bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Perspectives on Geriatrics-Surgery Co-Management Program by Specialty and Staff Role
Authors: Pandit Sonia , Simone Mark , Michener Alyson , Walke Lisa , Nembhard Ingrid 
Published: December 2021

Abstract
Co-management programs between geriatrics and surgical specialties have gained popularity in the last few years. Little is known about how these programs are perceived across surgical specialties and staff roles. We conducted a mixed methods study to assess perspectives on a geriatrics-surgery co-management program (GSCP) at a hospital where geriatricians co-manage patients 65 or older admitted to Orthopedic Trauma, General Trauma, and Neurosurgery. We used semi-structured interviews (n=13) and online surveys (n=45) to explore program value, facilitators, use, understanding, and impact by specialty and staff roles (physicians, advanced practice providers, nurses, case managers, social workers). Interview transcripts were analyzed using qualitative thematic analysis, and survey data were analyzed using Kruskal-Wallis, ANOVA, and Fisher’s exact tests. Interviews revealed three themes: 1) GSCP is valued because of geriatricians’ expertise in older adults, relationship with patients and families, and skill in addressing social determinants of health; 2) GSCP facilitators include consistent availability of geriatricians, clear communication, and collaboration via shared data-driven goals; and 3) GSCP use varies by surgical specialty and role depending on expertise and patient complexity. Survey data analysis affirmed interview themes and showed significant differences (p-values&lt;0.05) between perspectives of surgical specialties and roles on GSCP use, understanding, impact, and which specialty should manage specific clinical issues. Findings suggest that while there are similarities across surgical specialties and roles regarding the value of, and facilitators for, a GSCP, specialties and roles differ in use, understanding, and perceived program impact on care. These findings suggest strategies for optimizing this intervention across groups.
Referral Processes and Dispositions in a Multidisciplinary Team for Older Adults With Cognitive Vulnerability
Authors: Fortinsky Richard , Annis-Brayne Kristen , Smith Marie , Obuchon Kathleen , Robison Julie , Kuchel George , Ladda Shawn 
Published: December 2021

Abstract
Multidisciplinary team care for community-dwelling older adults with multiple chronic conditions has proven value. Older adults receiving team care experience better outcomes than by solo practitioners alone, and teams are being established as outgrowths of primary care and other clinical settings. Yet little is known about the inner workings of multidisciplinary teams, both in terms of how referral patterns among team members are established and the extent to which older adults and their families accept referrals from team leaders to other clinical disciplines within teams. In this presentation, we provide details about referral patterns and rates of acceptance by study participants in an ongoing clinical trial testing a multidisciplinary team designed to provide care management to older adults (age &gt;65) with cognitive vulnerability due to dementia, depression, and/or delirium (3D Team). Nurse practitioners lead the 3D Team, conduct in-home clinical assessments and make referrals to other team members based on study protocols specifying participants’ eligibility for each 3D Team member. Results are based on the first 209 older adults randomized to the 3D Team. Pharmacist: all 209 members accepted having their medications reviewed and reconciled. Registered Dietician: of 134 referrals, 52 (38.8%) accepted. Occupational Therapist, of 117 referrals, 65 (55.6%) accepted. Physical Therapist: of 109 referrals, 92 (84.4%) accepted. Community Health Educator: of 106 referrals, 101 (95%) accepted. LCSW for depression-related problem solving therapy: of 76 referrals, 55 (72.4%) accepted. Criteria for referrals and interpretations of variations in referral acceptance rates by older adults and their families will be discussed.
Improving Quality and Access to Care in Long-Term Care Settings
Authors: Dudley Nancy , Dudley Nancy 
Published: December 2021

Abstract
Innovative delivery models that assure access to quality care in long-term care settings are needed for the diverse high-risk aging U.S. population. The 2008 National Academy of Medicine report, “Retooling for an Aging America: Building the Health Care Workforce” highlighted the need for changing the roles of health care providers in order to provide high-quality and cost-effective care to older Americans. Moreover, from the providers’ perspective, workplace violence in health care institutions, such as nursing homes, negatively affect the delivery, quality, and accessibility of health care. In this symposium, we identify needs and care provisions in the context of older adults aging in long-term care settings and discuss the implications for policy and health care transformation. This symposium comprises three distinct presentations: (1) identifying and addressing the needs of diverse older adults aging in low-income independent living facilities in community health practice; and based on pilot survey results from nurses in the State of New Hampshire, (2) reframing residents’ violence directed toward providers as self-protection and (3) proposing legislative and policy changes designed to meet the needs of staff and residents of long-term care facilities. These presentations represent efforts across long-term care settings to improve access and quality of care in the context of diverse older adults aging in the U.S.
Inequities in Palliative and Dementia Care and Health in Long-Term Supportive Services Settings
Authors: Brody Abraham 
Published: December 2021

Abstract
Most older adults with serious illness, including Alzheimer’s Disease and Related Dementias (ADRD) reside in community-based settings. These individuals and their care partners rely on Long Term Supportive Services (LTSS) including nursing home, home health, hospice, and adult day centers to provide support. LTSS are often under-resourced and reimbursed however, with significant regulatory restrictions on the care they can provide. These issues combined with other systemic factors in our healthcare system and society, including racism and poverty, lead to substantial inequities. Even preceding the use of LTSS, ADRD is diagnosed later in non-white individuals and access to high-quality services, including palliative care is severely limited. Moreover, few palliative care interventions address ADRD and even fewer have been specifically tailored to address the needs of our multi-cultural, racially and ethnically diverse society. This symposium will therefore utilize data from several nationwide data sets collected as part of routine care for clinical, billing, and/or regulatory purposes to assess inequities that exist across LTSS sites related to ADRD and palliative care. The individual abstracts show a clear pattern of inequities that stem from endemic systems failures towards people of color in the United States that must be addressed through a multipronged approach. This research shows that policies must be changed to require adequate collection of social determinants of health, to target policies that allow sub-standard or limited access to care, and research and clinical reform to produce a more culturally sensitive approach to care for those with ADRD and other serious illnesses.
Associations Between Dementia, Race-Ethnicity, and Intensive and Patient-Centered End-of-Life Care
Authors: Luth Elizabeth , Reich Amanda , Semco Robert , Prigerson Holly , Weissman Joel , Manful Adoma 
Published: December 2021

Abstract
A retrospective cohort analysis of Medicare administrative claims data from 2016-2018 compared intensive and patient-centered end-of-life care measures in persons with and without dementia, including the moderating effects of race/ethnicity. Over half (53%) of 485,209 Medicare decedents had a dementia diagnosis. Decedents with dementia were 31-34% less likely to receive intensive end-of-life care (hospital death 95%CI: 0.64-0.67; hospitalization in last 30 days 95%CI: 0.68-0.70) and 50% more likely to receive timely hospice care (95%CI: 1.48-1.52). The association between dementia and end-of-life care varied by decedent race/ethnicity. Compared to non-Hispanic white decedents without dementia, non-Hispanic Black, Hispanic and Asian decedents with dementia were significantly more likely to receive intensive end-of-life care. Non-Hispanic Black decedents with dementia were 23% more likely to receive timely hospice care (95%CI: 1.11-1.36). Additional research is needed to understand why persons with dementia receive less intensive end-of-life care and why differences exist based on racial/ethnic status.
Inequity in Health Among People Living With Alzheimer's Disease and Related Dementias in Adult Day Centers
Authors: Boafo Jonelle , Yu Gary , Wu Bei , Brody Abraham , Sadarangani Tina 
Published: December 2021

Abstract
In adult day centers (ADCs), 58% of clients identify as racial/ethnic minorities, and at least 30% have Alzheimer’s Disease and related dementias (ADRD). ADCs offer culturally and linguistically congruent care to clients, making them well-positioned to address potential health disparities affecting persons with ADRD. We used data from 53 California ADCs (n=3,053) to identify differences in clinical characteristics among ADC clients’ with ADRD based on demographics such as race and English proficiency. We found that, when compared to their respective counterparts, a significantly greater proportion of racial/ethnic minorities and non-English speakers (p&lt;.001) had 5 or more chronic conditions in addition to ADRD. We noted considerable missing data on race, likely because ADCs in California are not mandated to report data on race/ethnicity. In order to identify inequities in care within this complex population, social determinants of health, including race, must be a standard component of client assessment.
Integrating Study Designs on Emotional Reactivity and Regulation in Old Age: New Evidence From the EMIL Study
Authors: Schilling Oliver , Luong Gloria 
Published: December 2021

Abstract
Key insights into emotional reactivity and regulation have been gained by studying how these dynamics evolve as older people are confronted with controlled stressors in the lab, go about their everyday routines, or develop across adulthood and old age. Yet, we are only beginning to understand how the dynamics on the different time scales observed in these study designs interact . Aiming for a comprehensive picture of the predictors, correlates, and consequences of emotional reactivity and regulation, the EMIL study integrates a lab-based study with ambulatory in-vivo assessments and a classic long-term longitudinal study. 130 young-old (65-69 years) and 59 very-old adults (83-89 years) from the ILSE study, contributing four waves of health, cognitive, and psycho-social data over almost 25 years, were tested in the lab and assessed six times a day over seven consecutive days. We provide an overview of and first across-design results from EMIL: Katzorreck et al. examined whether the frequency of exposure to daily stressors affects emotion regulation capacity as tested in the lab. Lücke et al. analyzed daily working memory performance, sleep, and its association with long-term change in cognitive functioning. Wieck et al. present differential effects of discrete negative emotions as induced in the lab and reported in daily life on social cognitive performance as indicated by empathic accuracy. Gerstorf et al. examined how long-term cognitive aging affects positive feelings and stressor reactivity in daily life. Gloria Luong will discuss the presentations, considering challenges and opportunities of integrating lab-based, ambulatory, and longitudinal study designs.
Linking Emotion Regulation Capacity and the Frequency of Daily Stressors in Old and Very Old Age
Authors: Katzorreck Martin , Gerstorf Denis , Lücke Anna , Wahl Hans-Werner , Schilling Oliver , Kunzmann Ute 
Published: December 2021

Abstract
Lifespan theories and lab-based research both suggest that the ability to downregulate negative emotions is often well preserved into old age, but becomes increasingly fragile in very old age. However, little is known about factors that may alleviate such age differences. Here, we ask whether exposure to daily stressors helps very old adults to maintain effective emotion regulation skills. We used data from 130 young-old (65-69 years, 48% women) and 59 very-old adults (83-89 years, 58% women) who watched negative emotion evoking film clips in the lab under emotion regulation instructions and also reported stress situations they experienced in everyday life (42 occasions across seven days). Initial results indicate that very-old adults were indeed less successful in regulating sadness than young-old adults, but those very-old adults who reported many daily stressful situations were as capable of emotion regulation as young-old adults. We discuss possible factors contributing to our age-differential findings.
Long-Term Cognitive Aging Trajectories as Predictors of Daily Affect
Authors: Gerstorf Denis , Schilling Oliver , Kunzmann Ute , Katzorreck Martin , Lücke Anna , Wahl Hans-Werner , Ram Nilam 
Published: December 2021

Abstract
Multiple-time scale studies provide new opportunities to examine how developmental processes evolving on different cadences are intertwined. Theories about age-related accumulation of stress suggest that long-term progressive loss of cognitive resources should manifest in and shape short-term daily affective experiences. Applying growth modeling and intraindividual variability methods to data obtained from 123 young-old (65-69 years, 51% women) and 47 very-old adults (85-88 years, 49% women) who provided 20+ year longitudinal data on Digit Symbol performance and 42-occasion momentary data about the emotions and stressors they experienced during everyday life (6 reports per day), we found that shallower long-term loss of cognitive performance was associated with less fluctuation in momentary positive affect, as well as less “spikiness” of and reactivity to stress. We discuss and present further results highlighting how mid-term processes surrounding age, gender roles, and health additionally contribute to and shape links between long-term and short-term dynamics of aging.
Sex Differences in Potentially Inappropriate Prescribing Among Older Adults With Multimorbidity
Authors: Ukhanova Maria , Markwardt Sheila , Furuno Jon , Davis Laura , Noble Brie , Quiñones Ana 
Published: December 2021

Abstract
Sex differences in prescribing potentially inappropriate medications (PIMs) for various multimorbidity patterns are not well understood. This study sought to identify sex specific risk of PIMs in older adults with cardiovascular-metabolic patterns. Secondary analysis of the Health and Retirement Study interview data (2004-2014; n=6,341, ≥65 y/o) linked to Medicare claims data was conducted. Four multimorbidity patterns were identified based on the list of 20 chronic conditions and included: ‘cardiovascular-metabolic only’, ‘cardiovascular-metabolic plus other physical conditions’, ‘cardiovascular-metabolic plus mental conditions’, and ‘no cardiovascular-metabolic disease’ patterns. Presence of PIM prescribing was identified using the 2015 American Geriatrics Society Beers Criteria, limited to the list of medications to avoid in older adults. Chi-square tests and logistic regressions were used to identify sex differences in prescribing PIMs across multimorbidity patterns: (1) for PIMs overall and (2) for each PIM drug class. Results indicate that on average women were prescribed PIMs more often than men (39.4% and 32.8%, respectively). Women with cardiovascular-metabolic plus other physical patterns (Adj.OR=1.25, 95% CI: 1.07-1.45) and cardiovascular-metabolic plus mental patterns (Adj.OR=1.25, 95% CI: 1.06-1.48) had higher odds of PIM compared to men, however, there were no sex differences in PIM prescribing in the cardiovascular-metabolic only patterns (Adj.OR=1.13, 95% CI: 0.79-1.62). There was variation by sex across different PIM drug classes. Our study emphasizes the need to further reduce PIM prescribing among older adults, and identifies target populations for potential interventions to improve medication prescribing practices.
Thyme and Oregano Terpenoids Activate Autophagy and Protect Against Hepatic Steatosis
Authors: Civiletto Gabriele , Jacot Guillaume Eric , Sizzano Federico , Muller Kamila , Hermant Aurélie , De Marchi Umberto , Feige Jerome , Gut Philipp 
Published: December 2021

Abstract
Caloric restriction has been shown to reduce chronic illness in aging and increase life expectancy in most living organisms including mammals. Autophagy, a ubiquitous catabolic pathway of cellular quality control, is a key mechanism mediating the benefits of caloric restriction. In addition, mutations in genes involved in autophagy have been associated with the early onset of age-related diseases such as neurodegeneration, highlighting autophagy as a potential therapeutic target. Here, we aimed to discover autophagy inducers from a library of edible molecules for potential use in food applications. To this end, we developed a novel in vivo high-content screening strategy using fluorescent reporter zebrafish that monitor autophagy flux in skeletal muscle. We identify the thyme and oregano constituent thymol as a novel potent autophagy inducer in zebrafish, human cells and mouse tissues. Mechanistically, thymol triggers an hormetic effect on mitochondria in synergism with a calcium-dependent autophagy response which, in turn, leads to mobilization of intracellular lipid stores. We tested the effects of chronic thymol supplementation in mice fed a high-fat diet and showed that thymol mobilizes fatty acids, reduces liver triglycerides and improves markers of liver damage. In sum, we validate the use of zebrafish screening as a discovery model for autophagy-based therapeutics and demonstrate that thymol is an autophagy inducer with potential for the prevention of chronic metabolic diseases and other age-related conditions.
Identification of Latent Sleep Profiles in Middle-Aged Adults and Connections to Well-Being
Authors: Smith Claire , Lee Soomi 
Published: December 2021

Abstract
For middle-aged adults, achieving adequate sleep is a challenge but essential for long-term health. The present study identified latent sleep profiles to clarify how multiple sleep variables (i.e., regularity, satisfaction, alertness, timing, efficiency, and duration) cooccur within middle-aged adults and the implications these holistic sleep experiences have for well-being. Three profiles emerged within the Midlife in the United States II dataset (MIDUS; N=4030, Mage=56.23 years): (i) good sleepers, (ii) nappers/poor night sleepers, and (iii) sufficient but irregular sleepers. Generally, good sleepers reported the best well-being, sufficient/irregular sleepers reported comparatively moderate well-being, and nappers/poor night sleepers reported the worst well-being across a variety of indicators (i.e., chronic health conditions, life satisfaction, positive affect, negative affect, and psychological well-being) after adjusting for sociodemographic characteristics. Age moderated these associations. Our findings advance understanding of sleep health as a multifaceted construct and of its connection to well-being in middle-aged adults.
Characterizing Component Activities of Older Adult Sedentary Time by Age, Gender, and Device-Based Sitting Patterns
Authors: Greenwood-Hickman Mikael Anne , Walker Rod , Bellettiere John , LaCroix Andrea , Rosenberg Dori 
Published: December 2021

Abstract
The activities that compose older adults’ considerable sedentary time are not well characterized. We described daily time spent in self-reported sedentary activities and explored differences by age, gender, and activPAL sitting patterns. Participants self-reported a total of 10.7 hours of sitting time and spent the most time watching TV (2.6 hrs/day), using the computer (1.7 hrs/day), and reading (1.6 hrs/day). Women spent more time watching TV, engaged in hobbies, and socializing and less time on the computer compared to men. Older participants spent more time watching TV, reading, and participating in group activities and less time on the computer than younger participants. Those with low activPAL sitting time and frequent activPAL sitting breaks (low mean bout duration) ~1 hr /day less watching TV than those with high activPAL sitting time. These findings help illuminate future intervention targets and lay the path to explore associations between different sedentary activities and health.
The Impact of FFC-AL-EIT on Resident and Setting Outcomes
Authors: Boltz Marie 
Published: December 2021

Abstract
FFC-AL-EIT was implemented by a Research Nurse Facilitator working with a community champion and stakeholder team for 12 months to increase function and physical activity among residents. FFC-AL-EIT included four steps: (Step I) Environment and Policy Assessments; (Step II) Education; (Step III) Establishing Resident Function Focused Care Service Plans; and (Step IV) Mentoring and Motivating. A total of 85 communities and 794 residents were included. The age of participants was 89.48 (SD=7.43), the majority was female (N=561, 71%) and white (N=771, 97%). Resident measures, obtained at baseline, four and 12 months, included function, physical activity, and performance of function focused care. Setting outcomes, obtained at baseline and 12 months, included environment and policy assessments and service plans. Effectiveness was based on less decline in function (p&lt;.001), more function focused care (p=.012) and better environment (p=.032) and policy (p=.003) support for function focused care in treatment sites.
Diversity of Activities and Loneliness Among Heterosexual and LGBT Older Adults
Authors: Lee Jeongeun , Svec Joseph 
Published: December 2021

Abstract
The extant literature highlights the physiological and psychological benefits of active lifestyles among older adults, though there is a considerable gap in scholarship for sexual minority groups. Utilizing the Social Integration Model, we hypothesize that social activities enhance individual psychological well-being, but those effects differ by one’s social identities. Using a national AARP foundation survey of adults (45+), this study examines whether individuals’ activities predict loneliness and depressive symptoms of heterosexual (n=2905) and LGBTQ adults (n=318). We utilize an index of diverse activities, which includes, social technology use, meeting with friends, and volunteer activities. Multiple linear regression is used to study cross-sectional associations of loneliness and depressive symptoms on the diverse activity index. Results show that a wider array of activities correspond with higher psychological well-being and lower loneliness, and this association is higher for LGBTQ older adults. We discuss implications for counseling and wellness programming for LGBT older adults.