bluuebunny/crossref_metadata_2025_split huggingface dataset:
When Does Support to Adult Children Negatively Affect the Subjective Well-Being of Older Japanese?
Authors: Kobayashi Erika 
Published: December 2021

Abstract
Providing time and money to adult children may enhance perceived usefulness and consequently the subjective well-being (SWB) of older parents. However, non-reciprocal relationships with children and conflicts with leisure activities could negatively affect parents’ SWB. It was hypothesized that a substantial amount of support to children would be associated with lower SWB when older parents (a) had a low expectation of receiving long-term care from the children, and (b) were engaged in hobbies/learning activities. Life satisfaction and depressive symptoms measured as SWB were predicted based on the Generalized Estimating Equations, using panel data (2012-2017) with a nationwide representative sample of Japanese adults aged 60 years and older (1,212 parents). Providing child-rearing support (i.e., grandchild care) of 30 hours or more per month was positively associated with SWB regardless of conditions (a) and (b). Hypothesis (b) was partially supported: providing financial support enhanced depressive symptoms among older adults with hobbies/learning.
Who Should Make Care Arrangement for Older Adults? Heteronormative Family Responsibility in Japan
Authors: Hirayama Ryo 
Published: December 2021

Abstract
In Japan, despite the greater availability of public care services upon implementation of national long-term care insurance, families are still considered as primarily responsible to make care arrangement for older adults. My aim in this study was to explore (hetero)normative ideas about families that underlie Japan’s institutionalized practices of elder care. In doing so, I focused on care managers, who are certified care practitioners helping families to make care arrangement, and whether they would count older adults’ same-sex partners as legitimate family members to participate in such arrangement. Data were collected from 1,580 care managers working for officially designated in-home care providers across the nation. Preliminary analysis revealed that although most care managers believed the voices of same-sex partners should be preferably reflected in the process of care arrangement, they also thought that these partners could not participate in such process without permission from older adult’s “blood relatives” (e.g., siblings).
Technology is the New Normal for Individuals Aging-In-Place With Disabilities
Authors: Kadylak Travis , Stark Susy 
Published: December 2021

Abstract
Technology designers often exclude individuals aging with diverse needs, capabilities, and disabilities from engaging in the design process, which can hinder the usability and usefulness of emerging technologies. In this symposium, investigators report on research and development efforts aimed at understanding the needs of, and developing supportive technologies for, people aging with long-term disabilities. This symposium features projects from the Rehabilitation Engineering Research Center on Technologies to Support Aging-in-Place for People with Long-Term Disabilities (RERC TechSAge), which is an interdisciplinary collaboration between Georgia Tech and the University of Illinois at Urbana-Champaign. First, Bayles et al. will discuss findings from the Aging Concerns, Challenges, and Everyday Solution Strategies II study, focused on Deaf older adults’ use of technologies as solution strategies for common everyday challenges. Next, Mitzner et al. will highlight the development of an evidence-based group exercise intervention (Tellewellness Tai Chi for Arthritis) aimed at promoting both physical exercise and social interaction for older adults with long-term mobility disabilities. Kadylak et al. will describe how voice-activated digital assistants can support older adults aging with mobility disabilities by reporting on findings from a longitudinal demonstration project with older adults in assisted and independent living communities. Exploring the potential for smartbathroom technology to promote aging in place, Sanford et al. will discuss how smartbathroom sensor data can be analyzed and vizualized to identify ways to communicate insight from sensor data to improve training of occupational therapy practitioners. Susy Stark from Washington University will serve as the discussant for the symposium.
Access and Barriers to Use of Long Term Services: Contextual Issues
Authors: Glicksman Allen , Ring Lauren , Keating Norah 
Published: December 2021

Abstract
The challenges that some older adults face in accessing both health and social services is a topic of continuing concern. This panel will focus on contextual issues that often shape specific challenges. These contextual issues usually emerge either from issues of diversity among the older persons themselves (for example, minority status or foreign born) and diversity between the ways in which services are offered (usually established at the national or in the case of the United States, at the state level). The intersection of these two forms of diversity often define the specific challenges faced by older persons in accessing health and social services. Further, unexpected events, such as the COVID pandemic, can affect both types of diversity (greater challenges for persons who do not speak the dominant language; inability of services to quickly adapt to radically changed environment). Our panel will address these issues through four presentations, each taking a different look at the ways in which diversity affects access. Our first paper, by Torres, will place this discussion in wider context by presenting results from a scoping review. Our second paper, by Diederich looks at access to services by immigrant generation (that being another source of diversity) in Germany. The third paper, by Thiamwong looks at how the COVID crisis affected older Hispanic women. Finally, Ring will examine how a national policy, here the definition of poverty, affects outcome and access for older person in the United States.
Reframing Aging: A Generation's Work
Authors: D'Antonio Patricia 
Published: December 2021

Abstract
Changing American culture is challenging and changing attitudes and behaviors around the universal experience of aging especially so. Unless the field of advocates who care about aging issues cultivates a more visible, more informed conversation on older people, it will remain difficult to advance the systemic changes needed to adjust to a society with increased and increasing longevity. Advocates will need to be vigilant to avoid cueing negative attitudes towards aging and aging policies. The Reframing Aging Initiative is a long-term, social change endeavor designed to improve the public's understanding of what aging means and the many contributions older people bring to society. Using evidence-based research, the initiative seeks to teach how to tell an effective story about aging that will promote positive perceptions of aging and reduce ageism.
Age Equity: A Framework for Addressing Ageism, Stigma, and Bias
Authors: Goldsen Karen Fredriksen , Emlet Charles 
Published: December 2021

Abstract
In the Covid-19 context, researchers and policy makers have turned their attention to long-standing disparities in health equity, including by race, ethnicity, poverty, sexuality, and gender. Yet, scholarship to date does not conceptualize age as a critical aspect of difference requiring an equity lens. In this presentation, we utilize an Age Equity Framework to investigate ageism based on research findings from the 2018 National Health, Aging and Sexuality/Gender Study (NHAS): Aging with Pride. Investigating ageism, stigma, and bias, we found nearly half of LGBTQ older adults feel invisible and disrespected. After adjusting for background characteristics, experiences of ageism were associated with higher rates of stigma, lifetime victimization, discrimination, lower support and community engagement, and adverse outcomes (lower mental and physical health and quality of life). The rapidly growing older adult population highlights the pressing need to consider age inequities and the importance of achieving age equity across the life course.
Smartwatch Technology for Physical Activity in Older Adults: A Qualitative Study
Authors: Li Mengchi , McPhillips Miranda , Szanton Sarah , Wenzel Jennifer , Li Junxin 
Published: December 2021

Abstract
Older adults’ experiences using smartwatch technology for physical activity (PA) have not been well studied. We studied older adults’ acceptance, capacity, and experience using smartwatches for self-monitoring and promoting PA. We conducted individual interviews using semi-structured interview guides with 15 older adults who participated in two studies. The two studies employed smartwatches in combination with personalized exercise training to promote PA and the interventions were 4 and 24 weeks in length. Interviews were transcribed verbatim. Two researchers conducted inductive content analysis using NVivo V.12 to identify and categorize codes into major themes. Participants reported high overall acceptance, ease of use (i.e., charging, checking steps, reading the screen), and attractive design of smartwatches. Participants’ positive descriptions of their smartwatch experience included: increased activity awareness (step counts and heart rate), improved exercise accountability, and enhanced motivation (response to prompts). Most participants expressed interest in long-term smartwatch use. While participants expressed enjoyment of smartwatch technology for self-monitoring and PA promotion, some reported decreased motivation over time. Participants’ concerns of smartwatch functionalities included short battery life, inaccurate step-recordings, and touchscreen insensitivity. Some also reported failure to troubleshoot smartwatch syncing/pairing problems with smartphones and daily smartwatch charging issues. Smartwatch Bluetooth connectivity and battery life can be improved to increase usability and acceptability among older adults. Future research should explore the role of smartwatches for older adults’ PA with emphasis on behavior change over time.
The AgingPLUS Trial: Intervening to Promote Physical Activity in Middle-Aged and Older Adults
Authors: Rebok George , Roth David , Chung Shang-En (Michelle) , Li Kaigang , Nehrkorn-Bailey Abigail , Thompson Katherine , Diehl Manfred 
Published: December 2021

Abstract
This paper investigated whether the AgingPLUS program promotes physical activity in middle-aged and older adults by examining outcomes at weeks 4 and 8 with baseline scores included as covariates. The analyses assessed intervention effects on negative views of aging (NVOA), physical activity (CHAMPS), physical function (SPPB, VO2max), and accelerometry measures (e.g., minutes sedentary). We found significant intervention effects on NVOA (p &lt; .001) and frequency of moderate intensity exercise (p = 0.048), but no significant effects on physical function, VO2max, or the accelerometry measures. Standardized effect sizes for the significant effects ranged from 0.31 to 1.03 standard deviation units. These findings suggest that AgingPLUS improved motivational factors for engaging in physical activity but did not lead to objective changes in physical activity in the short term. Further research will investigate the mediational role of these motivational factors in enhancing physical activity over the longer term (6 months).
AgingPLUS: Examining the Malleability of Implicit Views of Aging
Authors: Tseng Heidi , Forsyth Garrett , Nehrkorn-Bailey Abigail , Rodriguez Diana , Thompson Kat , Diehl Manfred 
Published: December 2021

Abstract
AgingPLUS also examines whether the intervention can change participants’ implicit VOA. To that end, participants completed a lexical decision-making task (LDMT) and the Brief Implicit Association Test (BIAT) at baseline and post-intervention. One-way ANCOVAs with baseline scores as covariate were used for these analyses. For LDMT, there was no significant difference between the groups regarding their post-intervention latencies for old-positive words, F(1,181) = 0.01, p = .60, old-negative words, F(1,181) = 0.43, p = .51, young-positive words, F(1,181) = 0.19, p = .67, and young-negative words, F(1,181) = 1.16, p = .28. For BIAT, both groups showed a slight preference for the young at baseline (mean d = 0.39), and post-intervention (mean d = 0.38). There was no significant difference between the groups regarding post-intervention d scores, F(1,181) = 0.002, p = .97. These preliminary findings suggest that in the current subsample, AgingPLUS did not significantly change participants’ implicit VOA.
Cognitive Frailty and Its Long-Term Effect on Depression in an Older Population in Korea
Authors: Ji Yoonjung , Lee TaeWha , Kim Eunkyung 
Published: December 2021

Abstract
Cognitive frailty is a condition where physical frailty and mild cognitive impairment (MCI) co-exist without dementia. It occurs in 1.8%-8.9% of the general older population, and older people with depression have a higher risk of frailty. However, the relationship between cognitive frailty and depression is still unclear. This study aimed to determine the relationship between cognitive frailty and depression of older adults by time using comparative group analysis. A secondary analysis was conducted using the Korean Longitudinal Study of Aging (KLoSA) dataset from 2010 to 2018. A sample was 981 older adults who were 65 years old and without dementia over residing in the community. Cognitive frailty was defined as having a mini-mental state examination score of 18-23 and 3 or more of the Fried frailty indexes. Generalized Estimating Equation model and chi-square test were employed. Of the 981 subjects, the cognitive frailty(CF) was 28.5%, followed by robust (37.7%), physical frailty (PF, 29.4%), mild cognitive impairment (MCI, 4.4%) at baseline. The group differences on depression measured by the Center for Epidemiological Studies Depression (CESD) were statistically significant in the PF (F=4.70, p&lt;.001) and the CF (F=4.95, p&lt;.001) group compared to the robust group. The time difference effect (F=.09, p=.05) and a group-by-time interaction effect were observed (p&lt;.001). This study confirmed that cognitive frailty is strongly associated with depression. Effective approaches to managing psychological wellbeing, including dementia, are essential for older adults with cognitive frailty.
Hip Accelerometry Activity Patterns Improve Machine Learning Prediction of 1-Year MoCA Score Change
Authors: Shi Chengjian , Urbanek Jacek , Babiker Niser , Gonzolez Alan , Soto Jovany , Rzhestsky Andrey , Huisingh-Scheetz Megan 
Published: December 2021

Abstract
We tested whether free-living hip accelerometry measures improved prediction of 1-year change in Montreal Cognitive Assessment (MoCA) scores beyond clinically available information. We analyzed data (n=126) from predominantly African American (78.2%) older adults without moderate-severe dementia residing near our geriatrics clinic. Age (73.6 ±6.1 years), gender, education, comorbidities, income, and MoCA performance were collected at baseline; participants then wore a right hip, triaxial Actigraph accelerometer (30Hz) continuously for 7 days. A MoCA was repeated at 1 year. Six measures were calculated from the daytime (7am-5pm) data: mean/variance of hourly counts per minute, mean/variance of daily percent of time spent in the lowest activity quartile, and mean/variance of daily percent of time spent in the highest activity quartile. In a random forest model containing baseline MoCA, demographics and comorbidities, the accelerometry measures improved prediction of 1-year MoCA performance by ~17.8%. Accelerometry data may be clinically useful for predicting early cognitive decline.
Mean Arterial Pressure and Risk of Falls Resulting in Hospital Presentation in Older Adults
Authors: Hussain Sultana Monira , Ernst Michael , Reid Christopher , Tonkin Andrew M , Neumann Johannes , Le Thao Thi Phuong , Barker Anna , McNeil John 
Published: December 2021

Abstract
Utilising data from the ASPirin in Reducing Events in the Elderly trial participants aged 70-years, we estimated MAP and variation in MAP defined as within-individual SD of MAP from baseline and first 2 annual visits. Falls were confined to those involving presentation to a hospital. Cox proportional hazards regression was used to calculate hazard ratio (HR) and 95% confidence interval (CI) for associations with falls. Amongst 16,703 participants (1,540 falls), MAP was not associated with falls irrespective of antihypertensive medication status (all: HR 1.00, 95% CI 0.99-1.01, not on antihypertensive: HR 1.01, 95% CI 0.99, 1.02, on antihypertensive: HR 1.01, 95% CI 0.99-1.02). Amongst 14,818 participants who remained in the study up to year 2 without falls, 1 unit escalation in MAP variability increased the risk (HR 1.01, 95% CI 1.00-1.03). Compared with those in the lowest tercile of variability, those in the middle or highest tercile of variability experienced an increased risk of falling (middle: HR 1.32, 95% CI 1.06-1.65; highest: HR 1.25, 95% CI 1.01-1.55). When stratified for antihypertensive medication status, those receiving diuretics (HR 1.18, 95% CI 1.00-1.39) or beta-blockers (HR 1.37, 95% CI 1.08-1.73) were at increased risk compared to those receiving renin-angiotensin-system acting agents. All results persisted after adjustment for multiple covariates. The association of diuretics and beta-blockers with falls remained significant even after excluding those with history of heart failure. Older community-dwelling adults with high variability in MAP are at increases risk of falls, particularly amongst those receiving beta-blockers or diuretics.
Measurement Disparities in Frailty Among Kidney Transplant Patients: Impact of Differential Item Functioning
Authors: Chu Nadia , Gross Alden , Chen Xiaomeng , Xue Qian-Li , Bandeen-Roche Karen , Segev Dorry , McAdams-DeMarco Mara 
Published: December 2021

Abstract
Frailty is commonly measured for clinical risk stratification during transplant evaluation and is more prevalent among older, non-White kidney transplant (KT) patients. However, group differences may be partially attributable to misclassification resulting from measurement bias (differential item functioning/DIF). We examined the extent that DIF affects estimates of age, sex, and race differences in frailty (physical frailty phenotype/PFP) prevalence among 4,300 candidates and 1,396 recipients. We used Multiple Indicators Multiple Causes with dichotomous indicators to assess uniform DIF in PFP criteria attributable to age (≥65vs.18-64 years), sex, and race (Black vs.White). Among candidates (mean age=55 years), 41% were female, 46% were Black, and 19% were frail. After controlling for mean frailty level, females were more likely to endorse exhaustion (OR=1.20,p=0.003), but less likely to endorse low activity (OR=0.83,p=0.01). Younger candidates were more likely to endorse weight loss (OR=1.30,p=0.005), exhaustion (OR=1.60,p&lt;0.001), and low activity (OR=1.80,p&lt;0.001). Black candidates were more likely to endorse exhaustion (OR=1.25,p&lt;0.001), but less likely to endorse weakness (OR=0.79,p&lt;0.001). Among recipients (mean age=54 years), 40% were female, 39% were Black, and 15% were frail. Younger recipients were more likely to endorse weight loss (OR=1.55,p=0.005) and low activity (OR=1.61,p=0.02); however, no DIF was detected by sex or race. Results highlight the impact of DIF for specific PFP measures by age, sex, and race among candidates, but only by age for recipients. Further research is needed to ascertain whether candidate- and/or recipient-specific thresholds to correct for DIF could improve risk prediction and equitable access to KT for older, female, and Black candidates.
Family Caregiving for Persons With Emotional, Developmental, and Behavioral Disorders During COVID-19
Authors: Beach Scott , Schulz Richard , Donovan Heidi , Rosland Ann-Marie , Klinedinst Tara , Kim Hansol 
Published: December 2021

Abstract
COVID-19 has the potential to exacerbate stresses of family caregiving. While studies during COVID-19 have focused on caregivers of those with memory / cognitive issues like Alzheimer’s Disease, less attention has been paid to those caring for persons with emotional / developmental / behavioral disorders. This paper compares family caregivers of persons with emotional / developmental / behavioral disorders (EDB); physical conditions (PH); and memory / cognitive problems (MC) during the early phase of the pandemic. We focus on demographics, caregiving context, COVID-related caregiver stressors, and validated physical, psychosocial, and financial well-being outcomes. We conducted a cross-sectional national online survey during April-May, 2020 (n = 556). The sample included 274 PH (50%), 141 MC (25%), and 141 EDB (25%) caregivers. EDB caregivers were younger, with younger care recipients who were more likely to be their child. EDB caregivers reported more COVID-related caregiver stressors than MC or PH caregivers, including increased caregiving duties (p&lt;.01); more family disagreements about care provision (p=.05); and worsened mental health of the care recipient (p&lt;.01). In multivariate regression models, EDB caregivers had significantly higher anxiety; depression; and fatigue (all p&lt;.01); more sleep disturbance (p=.05); less social participation (p&lt;.05); and poorer overall financial well-being (p&lt;.05). MC caregivers also reported more negative outcomes, but effects were consistently strongest for EDB caregivers. This study shows that EDB caregivers are at significantly elevated risk for negative impacts due to COVID-19 and should receive increased support and attention during this public health crisis.
Ohio's Large Scale Experiment on Integrated Care: Results and Implications for Long-Term Services Reform
Authors: Applebaum Robert , Nelson Matt , Bowblis John 
Published: December 2021

Abstract
Implemented through five health plans, Ohio’s MyCare demonstration began in 2014 and was designed to coordinate primary, acute care, behavioral health and long-term services in the major urban areas of the state. Individuals who are dually eligible for both Medicaid and Medicare and who reside in specified geographic regions must enroll into a managed MyCare plan. MyCare beneficiaries are assigned to two primary categories: community well and those needing long-term services and supports (LTSS). Individuals receiving the integrated MyCare intervention were expected to have lower acute care hospitalizations, lower long-term nursing home use, better longevity and lower overall health and long-term care costs. Using a propensity score matching design, the evaluation compared MyCare enrollees to comparison group members in non-MyCare counties of the state, using Medicaid and Medicare claims data. The 120,000 MyCare program participants represented about half of the dual eligible individuals in the state.