019, intergenerational conflict is touted as existing at an all-time high. Although the age diversity of today’s workforce is unprecedented, spanning nearly five generations of workers, generational stereotyping and its influence on the identities and experiences of those individuals is not new. In this talk, we will advocate for the role that lifespan developmental psychology can play in preparing students to enter a sometimes contentious, misrepresented multigenerational workforce. We will demonstrate the value of helping students distinguish normative age-graded, normative history-graded, and non-normative influences to better understand individual similarities and differences in developmental experiences. We will discuss research on age identity and generational identity as distinct and self-enhancing life-span processes. Finally, we will highlight the developmental barriers that must be navigated in order to foster intergenerational cohesion.
Having a Casino in the Community: Implications for Older Residents
Authors: Bui Cindy , Coyle Caitlin 
Published: December 2020

Abstract
Casino-going has been acknowledged as a common leisure activity for older adults, but what having a casino in the community means for the local older population has been understudied. Previous research has focused on problem gambling among older adults, but little is understood about how older residents perceive having a casino nearby and further how it impacts relevant senior services. This mixed-methods study gathered perspectives from 14 senior center directors and older residents (N = 411) of communities in Massachusetts that surround Plainridge Park Casino, the first casino that opened in the state in 2015. We conducted qualitative interviews with senior center directors and distributed a quantitative survey to older residents of the surrounding communities and those who visited the casino during the study period. We found that while most senior centers did not engage in trips to this “hometown” casino, many had other creative interactions with the casino, such as using casino space to host senior center events or seeking funding support from the casino. Older residents exhibited low rates of problem gambling risk, preferred to go to casinos outside of the state as an excursion, and attributed their reasoning to go to casinos to socializing rather than gambling aspects. While we must be aware of risks for problem gambling, this study also highlights the possibility of reframing a local casino as a potential asset that could contribute back to the community by providing resources for senior service providers and expanding social engagement opportunities for the older population.
GSA and AGHE: 75 Years of Leading Innovative, Interdisciplinary, Intergenerational, and Engaging Education
Authors: Howe Judith , Bernard Marie 
Published: December 2020

Abstract
The AGHE Symposium will highlight the many ways that education has advanced interdisciplinary work, innovative programs, intergenerational services and community engagement in the field of aging over the last decades. Presenters will reflect on how these educational modalities can inform the future of gerontology education. Educators have innovated over decades to develop a field characterized by a diversity of programs, including internships, applied learning experiences in research, policy and practice, and leadership. The history of AGHE and interdisciplinary education are linked, with AGHE serving as an incubator for the advancement of change in this area. Over the course of the last five decades, funding from federal and foundation initiatives have resulted in multi-disciplinary university based centers, interprofessional team training programs, and workforce development initiatives. These efforts have improved the health and well-being of older adults and contributed to the development of new collaborative care systems. AGHE members have also long been involved in intergenerational teaching and learning strategies, including service-learning and community activities. Intergenerational work in the field of aging has helped to shape the Age-Friendly University initiative which calls for colleges and universities to promote intergenerational learning through reciprocal sharing of expertise among learners of all ages. Finally, the AGHE community has long promoted engaged learning with opportunities for students to interact with community partners through programs such as community-based research and clinical experiences and local policy efforts. The ideas presented in the symposium will lead to reflection on how AGHE can expand its value as GSA’s educational arm.
Older Adults as Citizen Scientists and Policy and Planning Voices in Higher Education
Authors: Kaye Lenard , Burby Sarah 
Published: December 2020

Abstract
The University of Maine is embarking on achieving AFU status. In addition to maximizing older adult participation in all facets of campus life (education, recreation, culture, etc.), their presence in nontraditional sectors of university activity will be emphasized. Building on the principles of community-based, participatory research, focal points of UMaine’s AFU strategy will be to ensure that age-specific, engagement mechanisms are created and maintained that ensure older citizens play an influential role in guiding and interpreting academic research and development and curricula innovation across multiple professions and disciplines. Using a state-wide, older adult research registry, and co-design, community test-beds in partnership with continuing care retirement communities, older adults will serve as citizen scientists. Other empowerment strategies for maximizing elder voice include expanding the number of departments that incorporate life span perspectives in their mission statements and expanding the number of older adult advisory bodies that inform university policy and practice.
The Age-Friendly University Umbrella: New Synergies for Gerontology Programs, Aging Centers, and Health Systems
Authors: Schumacher John 
Published: December 2020

Abstract
Higher education has a tentative relationship with gerontology programs and research centers. Despite demographic shifts, academic gerontology serves a modest student body and attracts limited research/scholarly interest. Our new Age Friendly University (AFU) designation served to motivate our university leaders and faculty to re-imagine how aging issues are fundamental to our mission framed by: 1) Interdisciplinarity; 2) Intergenerational relations; and 3) Inclusiveness of the life course. Additionally, the AFU initiative energized the relationships among our health professions schools, academic departments, and research center to collaborate on grant opportunities. Our AFU also started collaborating with a local health system seeking Age Friendly Health System status. Finally, our AFU designation raised visibility with our three local county governments who had just received Age Friendly Community status. Our AFU efforts have served as an inclusive umbrella to attract new, interested partners in our shared effort to improve the lives of older adults. Part of a symposium sponsored by Directors of Aging Centers Interest Group.
The Contribution of Geriatric Educators to Public Policy
Authors: Faul Anna , Severence Jennifer , Waters Leland 
Published: December 2020

Abstract
Despite the current pressure to reduce state and federal spending, policymakers must find ways to address the challenges of a growing population of older adults with complex health care problems. There is an increased need for the health professions workforce to have collaborative care skills and geriatric clinical competencies. Therefore, programs like the Geriatric Workforce Enhancement Program (GWEP) and the Geriatric Academic Career Awards (GACA) are important in strengthening the workforce and supporting policy development that addresses increased demands on the health care system. In 2019, the Bureau of Health Professions, under the Health Resources and Services Administration, provided 48 GWEP awards and 26 GACA awards in 37 states and 2 territories. These programs play an important advocacy role to improve on and expand geriatric education. This symposium provides an overview of these programs and their role in advancing geriatric care and in shaping policy.
Engaging Older Adult Learners Through Intergenerational Learning Opportunities
Authors: Leedahl Skye , Clark Phillip , Leconte Beth 
Published: December 2020

Abstract
The University of Rhode Island became a part of the AFU network in 2018, and much of our rationale for joining the network was based on our strengths and growing interest in intergenerational programs and learning. The URI Osher Lifelong Learning Institute (OLLI) currently has over 1,300 members, and a large aspect of their strategic plan and current efforts are focused on increasing intergenerational learning opportunities due to interest and successes in these areas. Some of the successful strategies that have been used include an intergenerational classroom of OLLI member and university students designed within a traditional college class, a matching program where students are partnered with OLLI members, intergenerational service learning opportunities for students to engage with OLLI members in different ways, and question and answer sessions with OLLI members within college classes. This presentation will highlight these efforts, lessons learned, and efforts to track participation and outcomes.
Older Adults’ Adherence to Technology-Based Intervention: The Role of Messaging and Individual Differences
Authors: Boot Walter , Roque Nelson , Harrell Erin , Charness Neil 
Published: December 2020

Abstract
Adherence to health behaviors is often poor, including adherence to at-home technology-based interventions. This study (N=120) explored adherence to a cognitive training intervention delivered via computer tablet, assessed adherence over a 4.5 month period, explored how individual difference factors shaped adherence, and tested the efficacy of message framing manipulations (positive vs. negative framing) in boosting adherence. Individual difference factors predicted adherence, including variations in self-efficacy and belief in the efficacy of cognitive training. Overall message framing had little impact. However, during the final portion of the study in which participants were asked to play as much or as little as they wanted instead of following a schedule, participants who received positively framed messages engaged with the intervention more. Implications for predicting and boosting adherence to home delivered technology-based interventions will be discussed.