bluuebunny/crossref_metadata_2025_split huggingface dataset:
Male Family Caregivers’ Well-Being: Balancing Work and Care for Parents in Japan
Authors: Umegaki-Costantini Hiroko 
Published: December 2020

Abstract
Despite substantial discussions on caregivers in policy making and academic research, a rapidly emerging new group of middle-aged male family caregivers who often also work are largely understudied. Inadequate understanding of male family caregivers jeopardises not only themselves but also care recipients, other family members and society: better care for older people depends on caregivers’ well-being. I address this gap by understanding how and why gender affects male family carers’ choices of care practices, and how male caregivers as ‘gendered beings’ sustain their well-being while reconciling work and care for their parents. Through in-depth-qualitative narrative interviews based on social anthropology of everyday life with 23 male working family carers in Tokyo in 2019, I find that men select care practices with priority given to familiar tasks deemed appropriately masculine. To perform ‘appropriate’ care for their parents, such men tend to approach care as they do their ‘work’: they ‘work-nise’ care. Such a gendered approach to care practices has important implications for addressing gender in public interventions. Also, I find that for male family working carers, achieving well-being does not mean balance in work, care and family. Rather, for them a source of well-being is from fulfilling filial duty as sons, which, however, requires making an appropriate effort and devoting themselves to some extent to support their parent(s). Thus, such men need to be embedded in a care and employment system that enables them to achieve such well being that, in turn, significantly impacts their care provision.
Partner Effects on Depressed Mood in Caregiving Dyads Are Most Pronounced in Cancer Caregiving, Partner Caregiving
Authors: Nassar Nadia Al , Litzelman Kristin 
Published: December 2020

Abstract
Theory and empirical evidence indicate that the well-being of caregivers and their care recipients is interrelated, although conflicting evidence has emerged across different caregiving populations. To establish a more nuanced understanding of this phenomenon, we used data from the National Health and Aging Trends Survey and the National Survey on Caregivers (2015 and 2017, n=759 dyads with complete longitudinal data) to construct actor-partner interdependence models assessing how spillover of depression varies by care recipient health condition (cancer, dementia, stroke, diabetes, or other conditions) and relationship type (spouse/partner, child, or other). Across condition types, the largest magnitude partner effects were observed in dyads with cancer, in which a one-point increase in caregiver depressed mood was associated with a 0.23-point increase in subsequent care recipient depressed mood (p=0.02) and a one-point increase in care recipient depressed mood was associated with a 0.33-point increase in subsequent caregiver depressed mood (p&lt;0.01). Moderation by cancer status was statistically significant (pinteraction=0.03). Among spouse/partner caregivers, caregivers’ depressed mood was associated with subsequent depressed mood in the care recipient (p&lt;0.05) but there was no evidence of spillover from the care recipient to the caregiver. Conversely, in both adult child caregivers and other caregivers, there was evidence for spillover from the care recipient to the caregiver (p&lt;0.05) but not the reverse. The findings show that the interrelationship in the well-being of caregivers and care recipients varies by key caregiving characteristics, with implications for the development, dissemination, and implementation of interventions targeting caregiver, care recipient, and dyadic well-being.
Resilience and Service Needs Among African American Caregivers of People With Dementia: A Pilot Mixed-Methods Study
Authors: Moon Heehyul , Rote Sunshine , Decker Hallie , Kelsey Burton , Burton Chelsea , Moore Sharon , Babicka Tewsdaay 
Published: December 2020

Abstract
African American caregivers face unique challenges and strengths in addressing the needs of dementia care recipients. The purpose of the current study was to explore the roles of the familism and faith and service preferences and needs for African American dementia caregivers. Through collaborative partnerships among the research team, Alzheimer’s’ Association, Area Agency on Aging, and local churches, we obtained focus group and survey data (N=30) from African American dementia caregivers. Most caregivers were female (90%) and older than 51 years and had provided care more than 3 years. CGs showed strong cultural reasons (e.g., faith, duty, paying back) for providing care (range 0-40;M= 34.5; SD= 5.2). Focus groups data, which was audio taped, transcribed, and analyzed by three researchers using content analysis, revealed three major themes related to dementia care experiences and needs. First, caregivers explained positive aspects of caregiving for both the individual caregiver and family (growth in faith, sense of self -efficacy, feeling of gratefulness). Second, caregivers also described negative aspects that pose substantial challenges such as lack of services, lack of balance in life, family conflicts over care, and mistrust based on their previous experiences with existing health care systems. Third, caregivers described their knowledge of dementia and shared their self-care and coping strategies and a need for support group services. The findings show an urgent need to implement culturally responsive services, especially in undeserved areas and populations, for caregivers to maintain or improve their emotional well-being and quality of care as well as family relationships.
The Dyadic Effects of Perceived Support on Depression in Spousal Care Partners
Authors: Meyer Kylie , Patel Neela , White Carole 
Published: December 2020

Abstract
Relationship quality is an important factor affecting care partners’ health and wellbeing. Supportive marital relationships are associated with better physical and subjective health, whereas strain is associated with poorer health. Recent studies now indicate a dyadic effect of relationship quality on health outcomes, such that an individual’s perceptions of their relationship also affects their partner’s outcomes. Few studies have examined the dyadic effects of relationship quality on mental health among older cognitively intact caregiving couples. To address the lack of dyadic research about how perceived support from one’s spouse related to experiences of depression for individuals and their care partners, we apply cross-sectional actor partner interdependence models (APIMs) to data from the Health and Retirement Study (HRS) (N=490 dyads). APIM regression models controlled for participant demographic characteristics, relationship length, and care recipient functional ability. Findings showed that positive perceived support from a spouse had a stronger negative association with one’s own depression for care recipients than for caregivers. Similarly, greater negative perceived support from a partner was associated with higher levels of depression; whether the partner was the caregiver or care recipient did not make a difference in this model. Although there are hundreds of caregiver interventions to address caregivers’ mental health, few have demonstrated improvement in care recipient outcomes. Observation of both actor and partner effects in this study suggests there may be opportunities to improve care recipient and caregiver mental health by targeting interventions to promote high quality relationships with caregivers or both members of the care dyad.
The Association Between Caregiving Burden and Depressive Symptoms Among U.S. Chinese Adult Children
Authors: Liang Shuting , Dong XinQi 
Published: December 2020

Abstract
Existing research has showed the impact of caregiving burden on physical and psychological outcomes among adult children, but less have examined its association among Chinese immigrants in the US. This research will present the association between caregiving burden and depressive symptoms among U.S. Chinese adult children. Cross-sectional data were drawn from the PIETY study with 547 Chinese adult children aged over 21 years old in the greater Chicago area between 2012-2014. Caregiving burden was assessed by 24-item caregiver burden developed by Novak and Guest and is composed of five factors: time-dependence, developmental, physical, social, and emotional burden. Depressive symptoms were assessed by the nine-item Patient Health Questionnaire. Logistic regression analysis was conducted. In our sample, 241 (44%) adult children had depressive symptoms and 174 (72.2%) were female. In the result of multivariate analysis, after adjusting for covariates, developmental burden (Odds ratio [OR] 1.13 [1.05-1.21]), physical burden (OR 1.17 [1.06-1.28]), social burden (OR 1.20 [1.08-1.32]), and emotional burden (OR 1.22 [1.11-1.35]) were positively associated with reporting any depressive symptoms. However, the time-dependence burden was not associated with depressive symptoms. The findings highlight the potential impact of caregiving burden on depressive symptoms and how different domains of caregiving burden are associated with depressive symptoms among Chinese caregivers in the U.S. Future research should include multidimensional social supports or acculturation as underlying factors which might affect the relationship between caregiver burden and depressive symptoms across Chinese community in the US.
Age-Related Patterns in the Subjective Appraisal of Cognition
Authors: Jacova Claudia , Smith Samantha , Robertson Frank 
Published: December 2020

Abstract
Subjective cognitive decline (SCD) is a construct of high interest in aging and dementia because individuals endorsing it are at higher risk of developing cognitive problems. It is unclear how individuals arrive at the judgement that they have SCD. Here we aimed to understand which SCD symptoms give rise to the perception of decline as older adults age. Community-dwelling adults (N=494, mean age=63.6, SD=5.44), completed the Subjective Cognitive Decline Questionnaire (SCD-Q) online, using an online crowdsourcing site. The SCD-Q consists of one global question regarding self-perceived decline (yes/no) and 24 questions about everyday functioning which we utilized to form a memory, language, and executive functioning domain score, higher for greater perceived decline. Logistic regression revealed that memory and language domains predicted the likelihood of endorsing SCD for adults aged &gt;64 (Memory: OR=1.76, CI=1.47-2.05; Language: OR=1.66, CI=1.30-2.02). Only the memory domain predicted the likelihood of endorsing SCD for adults &lt;63 (OR=2.69, CI=2.35-3.02). Executive functioning domain scores did not play a role in the relationship between SCD likelihood in either age group. The higher the self-perceived memory or language decline, the more likely older adults are to conclude they have SCD. Our results suggest there is an age-related trajectory in how people evaluate their cognition, with younger people only considering memory and older people considering both memory and language. Clinicians should be aware of this trajectory when examining patients with SCD. Executive functions should be specifically queried because they may not emerge from older adults’ self-reported cognitive problems.
Weight Status Influences Carotid Intima-Media Thickness to Executive Function Among Older Adults
Authors: Bygrave Desiree , Wright Regina 
Published: December 2020

Abstract
Carotid atherosclerosis has emerged as an early predictor of reduced cognitive function. Underlying this association are risk factors, such as overweight and obesity, that promote carotid atherosclerosis and poor cognitive outcomes. Given the prevalence of overweight and obesity among older adults, there is a critical need to better understand how atherosclerosis influences cognitive function in the context of elevated weight. To address this gap, the current study examined relations between carotid atherosclerosis (carotid intima-media thickness [IMT]), and attention (Trailmaking Test) and executive function (Verbal Fluency Test) performance, and whether they varied as a function of weight status (body mass index [BMI] classification). Data were analyzed from 162 older adults (mean age = 68.43y, 34% male, 41% African American), free of major disease. Mutliple regression and analysis of variance analyses, adjusted for age, sex, education and mean arterial pressure, showed a statistically significant IMT x BMI interaction for Verbal Fluency performance (p=.04) and a trending IMT x BMI interaction for Trailmaking A performance (p=.05). Simple effects analysis of IMT and Verbal Fluency performance showed that this association was most pronounced among those who are obese. Findings suggest atherosclerosis may influence executive function in the context of obesity among older adults. As the development of carotid atherosclerosis is strongly related to aging, our findings suggest that maintaining a healthy weight may reduce its impact on executive function in older adulthood.
Are We Missing the Target When Measuring Quality of Life?
Authors: Janssen Leah , de Medeiros Kate 
Published: December 2020

Abstract
Over the last several decades, many instruments have been created to measure quality of life (QoL) in older adults, particularly for intervention research on individuals living with dementia. However, since definitions of QoL lack standardization across the research literature, the question of how to holistically capture an elusive and expansive concept such as QoL remain. This research uses qualitative content analysis to explore definitions and domains of QoL with an eye toward overlap and gaps. Definitions of QoL were extracted from gerontology encyclopedia entries and other peer-reviewed supplemental resources and analyzed for themes using Dedoose qualitative software. Results revealed three over-arching themes: no standardized or universal definition of QoL, use of subjective and objective factors for measurement, and varying domains of QoL. Additionally, we further distilled theme three to identify eight unique QoL domains: 1) economic/financial, 2) environment, 3) ADL/IADL function, 4) participation in activities, 5) personal resources, 6) physical health, 7) psychological well-being, and 8) social/relational, the total of which were only found in one of 15 definitions of QoL. Overall, findings led to an overarching definition of QoL that cuts across multiple dimensions and factors. We argue that by having all eight domains our understanding and measurement of QoL is enhanced, thereby improving our assessment of existing definitions of QoL, as well as the instruments used to measure QoL.
Does Change Predict Change in the CHANGE Intervention Study?
Authors: Maitland Scott , Brauer Paula , Mutch David , Royall Dawna , Klein Doug , Tremblay Angelo , Rhéaume Caroline , Jeejeebhoy Khursheed 
Published: December 2020

Abstract
Does change in one lifestyle factor (e.g., exercise/fitness) help explain change in another factor or process (i.e., dietary behavior or cardiovascular risk)? The current modeling was a secondary analysis of a primary care feasibility study of individualized lifestyle (diet and exercise) treatment of metabolic syndrome (n=293; mean age = 59yrs) that achieved 19% reversal over one year. Diet quality was assessed by the Healthy Eating Index (HEI) (2005 Canada); while fitness was assessed by several measures (VO2max, flexibility, curl-ups, push-ups). Three occasions (i.e., baseline, 3-, and 12-month) were examined using latent change score and latent growth curve models (in AMOS) to assess whether changes in one domain predicted changes in the remaining domains: (1) diet (measured by HEI or latent construct); (2) fitness (measured by VO2max percentiles or latent construct); and, (3) 10-year risk of cardiovascular disease (by Procam Risk score). Results showed significant improvement in all three domains separately during the intervention, with greater change between baseline and 3-month assessment and continued change between 3- and 12-months. Initial status variables on observed constructs were moderately positively correlated and change in dietary behavior was significantly related to change in fitness levels, but neither were significantly related to change in the 10-year risk of cardiovascular disease. In addition, the associations between change in diet and changes in fitness were inconsistent baseline to 3 months, and 3-12 months. These results offered new insight on relationships among interventions in a behavioural counselling program which can inform future programming.
Weight Change and All-Cause Mortality in Later Life: Findings From the National Survey of the Japanese Elderly
Authors: Murayama Hiroshi , Liang Jersey , Shaw Benjamin , Botoseneanu Anda , Kobayashi Erika , Fukaya Taro , Shinkai Shoji 
Published: December 2020

Abstract
Recent studies predominantly in Western populations suggest that both weight gain and weight loss are associated with increased mortality risk in old age. However, evidence on this topic in Asian populations remains sparse. We examined the association between weight change and all-cause mortality in a nationally-representative sample of community-dwelling older Japanese. Data came from the National Survey of the Japanese Elderly (N = 4,869, age ≥ 60 years). Participants were followed for up to 30 years. Short-term (3 years) and medium-term (6 years) weight changes were classified as “loss ≥ 5%,” “loss 2.5%–4.9%,” “stable,” “gain 2.5%–4.9%,” and “gain ≥ 5%.” Cox proportional hazards models were used to assess the relative (stable weight as reference) mortality risk associated with weight change categories. Short-term weight loss ≥ 5% was associated with higher mortality compared to the stable category, after adjusting for sociodemographic factors, health behaviors, and health conditions (hazard ratio = 1.36; 95% confidence interval = 1.22–1.51). The other weight change categories had no significant association with mortality. This was observed both among males and females. Moreover, the same pattern of results was observed when we used the medium-term weight change indicator. In conclusion, we found that both short- and medium-term weight loss greater than 5% increased the risk of dying among older Japanese; however, other types of weight change did not. This finding could inform clinical and public health approaches to body-weight management aimed to improve the health and survival of older adults, particularly in Asian populations.
Future Care Plan at the Contemplation Stage Among Older Adults
Authors: Oladimeji Abolade , Kahana Eva , Kahana Boaz , Lee Jeongeun 
Published: December 2020

Abstract
Previous studies have shown that making future care planning often involves several steps. This is consistent with the transtheoretical model of behavior change which identified stages in which behavior changes over time and progresses through a series of six stages (Prochaska & Norcross, 2001). Although most studies on future care planning among older adults have examined the progression from the pre-contemplation stage to an action stage, little is known about the unique characteristics of older adults at the contemplation stage. Our sample included 409 randomly selected older adults in Cleveland, Ohio who were in the first wave of a longitudinal study of successful aging (µage = 78.8, SD=5.74). We used multivariate logistic regression to predict older adults who are more likely to have thought of their future care plans (contemplation stage). Results indicate several individual and relationship factors such as marital status, engaging in health behaviors (not smoking), being young old, and having personal transportation (OR=.42, .63, 2.81, and 1.73) account for contemplating future care. These findings underscore that several individual resources, as well as relationship status, are associated with contemplation stage of future care planning. The results reinforce the idea that future care planning is a stage-based behavior that people engage in, rather than a stand-alone activity.
Do Volunteers Make a Difference on Nursing Home Quality Measures?
Authors: Falkowski Paul , Kelly Christopher , Kelley Nancy 
Published: December 2020

Abstract
The purpose of this study was to explore the relationship between nursing home volunteer programming and quality measures and increase the knowledge base of nursing home volunteer programming in various settings. Fifty-two nursing homes were surveyed using electronic surveys and personal interviews. Questions focused on the organization of the nursing home, characteristics of the volunteer program and volunteer activities. Of the 52 facilities surveyed, 19 were not part of a chain, 37 were in urban settings, and 24 were for-profit entities. Volunteers were used in 46 nursing homes with a mean number of volunteers of 51.7 onsite an average of 4.9 days per week. Bivariate analysis revealed statistically significant correlations (p&lt;.05) between organizational and volunteer programming characteristics and six quality measures (pressure sores, urinary tract infections, depression, use of restraints, falls, use of antipsychotic and hypnotic drugs). Statistically significant (p&lt;.05) inverse relationships were found between volunteers providing individualized activities (e.g., feeding assistance, combing hair, doing nails, and letter writing) and the incidence of urinary tract infections and the use of psychotropic drugs. Multiple regression analysis revealed a statistically significant (p&lt;.05) inverse relationship between personal volunteer services such as combing hair and doing nails and the use of hypnotic drugs and antipsychotic drugs. This study indicates a significant correlation between volunteer programming and quality measure scores. A larger study of these relationships is indicated.
Expectations Regarding Aging After Relocation to an Assisted Living Community
Authors: Plys Evan 
Published: December 2020

Abstract
This study adds to the growing literature on attitudes toward aging in older adulthood by using a multidimensional measure to assess heterogeneous profiles of expectations regarding aging (ERA) in a sample of assisted living (AL) residents. The author analyzed secondary data from a cross-sectional quantitative study consisting of 202 residents of 21 ALs. Participants were mostly female (72%), white (90%), and widowed (59%); ages ranged from 51 to 100 (M = 83.05, SD = 10.32). Hierarchical Cluster Analysis identified four subgroups: (1) “healthy agers”, n = 54, 27%, characterized by high physical, emotional, and cognitive ERA; (2) “cognitively intact”, n = 41, 20%, characterized by low physical, low emotional, and high cognitive ERA; (3) “coping with decline”, n = 56, 28%, characterized by moderate physical, high emotional, and low cognitive ERA; and (4) “unhealthy agers”, n = 51, 25%, characterized by low physical, emotional, and cognitive ERA. Subgroups varied by mental health (healthy agers &gt; unhealthy agers), cognitive ability (cognitively intact &gt; coping with decline), and activity participation (coping with decline &gt; unhealthy agers). Surprisingly, groups did not differ based on social support from co-residents, staff, or family. Results demonstrate that distinct subgroups of ERA exist among AL residents, supporting the utility of assessing ERA as a multidimensional construct in this setting. In addition, findings suggest that expecting to retain health and ability in at least one domain may protect against behavioral consequences of negative ERA. The author also discusses implications for future research and clinical practice in AL.