bluuebunny/crossref_metadata_2025_split huggingface dataset:
Asian Older Adults, Trauma, Resilience, and Health: Recent Findings From the Rutgers Asian RCMAR
Authors: Dong XinQi , Simon Melissa , Wu Bei 
Published: December 2021

Abstract
U.S. Asians are the fastest growing group of older adults in the nation. However, there remains a dearth of disaggregated research for this population assessing health outcomes such as cognition, suicidality, mortality, and the influence of nutrition on chronic conditions. Drawing on the research of Rutgers Asian RCMAR Scientists, this symposium will examine these areas to provide a better understanding of the health of diverse groups of U.S. Asian older adults. Session 1 will assess the association between living in an ethnic enclave and better cognition among Chinese older immigrants and examine the influence of moderating factors. Session 2 will explore the prevalence of traumatic experience and discuss the association among trauma experience, lifetime mental disorder, and risk of endorsed suicide ideation among aging Asians. Session 3 will assess the relationship between family types and 6-year mortality among U.S. Chinese older adults in Chicago. Session 4 will examine the association between ultra-processed foods and cardiometabolic health (obesity, hypertension, high cholesterol, and diabetes) among U.S. adults 50 or older reporting a single ethnicity. In summation, this symposium describes key research areas such as cognition, suicidal ideation, mortality, and nutrition on the overall health of U.S. older adults. The symposium addresses both risk and protective factors that influence these health outcomes and aims to inform interventions to improve the health of U.S. Asian older adults in the areas of trauma, resilience, and health.
Long-Term Effects of Social Insurance on Adult Mortality: Evidence From Three Social Programs in Mexico
Authors: Aguila Emma , Dow William , Parker Susan 
Published: December 2021

Abstract
Research on the mortality effects of social insurance programs for older adults has generated conflicting results. Some studies suggest important health benefits, others find no effects, and still others find unintended adverse effects potentially linked to pathways such as increased obesity. Evidence has focused predominantly on short-run effects rather than net long-run mortality effects and their effects on the health of older adults has been particularly understudied. Mexico offers a unique opportunity for studying the long-run effects of social programs on adult mortality. Within a ten-year period, Mexico introduced the following influential social insurance programs: Progresa conditional cash transfer (CCT) program in 1997, 70 y más unconditional cash transfer (UCT) program for older persons in 2007, and Seguro Popular, a public health insurance program (PHI) for the uninsured, in 2004. In this paper we analyze effects on mortality for middle-age and older adults, by gender, 10-20 years after program implementation.
Long-Term Care Insurance Policy Intensity and the Policy Matching Degree of Pilot Cities in China
Authors: Peng Rong , Wu Bei 
Published: December 2021

Abstract
Since China launched long-term care insurance (LTCI) pilot in 15 cities in 2016, the LTCI policy schemes have been developed gradually. Based on the 61 LTCI policy documents, this study evaluated the LTCI policies intensity in each pilot area by building a PMC index model with 10 primary variables and 44 two-level variables. Using the coupled coordination model, the coordination development indexes were calculated to evaluate the level of matching between LTCI policies and economy development and population structure. The results showed that the PMC index valued between 0.646 and 0.922. The three cities having the highest level of policy strength (PMC&gt;0.8) were as follows: Qingdao, Nantong, and Jingmen. The three cities having the lowest level (PMC&lt;0.7) were Ningbo, Qiqihar and Chongqing. The indexes of the coordination degree varied from 0.263 to 0.594. Shanghai, Qingdao and Guangzhou had the highest level of coordination degree, while Anqing, Chende and Qiqihaer are the lowest .The difference of financing mechanism of pilot cities was one of the main determinants of policy intensity. The matching degree was relatively low. Qingdao was a unique city having both high policy intensity and matching degree. It was suggested that the intensity and matching degree of LTCI policies should be improved to develop a national LTCI system in China.
Trauma Exposure, Mental Disorder, and Risk of Suicide Ideation Among Aging U.S. Asians
Authors: Ma Ping , Li Ruike , Shigemoto Yuki , Chen Lei-Shih 
Published: December 2021

Abstract
This project aims to explore the prevalence of traumatic experience and examine the association among trauma experience, lifetime mental disorder, and risk of endorsed suicide ideation among aging Asians. Data were drawn from the National Latino and Asian American Survey and participants aged 55 and above were included in the study. Descriptive analyses and weighted logistic regressions were employed to analyze the association among outcomes of interest. Approximately 74% of 376 aging Asians experienced trauma exposures. Specifically, 17% of respondents with trauma exposure reported a lifetime mental disorder, and 8% had suicide ideation. After adjusting for demographic, social support, and family factors, aging Asians with traumatic experience had a significantly higher risk of experiencing discrimination and mental disorders (p-values&lt;.05). Assaultive or interpersonal violence exposure was positively associated with increased odds of suicide ideation. Culturally tailored mental health intervention and suicide screening are warranted for aging Asians with previous trauma exposure.
I Wouldn’t Search That With My Mobile Phone: Credibility and Trust in OHIRs Among Lower-Income Black Older Adults
Authors: Harrington Christina , Woodward Amanda 
Published: December 2021

Abstract
Online health information resources (OHIRs) such as conversational assistants and smart devices that provide access to consumer health information in the home are promoted as viable options for older adults to independently manage health. However, there is question as to how well these devices are perceived to meet the needs of marginalized populations such as lower-income Black older adults who often experience lower digital literacy or technology proficiency. We examined the experiences of 34 lower-income Black older adults aged 65-83 from Chicago and Detroit with various OHIRs and explored whether conversational resources were perceived to better support health information seeking compared to traditional online web searching. In a three-phase study, participants tracked their experiences with various OHIRs and documented health-related questions in a health diary. Participants were then interviewed about their diaries in focus groups and semi-structured interviews, followed by a technology critique and co-design session to re-envision a more usable and engaging conversational device. We present preliminary results of the themes that emerged from our analysis: cultural variables in health information seeking practices, perceptions of credibility, likelihood of use, and system accessibility. Participants indicated that their trust of different resources depended on the type of information sought, and that conversational assistants would be a useful resource that require less technology proficiency, even among those with lower e-health literacy. Although our findings indicate that familiarity and trust were salient constructs associated with perceptions of OHIRs, these devices may address digital literacy and technology familiarity with certain design considerations.
Factors Impacting Treatment Decision Making in Older Adults With Indolent Non-Hodgkin Lymphoma
Authors: Trevino Kelly , Martin Peter , Leonard John 
Published: December 2021

Abstract
Indolent non-Hodgkin lymphomas (NHL) are among the most common lymphomas and up to two-thirds of diagnoses are made in older adults (age≥65 years). Initial treatment options include cancer-directed therapy or active monitoring by the oncologist for disease progression. Despite the disparate nature of these treatments, the factors impacting older adults’ treatment decisions are unknown. This study examines the reasons older adults chose their initial treatment, factors influencing this decision, shared decision-making preferences, and differences in these factors relative to younger adults (age&lt;65 years). Adult patients (≥21 years) with a new diagnosis of indolent NHL in the past six months completed electronic self-report measures. The final sample consisted of 86 patients; 43.0% (n=37) were older adults. Over two-thirds of older adults (n=25, 67.6%) were being monitored by their oncologist with no age differences in current treatment (p=.55). Most older adults chose their treatment plan to “maximize my long-term health” (n=24, 64.9%) which did not differ from younger adults (p=.77). The primary factors impacting older adults’ treatment decisions were their doctor’s recommendation (M=3.92, SD=.28, Range=0-4) and their personal preference (M=2.88, SD=1.68, Range=0-4). Factors impacting treatment decisions did not differ by age (all p’s&gt;.05). Most older adults (n=25, 69.4%) expressed a preference for shared decision-making with their oncologist which did not differ from younger adults (p=.17). Treatment planning for older adults should consider long-term health, consistent with older adults’ values. Older adults may view treatment decision-making similarly to younger adults; assumptions about patients’ values and decision-making preferences based on age are likely inappropriate.
Remote Monitoring Activity Trajectory-Associated Weight Loss and Functional Ability in Obese Older Adults
Authors: Batsis John , Petersen Curtis , Kahkoska Anna , Fortuna Karen 
Published: December 2021

Abstract
Functional decline in older adults can often be mitigated by physical activity. As older adults increasing adopt wearable technology, an understanding of how remotely monitored activity is associated with clinical outcomes is needed. Data was analyzed from two cohorts of older adults with obesity (□65 years, BMI (□30kg/m2)) who completed weekly dietary and exercise-based weight loss interventions (n=93). Follow-up time varied between cohorts (n=37: 12-weeks; n=56: 16 weeks). All participants were provided a Fitbit to monitor physical activity. Baseline and follow up weight, 6-minute walk distance, grip strength, and Late Life Function and Disability Instrument (LLFDI) were collected. We used k-means clustering for longitudinal data to identify physical activity trajectories from Fitbit steps at the daily level. Linear regression models tested for differences in each outcome between trajectories, adjusting for age and sex. Baseline characteristics did not vary across cohorts: mean age 72.7±4.5 years, 76.5% were female, and mean BMI was 36.4±5.1 kg/m2. Two physical activity trajectories were identified, termed high and low activity based on differences in mean daily steps (7,476±4,117 vs. 2,960±2,453, p &lt;0.001). Participants in the high activity group experienced a 2.4% reduction in weight (p &lt;0.001) and a 4.74% increase in LLFDI score (p=0.007) relative to the low activity cluster. Other outcomes were not significantly different between trajectories. These results demonstrate the potential for remote monitoring data to elucidate longitudinal trends in weight and functional ability. As such, older adults’ use of wearable technology may facilitate improvements in weight and functional ability in the community.
Age Differences in the Association Between Anxiety Symptoms and Suicide Risk
Authors: Owsiany Montgomery , Cui Ruifeng , Fiske Amy 
Published: December 2021

Abstract
Suicide rates increase over the life-span, necessitating concern in older adults. Recent studies suggest that anxiety disorders are associated with suicidal thoughts and behavior. The present study examined the association between anxiety symptoms (General Anxiety Disorder-7) and suicide risk (Suicide Behaviors Questionnaire-Revised), testing whether the association differs between younger and older adults. Depression symptoms (Patient Health Questionnaire-8) were controlled for in the analyses. In a sample of 944 participants (46% 60+ years), anxiety symptoms, depression symptoms, and suicide risk were lower among older adults (60+ years) than younger adults (all p &lt; .01). Age moderated the significant association between anxiety symptoms and suicide risk (ΔR2 = .008, p &lt; .01). Results indicate that an increase in anxiety is associated with a smaller increase in suicide risk for older adults than younger adults. The need for suicide risk screening among individuals with elevated anxiety symptoms is critical, especially for younger adults.
Retirement and Suicidal Behaviours: A Review of the International Literature
Authors: Owsiany Montgomery , Crnek-Georgeson Kylie , Wilson Leigh 
Published: December 2021

Abstract
This scoping review maps published literature on retirement patterns and the effect retirement has on individuals. Recommendations are provided for future research, including changes to retirement policies, to decrease the prevalence of suicidal behaviours for older adults. A literature search (2014 - 2020) was conducted in Medline, PubMed, Cinahl and Scopus, using the terms retirement, transition, redundancy, and pathways. A rapid review of global literature was undertaken, identifying 204 articles, with 27 papers chosen for full review. Search terms included retirement, transition, redundancy and pathways to retirement. Themes arising from the data were experience of retirement, planning, health (physical and psychological), and levels of social participation. This review provides information for policy makers, health workers and employers to assist individuals with retirement, emphasising the need to maintain competency in a complex set of skills to improve health literacy and decrease psychological stress/ suicidal behaviours in older adults.
Racial Disparities in Use of Memory Care and Prevalence of Duals in Assisted Living
Authors: Cornell Portia 
Published: December 2021

Abstract
Assisted living (AL) communities with memory care licenses are disproportionately located in affluent and predominantly White communities and Black older adults are underrepresented in AL. But little is known about characteristics of AL that care for Black residents. We estimated the association of facility-level characteristics as proxy measures for AL resources, such as memory care designations and percentage of dual-eligible residents, across low (0-5%), medium (5-10%) and high (&gt;10%) percentages of Black residents. We found broad differences among communities in the three levels of Black-resident prevalence. High percentage of Black residents was associated with large differences in the percentage of Medicaid-enrolled residents (high 54% duals [s.d.=34], med 28% [31], low=13% [22], p&lt;0.001). ALs with high Black populations were less likely to have a memory-care designation than ALs with medium and low percentages of Black residents (high 4.7% memory care, med 11%, low 17%).
Spillover Effects of Retirement on Physical and Mental Health of a Spouse or Partner: Do Gender and Sexuality Matter?
Authors: Liu Jingwen 
Published: December 2021

Abstract
While the health implication of retirement on retirees has been widely discussed in social sciences, less is known about its spillover effects on one’s spouse or partner. Indeed, large quantities of studies have shown that retirement is a joint decision of couples that may influence the time use of spouses and the incidence of divorce, and so leaving the cross-spouse effects unexplored may underestimate the influence of retirement and social security policies. Using ten waves of Health and Retirement Survey (HRS 1996-2014, N = 85039 observations), this research adopts fixed effects models and instrumental variable methods to examine the causal effects of a retiree’s retirement on the physical and mental health outcomes of his/her spouse or partner, with particular attention paid to the gender and sexuality differentials. Regression results suggest that transitioning into retirement is associated with enhanced self-reported health and cognitive function and decreased depressive symptoms, physical limitation, and BMI among the retirees’ spouses or partners. However, the timing when retirement occurs also matters that retirement at the culturally expected retirement age leads to beneficial spillover effects, while late retirement brings about detrimental effects. Further comparison analysis indicates that retirement’s spillover effects are more prominent among females and heterosexual couples than among their male and gay and lesbian counterparts. These findings inform policymakers of the cross-couple spillover effects of postponing retirement ages and the increasing physical and psychological disparities of females and gay and lesbian couples within families in middle and later life.
Doing Time: Experiences of Care Home Residents in Germany During the Early Phase of the COVID-19 Pandemic
Authors: Leontowitsch Miranda , Oswald Frank , Schall Arthur , Pantel Johannes 
Published: December 2021

Abstract
Residents of care homes across the globe are affected by the spread of SARS-CoV-2 as they have been identified as a high-risk group and because they experienced strict social isolation regulations during the first wave of the pandemic. Social isolation of frail older people is strongly associated with negative health outcomes. The aim of this research project was to investigate how residents in care homes experienced social isolation during the first phases of contact ban in Germany. This paper draws on structured interview data collected from 22 residents in two care homes during early June 2020 in Frankfurt/Main. The findings show that their experiences were shaped by three factors: care home staffs’ approach to handling the contact ban; biographical sense of resilience; and a hierarchy of life issues. The findings highlight the importance of locally specific response mechanisms in care homes, and the need to contextualize residents’ experiences.
Transplant Centers That Measure Frailty as Part of Clinical Practice Have Better Outcomes
Authors: Chen Xiaomeng , Liu Yi , Chu Nadia , Walston Jeremy , Segev Dorry , McAdams-DeMarco Mara 
Published: December 2021

Abstract
Frailty predicts adverse outcomes for kidney transplant (KT) patients; yet the impact of clinical assessments of frailty on center-level outcomes remains unclear. We sought to test whether KT centers that measure frailty as part of clinical practice have better pre- and post-KT outcomes. We conducted a survey of US transplant centers (11/2017-4/2018), 132 KT centers (response rate=65.3%) reported frequencies of frailty assessment at candidacy evaluation and KT admission. Center characteristics and clinical outcomes were gleaned from the national registry (2017-2019). Poisson regression was used to estimate incidence rate ratios (IRRs) of waitlist mortality rate and transplantation rate in candidates and graft loss rates in recipients by frequency of frailty assessment. All models were adjusted for case mix and center characteristics. Given similar center characteristics, centers assessing frailty at evaluation had a lower waitlist mortality rate (always=3.5, sometimes=3.2, never=4.1 deaths per 100 person-years). After adjustment, centers assessing frailty at evaluation had a lower rates of waitlist mortality (always IRR=0.91, 95% CI:0.84-0.99; sometimes=0.89, 95% CI:0.83-0.96) and transplantation (always IRR=0.94, 95% CI:0.91-0.97; sometimes=0.88, 95% CI:0.85-0.90) than those never assessing frailty. Centers that always assessed frailty at KT admission had 0.71 (95% CI:0.54-0.92) times the rate of death-censored graft loss than their counterparts never assessing frailty. Assessing frailty at evaluation is associated with lower transplantation rate but better waitlist survival; centers always assessing frailty at admission are likely to have better graft survival. Research is needed to explore how routine assessment of frailty in other clinical practices benefits broader patient populations.
Home Health Agencies With More Socially Vulnerable Patients Have Lower Experience-of-Care Ratings
Authors: Wang Jinjiao , Ying Meiling , Li Yue 
Published: December 2021

Abstract
Little is known about the disparities in patient experience of home health (HH) care related to social vulnerability. This study examined the relationships of patient Medicare-Medicaid dual eligible status and race and ethnicity with patient experience of HH care. We analyzed national data from the Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS), Outcome and Assessment Information Set, Medicare claims and Area Health Resources File for 11,137 Medicare-certified HH agencies (HHA) that provided care for Medicare beneficiaries in 2017. Patient-reported experience of care star ratings (1-5) in HHCAHPS included 3 domains (professional care delivery, effective communication, and specific issues in direct patient care) with each dichotomized into high (4-5) and low (1-3) experience of care. The proportion of patients with dual eligibility and the proportion of racial/ethnic minorities were summarized at the HHA level. HHA with higher proportion of dual eligible patients were less likely to have high experience of care rating in professional care delivery (smallest Odds Ratio [OR]=0.514; 95% CI: 0.397, 0.665; p&lt;0.001), effective communication (smallest OR=0.442, 95% CI: 0.336, 0.583; p&lt;0.001), and specific direct care issues (smallest OR=0.697, 95% CI: 0.540, 0.899; p=0.006). HHA with higher proportion of racial/ethnic minorities were also less likely to have high patient experience of care rating across all three domains (smallest OR=0.265, 95% CI: 0.189, 0.370; p&lt;0.001). Disparities in patient experience of HH care exist and they are associated with low income and racial/ethnic minority status, indicating substantial unmet needs among these socially vulnerable patients.
Support From the Top: Diverse Leadership Partners for Sustained STAR-VA Implementation
Authors: Karel Michele , Snow A Lynn , Hartmann Christine , Jedele Jenefer , Minor Lisa 
Published: December 2021

Abstract
The STAR-VA program was an initiative out of what is now called the VA Office of Mental Health and Suicide Prevention, partnering with the national Offices of Geriatrics and Extended Care and Nursing Services. Ongoing collaboration with these national, as well as regional and medical-center-level leaders, has been critical for informing program implementation and dissemination strategies. We will discuss several key partnered strategies, including (1) linking STAR-VA to national CLC systematic quality improvement efforts; (2) engaging national inter-office program leaders in decisions about outreach to and inclusion of facilities in STAR-VA training and implementation; (3) training local STAR-VA champions on strategies for engaging local leadership support; (4) briefing leaders across the system with program updates; and (5) using national VA data to inform STAR-VA sustained implementation. Discussion will address challenges and opportunities for engaging leadership stakeholders in facilitating sustained implementation of evidence-based programs.