bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lessons Learned From Clinical Recruitment of Older Adults With MCI for an Internet-Delivered Intervention Study
Authors: Mattos Meghan , Quigg Mark , Manning Carol , Davis Eric , Sollinger Ann , Barnes Laura , Ritterband Lee 
Published: December 2021

Abstract
Clinical research involving participants with mild cognitive impairment (MCI) presents challenges to recruitment that may be further compounded by concerns when delivering a behavioral intervention via the Internet. The purpose of this talk is to describe recruitment adaptations for an Internet-delivered behavioral intervention study with older adults living with MCI and insomnia. Over the course of study recruitment, unforeseen barriers to recruitment were discovered, including fewer older adults with MCI endorsing sleep concerns than expected. The most substantive changes made to improve clinical recruitment were related to eligibility criteria, yielding 50% of the overall sample. Anticipated concerns of older adults with MCI using technology or accessing the Internet were not significant barriers to recruitment. Study findings support Internet-delivered intervention use in this population, which in the context of the COVID-19 pandemic, presents a potentially efficient and effective method for recruiting and delivering behavioral interventions in this difficult-to-enroll population.
Engaging Rural and Racial-Ethnic Populations in Gerontological Research
Authors: Williams Ishan 
Published: December 2021

Abstract
Older adults from racial/ethnic populations, as well as rural-dwelling older adults, are often at heightened risk for experiencing health disparities. Reasons for these disparities may include access issues, language barriers, distrust, lack of awareness, and of culturally appropriate materials. Racial/ethnic populations and rural-dwelling populations are also less likely to be included in research to help minimize the impact of these disparities. Shifting from reducing disparities to eliminating disparities will require attentiveness to designing programs and research that focus on increasing representation of racial/ethnic groups in research, integrating diverse populations (particularly rural and other marginalized groups) into the development of ideas and projects, and finally a commitment to culturally appropriate and inclusive approaches to research and education. Applying these strategies can provide guidance on how to best facilitate inclusive and equitable research, collaborative partnerships, and equitable healthcare for everyone, especially those from populations often underrepresented.
Resources and Services for Family Caregivers in the Time of COVID-19
Authors: McGhan Gwen , McCaughey Deirdre , Flemons Kristin , Hindmarch Whitney 
Published: December 2021

Abstract
COVID-19 has led to increased burden on family caregivers (FCGs) for people living with dementia (PLWD), while simultaneously limiting the resources available to them. Our study surveyed Alberta, Canada FCGs to assess their needs and generate recommendations to inform policies about care access, resources, and agency supports. We conducted a mixed methods study using a sequential triangulation design (QUANTITATIVE + qualitative). Our Community Advisory Committee was involved in all stages of study planning, execution, and dissemination. Survey results informed the qualitative data collected from focus groups with FCGs. A total of 230 FCGs participated in the survey, with an average age of 59. The average age of PLWD was 75. The majority were women (77%), 46% were spouses and 41% were adult children. Respondents reported feeling more isolated (69%), more strain (66%) and decreased quality of life (55%) compared to pre-pandemic. Resource use by FCGs decreased from an average of 5 resources pre-pandemic to 1.6 during COVID-19. Services including day programs and home care were no longer available or reconfigured, leading to greater strain and heightened need for respite, which was also unavailable. Focus groups highlighted that system navigation and accessing services during COVID-19 was overly burdensome, leaving FCGs feeling abandoned by the system. FCGs reported an increase in caregiving responsibility and less access to services resulting in PLWD experiencing a decline in wellness and function. As such: 1) resources should be consistently available for FCGs and 2) FCGs require clear, correct, and concise information about COVID-19.
Promoting Inclusivity in Dementia Education and Screening in an Ethnically Diverse, Rural Community During a Pandemic
Authors: Wiese Lisa , Williams Ishan , Schoenberg Nancy , Galvin James , Lingler Jennifer 
Published: December 2021

Abstract
Rural, ethnically diverse older adults experience disparities in dementia detection/management. The Covid-19 quarantine exacerbated these disparities, and threatened faith-based dementia education and screening activities. We investigated the effectiveness of a telephone-based outreach for increasing dementia knowledge and detecting cognitive risk among a rural, diverse, underserved community of 89% African American, Hispanic, and Haitian Creole residents, Faith-based health educators, trained using virtual Alzheimer’s Association resources, contacted church congregants who responded to radio worship service announcements. Participants completed telephone measures of basic dementia knowledge and cognitive risk. Of the estimated 120 persons across five churches who received an invitation, 75% (n = 90) participated in dementia education and memory screening via telephone. Twelve (80%) of the 15 participants assessed as being at risk followed up with their provider. Rural residents are known for preferring face-to-face contact. Their willingness to complete health-promoting research activities by telephone highlighted the community’s interest in dementia awareness.
A Scoping Review of Financial Elder Exploitation Interventions
Authors: Skees Stephanie 
Published: December 2021

Abstract
Elder financial exploitation (EFE), defined by the National Center for Elder Abuse (2021) as “the misappropriation of an older person’s money or property,” is a continuing public health crisis shown to cost individuals at least $2.9 billion a year (MetLife Mature Market Institute, 2011). Many believe this impact will increase exponentially due to the effects of COVID-19. In fact, a recent study conducted by Chang & Levy (2021) found that the prevalence of elder abuse as a whole increased from 1 in 10 older adults to 1 in 5 in the past year. Although increased collaboration between state attorneys general, Adult Protective Services, and financial institutions has driven progress in the field; there is still little known regarding EFE interventions. To address this issue, this study conducts a scoping review of the EFE intervention literature. This approach was chosen over a systematic review primarily due to the lack of a universal definition of EFE, as well as the limited number of studies available delineating between EFE and elder abuse as a whole. The main findings of the review reveal that current EFE intervention practices are focused on preventing abuse before it occurs by addressing risk factors for abuse in older adults; and are largely reliant on Adult Protective Services and the legal system. This finding is significant because state policies differ in their qualifications of EFE, thus leaving many older adults vulnerable and unprotected. Further interventions that address EFE while it is occurring and alignment across governing bodies are needed.
Older Victims of Mass Marketing Scams: An Analysis of Data Seized From Scammers
Authors: DeLiema Marguerite , Langton Lynn 
Published: December 2021

Abstract
Mass marketing scams are some of the most common frauds in America, and include scams perpetrated through the mail. A growing body of research indicates that older adults face a greater risk of victimization due to age-related changes in cognitive functioning and social isolation, and may be more likely to fall victim repeatedly. The aim of this study is to determine the frequency of repeat mass marketing fraud (revictimization) among older adults and patterns of victimization associated with age, scam type, seasonality, and geography. We use two decades of non-public administrative data from the United States Postal Inspection Service (USPIS). These databases were seized during law enforcement investigations of mass mailing scam organizations and contain more than 2 million unique U.S. victims and their transactions with four different fraud organizations. Victims were matched across datasets using name, address, and a change of address file. We find that revictimization rates increase with age in psychic scams. The 10,000 victims who responded the most times (between 82 and 562 times) were 78 years old on average and suffered $4,700 in total losses per person. Other significant trends emerged for lottery and sweepstakes scams. Unlike prior fraud victimization studies, inferences on victim characteristics are based on actual victim experiences with fraud rather than hypothetical scenarios or surveys where victims must self-report fraud. Findings provide valuable policy-relevant information regarding older victims and the patterns of chronic victimization.
Sleep and Loneliness as Mechanisms Through Which Marital Quality Predicts Depression Among Older Adults
Authors: Marini Christina , Martire Lynn , Buxton Orfeu 
Published: December 2021

Abstract
Pathways through which spousal support and strain influence older adults’ well-being are poorly understood. We examined sleep quality and loneliness as mechanisms through which support and strain predict depressive symptoms across ten years utilizing National Social Life, Health, and Aging Project data. Our sample included partnered participants at waves 1 and 2 (N = 1,293; 39% female, M age = 66, SD = 6.93). Support (e.g., rely on spouse) and strain (e.g., spouse criticizes you) were measured at W1, loneliness (UCLA) and sleep quality (restless sleep) were measured at W2, and depression (CES-D) was measured at W3. We estimated latent-variable structural equation models, controlling for age, gender, and W1 depression. Indirect effects of support and strain on depressive symptoms through loneliness were significant. There was an additional trend-level indirect effect of spousal strain on depressive symptoms through restless sleep. Findings highlight multiple pathways through which marital quality predicts later-life well-being.
Improving Policy and Legislation Related to Healthcare Workplace Violence
Authors: Mistler Lisa , Taylor Rosemary , Shippee-Rice Raelene , DiNapoli Pamela , Armenti Karla 
Published: December 2021

Abstract
Our group conducted the first known New Hampshire survey on healthcare staff experience of workplace violence. Study questions focused on experiences of workplace violence, incident reporting mechanisms, and the availability and benefit of workplace violence training programs. Results were consistent with recently published literature: violence against healthcare workers remains a serious public health problem that is under-reported, understudied, “tolerated and largely ignored.” We will discuss the aspects of policy and legislative responses to workplace violence that have been insufficient to address this problem. We also will present some strategies that, if implemented, could lead to improved policy and legislation that may be more proactive in reducing such violence.
Nationwide Inequities in Nursing Home Palliative Care Services
Authors: Estrada Leah , Harrison Jordan , Dick Andrew , Stone Patricia 
Published: December 2021

Abstract
Inequities exist in nursing home (NH) quality of care for racial/ethnic minorities, but the extent of palliative care (PC) disparities in unknown. We used cross-sectional national survey data (2017-18) from 869 NHs to measure PC services (summative score: 0-100). Survey linked to Minimum Data Set and Area Health Resources Files. Descriptive statistics and NH-level, multivariable regressions examined regional differences in NH PC services by varying concentrations of Black and Latino residents. Substantial regional differences were recorded in mean PC score and by concentration. Mean PC services were highest in the Northeast and lowest in the South: Northeast (× ̅=50.45, SE=1.50); West (× ̅=49.96, SE=1.74); Midwest (× ̅=48.18, SE=1.17); South (× ̅=44.71, SE=1.30). After adjusting for urbanicity and county level poverty, NHs in the Northeast and West with increasing concentrations of Black and Hispanic residents offered significantly fewer PC services. Overall, NHs serving predominantly serving minority populations offer fewer PC services.
Case Management in Primary Care Associated With Service Use by Adults With Dementia and Comorbidities
Authors: Quach Emma , Moo Lauren , Hartmann Christine , Zhao Shibei , Ni Pengsheng 
Published: December 2021

Abstract
Community-dwelling adults with dementia are at higher risks than counterpart without dementia of poor health outcomes, and those with dementia and co-occurring conditions face even greater risks. Optimal treatment for dementia includes functional and psychosocial support through long-term services and supports (LTSS), but use remains low. Our study investigated whether case management provided in primary care and in dementia care settings facilitated LTSS use for Veterans with dementia and comorbidities. We performed a cross-sectional analysis of 2019 VA-paid health care on a cohort of Veterans with dementia, defined by clinical diagnoses (International Classification of Disease, Tenth Revision). Receipt of case management was measured by whether or not a Veteran enrolled in a VA (1) home-based primary care, (2) geriatric primary care, or (3) dementia clinic. Comorbidities were measured by an adapted Elixhauser comorbidities index and dichotomized as ≤ 3 or ≥ 4 comorbidities. LTSS use was measured by whether or not Veterans used home health, home respite, adult day care, hospice, or veteran-directed care. Multivariate logistic regressions showed that LTSS use was higher for enrollees in each case management program compared to Veterans not enrolled in any. LTSS use was also higher for enrollees in each primary care program with more comorbidities than program counterparts with fewer comorbidities. Case management in primary care settings may facilitate functional and psychosocial support to meet dementia and non-dementia related needs for adults who have dementia with comorbidities.
Habitual Sleep, Sleep Duration Differential, and Weight Change Among Adults
Authors: Liu Yin , Palta Mari , Barnet Jodi , Roberts Max , Hagen Erika , Peppard Paul , Reither Eric 
Published: December 2021

Abstract
We assessed longitudinal associations between diary-measured sleep duration and clinically assessed body mass index (BMI) among 784 men and women enrolled in the Wisconsin Sleep Cohort Study (mean [SD] age = 51.1 [8.0] years at baseline). The outcome was BMI (kg/m2). Key predictors were habitual sleep duration (defined as average weekday nighttime sleep duration) and sleep duration differential (defined as the difference between average weekday and average weekend nighttime sleep duration) at each data collection wave. Men with shorter habitual sleep duration on weekdays had higher BMI than men with longer habitual sleep duration on weekdays. Participants with larger differentials between weekday and weekend sleep duration experienced more rapid BMI gain over time for both men and women. Inadequate sleep, characterized as shorter habitual sleep during weekdays and larger weekday-weekend sleep differential, is positively associated with BMI levels and trajectories among men and women in mid-to-late life.
Pharmacist-Led Interventions to Improve Medication Adherence in Older Adults: A Meta-Analysis
Authors: Marcum Zachary , Jiang Shangqing , Bacci Jennifer , Ruppar Todd 
Published: December 2021

Abstract
As pharmacists work to ensure reimbursement for chronic disease management services on the national (e.g., Medicare) level, summative evidence of their impact on important health metrics, such as medication adherence, is needed. The objective of this study was to assess the effectiveness of pharmacist-led interventions on medication adherence in older adults. In April 2020, a comprehensive search was conducted in six databases for publications of randomized clinical trials of pharmacist-led interventions to improve medication adherence in older adults. English-language studies with codable data on medication adherence and diverse adherence-promoting interventions targeting older adults (age 65+) were eligible. A standardized mean difference effect size (intervention vs. control) was calculated for the medication adherence outcome in each study. Study effect sizes were pooled using a random-effects meta-analysis model. Moderator analyses were then conducted to explore for differences in effect size due to intervention, sample, and study characteristics. The primary outcome was medication adherence using any method of measurement. This meta-analysis included 40 unique randomized trials of pharmacist-led interventions with data from 8,822 unique patients (mean age, range: 65 to 85 years). The mean effect size was 0.57 (95% Confidence Interval [CI]: 0.38-0.76). When two outlier studies were excluded from the analysis, the mean effect size decreased to 0.41 (95% CI: 0.27-0.54). Moderator analyses showed larger effect sizes for interventions containing medication education and when interventions had components delivered at least partly in patients’ homes. In conclusion, this meta-analysis found a significant improvement in medication adherence among older adults receiving pharmacist-led interventions.
Effect of a Biobehavioral Environmental Approach on Sleep in Low-Income Older Adults
Authors: Li Junxin , Okoye Safiyyah , Sciarratta Lena , Szanton Sarah 
Published: December 2021

Abstract
Low socioeconomic status and disability are independent risk factors for disturbed sleep. The CAPABLE intervention used a multidisciplinary team approach of occupational therapist, nurse, and handyworker to reduce functional disability in low-income older adults. The 6-month intervention may benefit sleep as the intervention addressed multiple individual factors associated with sleep quality, including pain, depression, communication, mobility, strength, and balance. This study examined the effect of the CAPABLE intervention on actigraphy-measured sleep in a sub-sample of 73 older adults from the CAPABLE trial (26 intervention vs. 47 control). The sample was aged 75.8±7.45 years, 86.3% female, and 84.9% African American. No significant group differences in sleep parameters were found at 6-month, controlling for baseline values. The intervention resulted in a 5.56% increase in sleep efficiency (95% CI= [1.39, 9.71], Cohen’s d=0.54), and 7.39 minutes decrease in sleep onset latency (95% CI= [0.10, 14.5], Cohen’s d=0.41) within the intervention group at 6-months.
Finding a Composite Measure for Data From Wrist Actigraphy in Bipolar Disorder
Authors: Kaufmann Christopher , Lee Ellen , Wing David , Ancoli-Israel Sonia , Depp Colin , Yoon Ho-Kyoung , Eyler Lisa 
Published: December 2021

Abstract
Actigraphy can objectively measure sleep in studies on Bipolar Disorder (BD) where subjective sleep ratings might be influenced by affect. Actigraphy data are complex necessitating data reduction approaches. We created a composite score of actigraphy sleep metrics (total sleep time [TST], wake after sleep onset [WASO], and percent sleep [PS]) in BD. We computed z-scores of sleep measures for n=51 BD vs. n=80 healthy subjects and averaged scores. We examined associations with participant characteristics and used LASSO to identify metrics best explaining composite variability. Higher composite scores (better sleep) were seen in employed vs. unemployed (t=2.40, df=34, p=0.02), and correlated with higher medication load (r=0.41, p=0.004), lower mania symptomatology (r=-0.33, p=0.04) and lower interleukin (IL)-6 levels (r=-0.32, p=0.02). TST best explained variability in medication load and PS best explained employment, mania symptoms and IL-6. Given observed specificity of associations, selecting theory-driven sleep metrics may be more appropriate than a composite.
Aerobic, Strengthening, and Balance Activities Performed by Community-Dwelling Older Adults
Authors: Wingood Mariana , Levi Bonnell , Gell Nancy 
Published: December 2021

Abstract
Little is known about whether older adults meet the recommended physical activity (PA) guidelines, including aerobic, strength, and balance components. Given this gap, we examined self-report PA data from 1,352 older adult participants of the Adult Changes in Thought (ACT) study. We classified participants as meeting some components, meeting the full guidelines, or being insufficiently active. Multinomial regression was used to identify factors associated with meeting PA guidelines. Despite performing 9.5 hours of weekly PA, only 11% met the full guidelines, 13% met the aerobic, and 26% met the balance or strength recommendations. Increasing age and body mass index, needing assistance with instrumental daily activities, heart disease, and low income were associated with decreased odds of meeting PA guidelines. Older adults primarily perform aerobic PA and lower intensity PA with fewer participating in strength and balance activities. Interventions targeting strength, balance, and higher intensity PA should be developed.
Ambient Air Pollution and Increasing Depressive Symptoms in Older Women: The Mediating Role of The Prefrontal Cortex
Authors: Petkus Andrew , Wang Xinhui , Younan Diana , Beavers Daniel , Espeland Mark , Millstein Joshua , Gatz Margaret , Chen Jiu-Chiuan 
Published: December 2021

Abstract
Exposure to air pollution may accelerate brain aging and increase risk of late-life depressive symptoms (DS). Brain structures underlying these associations are unknown. Longitudinal data from 829 community-dwelling women without dementia (baseline age 81.6 ± 3.6 years old) who participated in both the Women’s Health Initiative Memory Study Magnetic Resonance Imaging study (WHIMS-MRI; 2005-06) and the WHIMS-Epidemiology of Cognitive Health Outcomes (2008-16) were analyzed to examine whether volumetric measures of brain structures mediated associations between long-term exposure to ambient air pollutants and annual increases in DS (as measured by annually assessed 15-item Geriatric Depression Scale). Annual PM2.5 (fine particulate matter of aerodynamic diameter &lt;2.5) and NO2 were estimated at the participants’ residence using regionalized universal kriging models and aggregated to the 3-year average prior to the WHIMS-MRI. Structural equation models were constructed to estimate associations between exposure, structural brain variables, and trajectories of DS (standardized on baseline mean and SD). Living in locations with higher NO2 (standardized β = 0.023; 95% Confidence Interval (CI) = 0.004, 0.042) or PM2.5 (standardized β = 0.021; 95% CI = 0.004, 0.038) was associated with larger annual increases in DS (~60% larger annual increase in DS). Higher NO2, but not PM2.5, was associated with smaller prefrontal cortical volumes (standardized β = -0.431; 99% CI = -0.518; -0.344). Prefrontal cortical volume explained 30.4% of the total association between annual DS increase and NO2. These findings underscore the importance of the prefrontal cortex in associations between NO2 exposure and increasing DS in later-life.