bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining Mental and Physical Health Status Among Sandwich Generation Caregivers
Authors: Kim Hansol , Schulz Richard , Beach Scott , Donovan Heidi 
Published: December 2021

Abstract
With a sample of 54,076 caregivers, the Behavioral Risk Factor Surveillance System (BRFSS, 2015-2017) provides an opportunity to assess the impact of caregiving on U.S. adults varying in age, gender, and race. We focused on sandwich generation (SG) caregivers, aged 30-59, with childcare and eldercare responsibilities (n=8,805). In multivariate regression models of mental and physical health, we evaluated the association of age, gender, race and caregiving factors controlling for marital status, education, housing status, income, employment status, and self-rated health status. SG caregivers were predominantly female (65.6%), white (69.6%), black (13%) and were caring for a parent/parent-in-law (50%) or another relative (26.4%). Age, gender, and race were associated with mental health outcomes such that SG caregivers who were younger (aged 30-39), female, and white reported poorer mental health during the past month (p&lt;.05). Older (aged 50-59), female, and white SG caregivers reported poorer physical health during the past month (p&lt;.05). Caregiving factors were not associated with mental health, but SG caregivers who had been providing care for a longer period of time were more likely to report poor physical health in the past month. Finally, education, income, employment, housing status, and self-rated health status were statistically significant covariates in both models (p&lt;.05). These findings demonstrate that young caregivers are at risk for poor mental health; older caregivers for poor physical health. Being female, white, with lower socioeconomic status is associated with poor mental and physical health. Future research should address the unique needs of SG caregivers with dual caregiving responsibilities.
Exploring the Subjective Caregiving Experience Among Chinese, Korean, and Southeast Asian Communities
Authors: Powers Sara , Schaffer Rachel , Bass David , Le Ocean , Pongan Lauren 
Published: December 2021

Abstract
Although the Asian American community is one of the fastest growing racial groups in the US, members of this group continue to be underserved and understudied, especially when it comes to the needs of family caregivers. Therefore, through a national initiative to understand the lived experiences of diverse family and friend caregivers, survey data was collected from a variety of Asian American ethnic subgroups including Chinese (n=148), Korean (n=131), and Southeast Asian (i.e., Vietnamese, Hmong, Cambodian, Laotian; n=161). Surveys were distributed in-person and online, and also offered in the translated native languages of the abovementioned groups. Caregivers had to be 18 years and older and providing care to a person aged 55 and older who needed assistance because of ongoing health problems or disabilities. For the overall sample of Asian American caregivers (n=440), participants were on average 51.68 years of age (SD=15.98), identified as female (n=336), were not born in the US (n=348), lived with the care receiver (n=247), and reported less than $10,000 in income per year (n=199). As guided by the Stress Process Model and through a series of ANOVA tests, when compared on all major outcomes, Southeast Asian caregivers significantly reported: 1) more difficulty with care related tasks (e.g., financial/legal decisions), 2) a stronger cultural commitment to caregiving, 3) higher work strain, and 4) more depressive symptomology. Discussion will focus on opportunities for professionals to meet the needs of Asian American caregivers through the use of available trainings and programs aimed to support diverse caregivers.
The Relationship Between Place of Death and Immigrant Status
Authors: Franco Yujin , Osuna Margarita , Ailshire Jennifer 
Published: December 2021

Abstract
Increasing attention is being paid to improving care at the end-of-life, including developing a better understanding of where individuals die, and factors related to place of death. The older immigrant population in the United States is increasing rapidly, and while prior research suggests they may differ in their end-of-life experiences, we know relatively little about foreign-born differences in where people die. This study investigates how the place of death (home, hospital, and nursing home) differs between the U.S.-born and foreign-born. We used data on 9,180 U.S.-born and 969 foreign-born respondents from the nationally representative Health and Retirement Study (HRS) for who end-of-life surveys were conducted with a proxy between 2002 and 2016. Approximately one-third of deaths occurred in nursing homes in both groups. Hospital deaths were more common in US-Born decedents (31.9%) than foreign-born decedents (25.2%), while death at home was lower for US-born (35.5%) than foreign-born (40.2%). We used multinominal logistic regression analysis to determine whether sociodemographic characteristics, cause of death, or receipt of family caregiving explained the observed differences in place of death by foreign-born status. Results from fully adjusted multivariate models indicate the foreign-born differences in place of death cannot be explained by socioeconomic, health, or family factors. Our research shows key differences in the end-of-life experience between US-born and foreign-born older adults and highlights the importance of examining end-of-life experiences for this small, but rapidly growing segment of the older U.S. population.
Limitations in Physical Activities and Loneliness: The Role of Guilt for Perceiving Oneself as a Burden
Authors: Chaparro María del Sequeros Pedroso , Cabrera Isabel , Vara-García Carlos , Fernandes-Pires José Adrián , Barrera-Caballero Samara , Mérida-Herrera Laura , Márquez-González María , Losada-Baltar Andrés 
Published: December 2021

Abstract
Loneliness is a prevalent problem associated with negative health consequences for older adults, such as greater cognitive decline. Limitations to perform physical activities have been associated with greater loneliness in older adults. This association could be moderated by maladaptive social cognition or feelings, such as guilt associated with perceiving oneself as a burden. The objective of this study was to analyze the moderating effect of guilt associated with perceiving oneself as a burden in the relationship between limitations in physical activities and loneliness. Participants were 195 community-dwelling people 60 years or older not showing explicit cognitive or functional limitations that prevent activities of daily life, but who may present limitations in some physical activities (e.g., walking a kilometer or more). A linear regression analysis was conducted for testing the interaction between limitations in physical activities and guilt for perceiving oneself as a burden in loneliness, controlling for gender and age. The interaction between limitations in physical activities and guilt for perceiving oneself as a burden was the only significant predictor of loneliness and the model explained 18.30% of the variance. Limitations in physical activities influenced loneliness when people have high levels of guilt for perceiving oneself as a burden. This study suggests that guilt for perceiving oneself as a burden may play an important role in the association between limitations in some physical activities and loneliness.
Effects of a Movement-Based Mind-Body Intervention in Managing Osteoarthritis Symptoms in Older Adults
Authors: Park Juyoung , Herron Carson 
Published: December 2021

Abstract
In a secondary analysis, this study examined differences in age (younger vs. older geriatric groups), gender, and living arrangement (living alone vs. living with others) in elderly patients with osteoarthritis (OA) who utilized chair yoga (CY) as an type of movement-based mind-body intervention (MMBI) for symptom management. A two-arm, assessor-blinded, randomized control trial was used to examine effects of CY (twice-weekly 45-minute sessions for 8 weeks) on pain interference, physical function, and psychosocial outcomes by gender, age, and living arrangement in older adults with OA who could not participate in traditional exercise. A total of 112 older adults completed CY or a health education program (HEP) and participated in five data collection points. Older women in the CY group showed greater reduction in pain interference during the CY intervention than those in HEP, F(4, 86) = 3.255, p = .016, η2 = .131. The younger group (ages 61 to 74) had decreased depression scores during the intervention, F(4, 87) = 2.598, p = .042, η2 = .107. Regardless of the intervention (CY or HEP), depression scores in older adults who were living alone decreased substantially during the intervention. Group-based and supervised CY interventions are recommended for older adults with OA to reduce pain interference, reduce depressive symptoms, and develop social networks. Online-based synchronous CY sessions may address physical activity needs and improve mental well-being in this population in light of physical distancing practices due to COVID-19.
High-Intensity Interval Training in Older Adults With Treatment Naive Chronic Lymphocytic Leukemia
Authors: Bartlett David , MacDonald Grace , Deal Mike , Hanson Erik , Pieper Carl , Weinberg J Brice , Brander Danielle , Sitlinger Andrea 
Published: December 2021

Abstract
Chronic lymphocytic leukemia (CLL) is the most common leukemia, affecting predominantly older adults. Treatment naïve patients (CLLtn) with low physical fitness have poor survival following commencement of treatment. CLLtn is characterized by inadequate immune functions, increased risk of secondary malignancies and infections. The aims of this study were to determine the feasibility and preliminary effects of 12-weeks of high-intensity interval training (HIIT) on CLLtn patients. We enrolled eighteen CLLtn patients (64.9±9.1yrs.). Eleven (5M/6F) were allocated to HIIT and seven (4M/3F) to the control group (CON). HIIT consisted of three 30-minute treadmill sessions/week plus two 30-minute strength training sessions/week. Feasibility was confirmed if &gt;70% of HIIT participants completed &gt;75% of prescribed sessions and prescribed minutes, and if &gt;80% of high-intensity intervals were at a heart rate corresponding to 80% of aerobic capacity (139±19 bpm). Results are presented as mean±SD and effect sizes (d), with 0.2, 0.5 and 0.8 representing small, medium and large effect sizes, respectively. Feasibility was achieved, with HIIT completing 5.0±0.2 sessions/week and 99±3.6% of prescribed minutes/week at 142±19 bpm. No adverse safety events were observed. Compared to CON, HIIT increased leg (d=2.602), chest (d=1.285), and seated row (d=3.323) strength, while aerobic capacity difference between groups was d=0.431. Compared to CON, HIIT increased in vitro natural killer immune cell cytolytic activity against K562 (d=1.586) and OSU-CLL (d=0.917) cancer cell lines, and autologous CLL cells (d=1.362). HIIT is safe and feasible in older adults with CLLtn. Preliminary effects suggest that HIIT increases muscle strength and important components of immune function.
Lessons Learned From Focus Groups and Community Education Provision in the African American Community
Authors: Frazier Robbin 
Published: December 2021

Abstract
The present symposium will synthesize themes derived from eight different projects designed to better understand dementia in Minnesota (MN) within the African American community (where individuals are disproportionately susceptible to dementia and the tolls of dementia care). These projects included focus groups, community outreach, community education, networking with aging service providers, and community forums. Projects were funded by and conducted in partnership with the MN Department of Human Services, the Alzheimer’s Association, the MN Board on Aging, and the MN Leadership Council on Aging’s Diverse Elders Coalition. Themes included the unique ways that African American elders share their viewpoints and the importance of faith-based outreach. Another major theme, which connects to the other symposium talks, was the importance of three S’s: Stigma, Shame, and Silence as cultural considerations in the African American, West African, and Latino/a/x/e communities as they apply to access to information and training to better understand AD/ADRD.
Testosterone Therapy for Men With Age-Related Low Testosterone: Tempest in a Teacup
Authors: Basaria Shehzad 
Published: December 2021

Abstract
Serum testosterone concentrations decrease in men with age, but benefits and risks of raising testosterone levels in older men remain controversial. In the T-Trials, a total of 790 men, age 65 and older, with a serum testosterone concentration of &lt; 275 ng/dL and symptoms of sexual dysfunction, fatigue or physical dysfunction were randomized to either testosterone gel or placebo gel for 1 year. Treatment in the testosterone arm increased serum testosterone levels to the mid-normal range for young men. Testosterone replacement was associated with a significant increase in sexual activity (p &lt; 0.001), libido and erectile function. In contrast, there was no improvement in vitality or physical function. Adverse findings included increases in non-calcified plaque formation and a higher rate of prostate events. In sum, testosterone treatment in older men was associated with modest benefits, while the risk on prostate and cardiovascular health remain unclear.
Assessing Well-Being Among Aging Women: Observations From the Women's Health Initiative
Authors: Pike Kenneth , Rillamas-Sun Eileen , Cochrane Barbara , Woods Nancy 
Published: December 2021

Abstract
Our aim was to develop a profile of well-being preserving the ability to estimate differential effects of both hedonic and eudaemonic dimensions of well-being on health outcomes. Numerous indicators of well-being from over 80,000 aging women included hedonic (enjoyment of life, happiness, satisfaction with life, quality of life) and eudaemonic (personal growth, purpose in life, environmental mastery, control, self mastery) dimensions. Using latent class analysis, we identified groups of women with distinct profiles of well-being. A four-class solution had both good statistical fit and made conceptual sense. Class 1 (n=9,146, 11%) had the lowest scores on hedonic and eudaemonic indicators, while Class 4 (n=38,246 47%) had the highest levels of all well-being indicators. Class 2 (n=7,106, 9%) had higher hedonic and lower eudaemonic scores and Class 3 (n=26,650, 33%) had lower hedonic and higher eudaemonic scores. These classes form a well-being profile useful for estimating differential effects on health outcomes.
Recruitment and Retention in Diverse Cohorts: Lessons From Community-Engaged Efforts
Authors: Nieman Carrie , Han Haera , Rebok George 
Published: December 2021

Abstract
Effective behavioral interventions and associated trials reflect the complexity and context of the communities with which they are tailored and the behaviors they seek to address. Community-engaged methodology can serve to capture these complexities, particularly when focusing on health inequities. Significant health and healthcare disparities persist among racial/ethnic minorities and representation of racial/ethnic minorities is lacking within trials that reflects the diversity of the U.S. population. Novel approaches are needed to increase the diversity of participants within behavioral intervention research. This symposium covers the unique barriers and facilitators related to recruitment and retention across a range of populations, including African American and Hispanic/LatinX older adults with hearing loss to diverse dementia family caregivers and community-dwelling Korean American older adults. Beyond the challenges and opportunities, the symposium will focus on effective recruitment strategies. The discussion will include 1) findings from 10 years of recruiting older Korean Americans into community-based trials, 2) lessons in tailoring recruitment efforts to dementia family caregivers, 3) the integration of human-centered design into a community-engaged hearing care intervention targeting low-income and African American older adults, 4) successful recruitment and retention efforts in a community-based participatory research trial in a borderlands community, and 5) the deployment of strategies to recruit Latino, Asian, and African American older adults with depression and anxiety in the setting of the COVID-19 pandemic. This symposium seeks to build the evidence related to recruitment of older racial/ethnic minorities in diverse settings, which is fundamental to addressing health inequities through behavioral intervention research.
Community Recruitment of Asian, Latino and African American Older Adults With Depression Symptoms During COVID-19
Authors: Bague Irene Falgas , Mukthineni Ravali , Lim Sahnah , Jimenez Aida , Ferreira Caroline , Markle Sheri Lapatin , Alegria Margarita 
Published: December 2021

Abstract
Recruitment and engagement of racial/ethnic minority older adults in clinical trials is crucial to expand implementation of evidence-based interventions for disability prevention. Public Health measures to counteract COVID-19 pandemic have increased the challenges on reaching this population. This study seeks to comprehensively evaluate a set of recruitment strategies to enroll Latino, Asian and African American older adults with symptoms of depression and anxiety during the first year of a randomized clinical trial. A partnership of three academic sites across the U.S. (NYC, MA and PR) involving several collaborations with community agencies recruited racial/ethnic minority older adults using different strategies involving bilingual interviewers calling from hospital research dataset and community agencies’ list of clients, referrals from primary care providers or psychotherapy waitlist. In this presentation we will report various recruitment and retention data including individual and organizational predictors of successful recruitment as well as challenges across all three sites.
Factors Associated With Deficient Housing Among Community-Living Older Adults in the United States
Authors: Okoye Safiyyah , Samuel Laura , Szanton Sarah , Wolff Jennifer 
Published: December 2021

Abstract
Housing quality is a recognized social determinant of health. Qualitative evidence suggests the ability of older adults to maintain their homes is affected by the domains of financial resources, social environment, and functional abilities, but this conceptualization has not been tested quantitatively. This cross-sectional study examined associations between financial resources (indicated by socioeconomic characteristics: education, racial-status, annual income, financial hardship, Medicaid eligibility), social environment (living arrangement, social integration), and functional abilities (lower extremity performance, self-care disability, independent-living disability, homebound-status, dementia, depression) with deficient housing among 6,489 community-living adults ≥ 65 years participating in the nationally representative 2015 National Health and Aging Trends Study. Sampling weights accounted for study design and non-response. An estimated 9.2% (3.2 million) older Americans lived in housing with ≥1 deficiency (any peeling paint, evidence of pests, flooring in disrepair, broken windows, crumbling foundation, missing siding, or roof problems). In bivariate logistic regressions, factors from all three domains were associated with deficient housing. In a multivariable model that included all variables above and adjusted for age and sex, indicators of financial resources and social environment remained associated with deficient housing (including financial hardship, adjusted odds ratio (aOR)=1.48, 95% confidence interval (CI): 1.10,1.98; and living with non-spousal others versus alone, aOR=1.48; 95% CI:1.09, 2.03), whereas indicators of functional abilities did not. To ensure quality housing for all community-dwelling older adults, efforts that increase financial resources and further examine the role of social environment in deficient housing are needed.
Living Alone in Late Life
Authors: Torres Jacqueline 
Published: December 2021

Abstract
Approximately one third of older adults in the United States (US) and 13% of older adults in Mexico live alone. In both countries, the prevalence of living alone is higher for women and increases with advanced age; in the US, an estimated 4.3 million older adults continue to live alone with cognitive impairment or dementia. We will present research from the US and Mexico on the receipt of long-term services and supports and unmet needs for care among older adults living alone, including with cognitive impairment, as well as factors that may modify these outcomes. For the US, we will describe recent findings about the health, health care, and caregiving outcomes of older adults living alone vs. living with others during the COVID-19 pandemic.
Framing Binational Challenges of Mental and Cognitive Health Care in Mexican-Origin Older Adults: Consensus Findings
Authors: Grasso Stephanie , Andrade Flavia , López-Ortega Mariana , Aguila Emma 
Published: December 2021

Abstract
Growth in older populations, and hence in the number of persons living with dementia, is particularly rapid for individuals of Mexican origin living in the U.S. and Mexico. In order to identify influences on cognitive health in this diverse population, the University Texas at Austin and Mexican National Institute of Geriatrics (INGER) organized their second Bridging Conference titled: "Framing Challenges of Cognitive and Mental Health Care in Mexican-origin Older Adults in Mexico and the U.S". In this presentation, we highlight the results of a consensus-building session, during which bi-national expert opinions were generated and synthesized addressing gaps in research, knowledge, and policy, as well as the setting of priorities for immediate action and future research. Reducing barriers to adequate care for those aging-in-place with dementia was a central theme of the identified priorities. Critical areas of identified need, more specifically, included reducing social isolation, caregiver burden, and diminishing retirement income.
Examining the Combined Estimated Effects of Hearing Impairment and Depression on Cognitive Decline and Dementia
Authors: Powell Danielle , Brenowitz Willa , Yaffe Kristine , Lin Frank , Gross Alden , Deal Jennifer 
Published: December 2021

Abstract
Late-life depression is a comorbidity which may co-occur in older adults with hearing loss- each as prevalent and independent modifiable risk factors for dementia. We used data from 1,820 participants (74 ± 2.8 years, 38% Black race) from the Health Aging and Body Composition Study to test if the hearing loss-dementia/cognitive decline (Modified Mini Mental State Exam[3MS] and Digit Symbol Substitution[DSST]) relationship differed in hearing impaired participants who also had depressive symptoms. Depressive symptoms were defined as CES-D 10 ≥10) at one or more visits from years 1-5. Algorithmic incident dementia defined using medication use, hospitalizations and cognitive test scores. Audiometric hearing loss was measured at year 5 and categorized as normal/mild vs ≥moderate loss. In linear mixed models adjusted for demographic and clinical covariates, presence of both hearing loss and depressive symptoms (vs. having neither) was associated with faster rates of decline in 3MS (-0.30, 95% CI:-0.78, -0.19) and DSST (-0.35,95% CI:-0.67, -0.03) over 10 years of follow-up. Both hearing loss and depressive symptoms (vs. neither) was associated with increased risk (hazard ratio (HR):2.91, 95%CI: 1.59, 5.33) of incident dementia in multivariable-adjusted Cox proportional hazards models. Comorbid conditions among hearing impaired older adults should be considered and may aid in dementia prevention and management strategies.