bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining Physical and Social Environments of Korean American Family Caregivers of Persons Living with Dementia
Authors: Lee Kathy , Shuffler Jon , Shin Hye-Won , Grill Joshua , Seo Chang Hyun , Miyawaki Christina 
Published: December 2021

Abstract
Introduction: East Asian Americans are considered a hard-to-reach population in the field. Existing resources are not inclusive of Korean family caregivers, and therefore, a community support system may be required for this ethnic group. Methods: We conducted a telephone-based survey and in-depth interview with Korean family caregivers of persons with dementia (N=36; Mean age: 63.3) to examine their physical and social environments. Results: Most caregivers (58%) co-resided with their care recipients. Those providing care with limited assistance from others showed greater financial hardship (p=0.03) and interference with employment (p=0.03). Job interference was further related to higher levels of caregiving burdens (p=0.01). The services used most were senior center services (25%) and in-home care services (17%), while desired services included health promotion and disease prevention services (50%) and culturally appropriate or medically tailored home-delivered meals services (31%). Caregivers socialized with others using a multi-messaging app (i.e., KakaoTalk) with others. About 74% of them addressed they used KakaoTalk always (52%) or often (22%), and nearly half of them (47%) said they searched for caregiving information online. Findings from our qualitative interviews confirmed positive attitude toward the use of technology. Korean family caregivers showed a lack of knowledge of not only existing community-based resources but also the disease-related information, particularly regarding early-stage support and home safety. Conclusion: It is critical to develop a community education program that reflects their unique physical and social environment conditions, potentially through technologically delivered interventions, for outreach and engagement for Korean family caregivers of persons with dementia.
Family Caregiving and Depression among Older Adults in Japan: A Cross-Sectional Study during the COVID-19 Pandemic
Authors: Noguchi Taiji , Hayashi Takahiro , Kubo Yuta , Tomiyama Naoki , Ochi Akira , Hayashi Hiroyuki 
Published: December 2021

Abstract
COVID-19 infections are particularly lethal in older adults; thus, social activities of older adults and their families in the community have been restricted. The threat of infection, restrictions on social activities, and limitations on the provision of care services for older adults could increase family caregivers’ burden and impact their mental health. This cross-sectional study examined the association between family caregiving and change in depression during the COVID-19 pandemic. In October 2020, we conducted a mailed questionnaire survey on a random sample of functionally independent community-dwelling older adults in a semi-urban area of Japan. Based on the depression status between March and October 2020, participants were classified into four groups: “consistently non-depressed,” “depression onset,” “recovering from depression,” and “remained depressed.” Participants were assessed for providing care for their family members or not. Caregiver participants were also assessed on their caregiving role (primary or secondary), the severity of their care-recipient’s needs, and an increased caregiver burden. Data from 957 older adults were analyzed. The participants’ mean age (SD) was 80.8 (4.8) years, and 53.5% were female. Multivariable multinomial logistic regression analysis revealed that family caregiving was associated with depression onset (OR=3.17 [95%CI=1.57-6.40], p=0.001) and remaining depressed (2.53 [1.36-4.71], p=0.004). Particularly, primary caregivers, those providing care for family members with severer care need-levels, and those with an increased caregiver burden had a higher risk of depression onset and remaining depressed. Family caregivers could have severe mental health conditions during the pandemic. Developing a support system is essential to protect their mental health.
Pivoting during the pandemic: A case study of the Senior Companion Program Plus
Authors: Fields Noelle , Xu Ling , Roark Erin , Sundar Sruthi , Williams Ishan , Gaugler Joseph 
Published: December 2021

Abstract
Introduction: Growing research supports the use of older volunteers to provide respite and community-based assistance to persons with ADRD and their caregivers. This study explores the impact of COVID-19 on a face-to-face, peer-led psychoeducational intervention for African American ADRD family caregivers, the Senior Companion Program Plus (SCP-Plus), and its subsequent need to ‘pivot’ during the pandemic. Method: The SCP-Plus was a randomized control trial across three states that assessed program impact on ADRD family caregiver stress/burden, coping, and social support. In spring 2020, the SCP-Plus intervention was halted because of the potential risk to participants due to COVID-19 (n = 20 enrolled dyads). In an effort to maintain rapport and trust, critical to retention in research studies, team members began weekly (March-April) and then bi-weekly calls (May-December) for the purpose of providing a social check-in and to provide updates on the status of the intervention. Results: A total of 396 calls lasting approximately 10 minutes each were completed. Participants shared concerns around safety, access to food/supplies/masks/testing, feelings of stress and loss, concern for others, and the importance of technology as a means of social connection. Although the intervention aspect of the SCP-Plus ultimately ended due to COVID-19, information gleaned from these check-ins were used to pivot the study. The study moved forward by using a descriptive phenomenological approach to capture dyads’ lived experiences during COVID-19. Discussion: Overall, purposeful participant engagement through weekly/bi-weekly phone calls suggests that this is a promising strategy for participant retention as well as for pivoting research.
The Impact of Social Support on Dementia Caregivers’ Psychological Well-being: Is Online Comparable to Offline?
Authors: Yi Eun-Hye 
Published: December 2021

Abstract
Along with the groundbreaking development of communication technology, caregivers have migrated to online platforms to seek help. Social support theory, including main effect and moderation effect models, has provided a framework to understand the association among caregivers’ stress, support from others, and their well-being. Despite the prevalence of online use for seeking help among caregivers, studies on the use of online social support within the context of caregivers’ stressors and well-being are still underdeveloped. Guided by social support theory, this study aimed to examine the association of online social support (OnSS) and caregivers’ mental health (MH) as compared with offline social support (OffSS). A subsample of caregivers of persons with Alzheimer’s from the Health Information National Trends Survey from 2017-2018 was selected (n=264). For an analysis, ordered logistic regression models with Jackknife estimation methods were applied using Stata 15.1SE. First, OffSS had a positive direct association with caregivers’ MH (Odds Ratio=12.48, p&lt;.05) while OnSS did not. Next, the moderation effect model analysis found that OffSS interacted with caregiving burden while OnSS interacted with life stressors. The MH of caregivers who are in less favorable situations, such as working part-time while caring for a person with Alzheimer’s, living with economic hardship, and having health problems, tended to be significantly affected by OnSS. Identifying the different roles of OnSS and OffSS for caregivers’ MH, the findings of this study call for more attention to developing novel strategies and sensitive approaches to support family caregivers, especially those who fall in underserved groups.
Caregiving Self-efficacy as a Mediator of Negative Emotional States and Potentially Harmful Behaviors
Authors: Hancock David , Czaja Sara , Schulz Richard 
Published: December 2021

Abstract
Potentially harmful behaviors (PHB), such as wanting to scream at or hit a care recipient, are more likely when caregivers experience higher levels of stress. The current study expands on this research and identifies caregiving self-efficacy (SE) for dealing with disruptive behaviors as a mediator of the relationship between caregiver distress and PHB. Multilevel mediation models were tested using a sample of 244 caregivers of persons with dementia assessed three times over a one year period. In two separate models, SE mediated the relationship between caregiving burden/depression and the frequency of wanting to yell or scream at the care recipient in the past six months. Individuals with higher levels of depression and burden had lower levels of SE for dealing with disruptive behaviors. As SE decreased, the risk of potentially harmful behaviors increased. This mediation effect occurred at the within and between subject levels of the model. A significant indirect effect at the within-person level suggests that at timepoints where caregivers experienced more distress, they had lower self-efficacy and increased PHBs. Similar effects were observed at the between person level. These data suggest that both caregiver distress and self-efficacy are important intervention targets for minimizing PHBs.
Cognitive-Behavioral Dementia Caregiving Styles: Associations With Care Stress and Well-Being
Authors: Leggett Amanda , Connell Cathleen , Gitlin Laura , Kales Helen 
Published: December 2021

Abstract
While Stress Process Models of family caregiving have been examined extensively, little focus has been placed on caregiver’s actual management of care. We consider whether caregiving style classified previously through k-modes machine learning models and based on cognitive-behavioral approaches to care impact caregivers’ experiences of care-related stress and well-being. The three previously identified styles include: Adapters- strong dementia understanding and adaptability, encouraging behavioral approach; Managers- poor dementia understanding and adaptability, critical behavioral approach; and Avoiders- moderate dementia understanding and adaptability, passive behavioral approach. Participants included 100 primary family caregivers for PWDs who were on average 64 years old, 74% female, and 18% non-White. Utilizing linear regressions, each caregiving style was considered a key predictor (reference: Adapters) of the Zarit Burden Interview (ZBI), Caregiver Assessment of Function and Upset (CAFU) upset score, Neuropsychiatric Inventory (NPI-C) distress scale, and Positive and Negative Affect scale (PANAS) controlling for dementia severity, care duration, co-residency, and demographics. Relative to Adapters, Managers had more CAFU upset (β=0.4, p&lt;.001), more NPI-C distress (β=0.4, p&lt;.001), and greater burden (ZBI) (β=0.3, p&lt;.001). Avoiders showed significantly greater CAFU upset than Adapters (β=0.2, p&lt;.05). Positive affect was not associated with caregiving style. Caregiving styles associated with less understanding and adaptability and a more critical behavioral approach showed worse caregiving outcomes accounting for dementia severity. Results can inform a nuanced approach to tailoring and targeting interventions based on caregiver styles with the goal of reaching caregivers at risk for poor outcomes and ultimately leading to significant public health impact.
Family Caregivers' Feelings of Preparedness for the Transition to End-Of-Life Caregiving
Authors: Fox Aimee , Sharp Julia , Fruhauf Christine 
Published: December 2021

Abstract
Family caregivers are vulnerable to emotional, psychological, physical, and financial stress during their care receiver’s end-of-life (EOL), and often do not have the knowledge or skills to provide the care needed at EOL. Yet, few studies have examined how prepared caregivers feel for making the transition to EOL care. The purpose of this exploratory study was to investigate how family caregivers perceive their preparedness for the transition to providing EOL care, and factors that may be associated with feelings of preparedness. Family caregivers (N = 252) providing care to an adult family member for more than six months were recruited to complete an online, self-report survey. An exploratory factor analysis was conducted to break down the construct of caregiver preparedness. One-way ANOVAs and a multiple regression were conducted to examine factors associated with preparedness. Most caregivers feel less prepared for the transition to EOL care (M = 2.67, SD = 1.17) than for general caregiving responsibilities (M = 3.42, SD = 0.90). Factors associated with preparedness for EOL caregiving included the familial relationship between the family caregiver and care receiver, hours per week providing care, perceived burden of caregiving, and family conversations completed about advance care planning, legal and financial matters, and EOL wishes. Future studies should explore how to help family caregivers recognize the importance of seeking support from family members and community services and discussing EOL care wishes and plans with aging family members so they can provide effective care and protect their own well-being.
Sleep Quality in Family Caregivers and Matched Non-Caregiving Controls: The REGARDS Study
Authors: Blinka Marcela , Spira Adam , Sheehan Orla , Cidav Tansu , Rhodes J David , Howard Virginia , Roth David 
Published: December 2021

Abstract
The high levels of stress experienced by family caregivers may affect their physical and psychological health, including their sleep quality. However, there are few population-based studies comparing sleep between family caregivers and carefully-matched controls. We evaluated differences in sleep and identified predictors of poorer sleep among the caregivers, in a comparison of 251 incident caregivers and carefully matched non-caregiving controls, recruited from the national REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Incident caregivers and controls were matched on up to seven demographic and health factors (age, sex, race, education level, marital status, self-rated health, and self-reported serious cardiovascular disease history). Sleep characteristics were self-reported and included total sleep time, sleep onset latency, wake after sleep onset, time in bed, and sleep efficiency. Family caregivers reported significantly longer sleep onset latency, before and after adjusting for potential confounders, compared to non-caregiving controls (ps &lt; 0.05). Depressive symptoms in caregivers predicted longer sleep onset latency, greater wake after sleep onset, and lower sleep efficiency. Longer total sleep time in caregivers was predicted by employment status, living with the care recipient, and number of caregiver hours. Employed caregivers and caregivers who did not live with the care recipient had shorter total sleep time and spent less time in bed than non-employed caregivers. Additional research is needed to evaluate whether sleep disturbances contributes to health problems among caregivers.
Frailty and Macronutrients Intake Among Older Brazilian Adults
Authors: Freiria Carolina , Silva Graziele , Hara Larissa , Brito Tábatta , Borim Flávia Arbex Silva , Corona Ligiana 
Published: December 2021

Abstract
The adequate nutrition has an important role in the prevent and treatment of frailty, however, there are only few studies showing the relationship between macronutrients intake and this geriatric syndrome, especially in Latin countries. The aim of this study was to analyze the association between macronutrients intake and frailty among older adults in Brazil. This study included 521 community-dwelling individuals aged 60 years old or older. Frailty was assessed using a self-reported instrument and individuals were categorized in two groups: frail and non-frail (robust + pre frail). Food consumption was evaluated using the 24-hour recall and the software NDSR®. Differences between groups was assessed using the Mann Whitney test. The prevalence of frailty was 42.0%. Older adults considered frails presented lower intake of calories (1510.9 kcal vs 1639.3 kcal; p = 0.016), carbohydrates (196.8 g vs 213.3 g; p = 0.011), proteins (60.7 g vs 68.5 g; p = 0.016) and fiber (15.1 g vs 17.5 g; p= 0.002). They also had lower intake of protein per kilograms of weight (0.88 g/kg vs 0.99 g/kg; p= 0.010). The findings demonstrate high prevalence of frail in our sample, and that intake of most macronutrients was significantly lower among older adults with frail, indicating the importance of the screening of frail as well the evaluation of macronutrients intake among community-based older adults, to prevent malnutrition, sarcopenia and frailty in this population.
Frailty in a Frailty Prevention Program Participants During COVID-19 pandemic: A Cross-Sectional Japanese Study
Authors: Kanamori Takuya , Suzuki Mizue , Naito Tomoyoshi , Inagaki Keigo , Umegaki Hiroyuki 
Published: December 2021

Abstract
Objective: Health conditions of older adults have deteriorated during the COVID-19 pandemic. Few studies have reported on the frailty of this group of people. The study aimed to investigate physical and social frailty in participants in a frailty prevention program during the COVID-19 pandemic. Methods: A cross-sectional survey was conducted in Japan from January 2021. Further, 863 participants of a frailty prevention program completed the survey. The frequency of program attendance in 2020, physical frailty (5-item frailty screening index), social frailty（diagnostic criteria of social frailty in NCGG-SGS), and depression (GDS-5) were assessed. A related factor of physical frailty was analyzed statistically by Welch's t test and the Chi-squared test. Results: The study participants’ mean age, proportion of women, and mean enrollment period in program were 86.8±4.9, 96.3%, 64.3±48.6 months, respectively. The program attendance ratio was 83.4% from January to March, 54.5% from April to June, 79.8% from July to September, and 80.0% from October to December. The prevalence of physical frailty was 20.3% non-frailty, 63.7% pre-frailty, and 15.6% frailty. The prevalence of social frailty was 10.0% non-frailty, 28.6% social pre-frailty, 61.8% social frailty, and the prevalence of depression was 36.8%. Participants with physical frailty were significantly older and showed higher prevalence of social frailty and depression, displaying significantly lower attendance program than non-frailty and pre-frailty older adults (p&lt;0.05). Conclusions: The study results suggest that more than half of the participants of a frailty prevention program have social frailty and a high risk of physical frailty due to COVID-19.
Exercise Modality Affects Older Adult CT-Derived Muscle and Bone Loss During Caloric Restriction
Authors: Weaver Ashley , Madrid Diana , Greene Katelyn , Walkup Michael , Ambrosius Walter , Marsh Anthony , Rejeski W Jack , Beavers Kristen 
Published: December 2021

Abstract
Caloric restriction (CR) can exacerbate muscle and bone loss. We examined 18-month changes in computed tomography (CT)-derived trunk muscle, and volumetric bone mineral density (vBMD) and finite element-estimated bone strength of the spine and hip in 55 older adults randomized to CR alone or CR plus aerobic (CR+AT) or resistance (CR+RT) training. Trunk muscle area loss trended higher with CR+AT [−16.8 cm2 (95% CI: −26.4, −7.1) vs CR: -6.7 (−12.8, −0.5), CR+RT: −9.0 (−14.5, −3.4)]. Spine vBMD loss trended higher with CR+AT [−0.014 g/cm3 (−0.027,−0.001) vs. CR: −0.005 (−0.022,0.012), CR+RT: −0.004 (−0.019,0.011)], and similarly for vertebral bone strength. Hip vBMD losses trended lower with CR+RT [−0.015 g/cm3 (−0.024,−0.006) vs. CR: −0.027 (−0.036,−0.019), CR+AT: −0.029 (−0.037,−0.020)]. Hip vBMD and trunk muscle losses were positively correlated (r=0.53), and spine vBMD loss tended to increase with trunk muscle loss (r=0.21) and fat infiltration (r=0.17). Collectively, aerobic training was less effective at preserving muscle-bone health during CR.
Implementation of 4M Age-Friendly Care in Arkansas Rural Primary Care Clinics Led to Improved Advance Care Planning
Authors: Tobey Leah , McAtee Robin 
Published: December 2021

Abstract
The 4Ms Age-Friendly Framework has been introduced and implemented into nearly 2,000 primary care practices across the United States by Geriatric Workforce Enhancement Program’s (GWEP) educational efforts. The AR Geriatric Education Collaborative, the GWEP in Arkansas, has provided monthly trainings to a rural federally qualified healthcare clinic system and educated clinicians about how to complete a Medicare Annual Wellness Visit (AWV) that was inclusive of an advance care plan. Specific educational training including the two main components of an ACP: living will preferences and medical power of attorney were reviewed as their role into “What Matters” was explained. Before 4Ms Age Friendly training, baseline data showed only 7% of older adults (OAs) had an established ACP in site 1 and 33% in site 2. After training, the rate of ACP rose to 47% in site 1 and 59% in site 2. During the training, not only were the two main components reviewed but case studies were provided about what questions to ask surrounding the “What Matters” question as a guide to further discuss an OAs wishes, priorities and end-of-life care. This project demonstrated that implementation of 4Ms Age-Friendly Care not only improves the completion of advance care plans but also further enhances the overall care of the older adult when “what matters” most to the older adults is known and communicated.
Medical/Pharmacy Students Interprofessional Older Adult Medication Interactions/Contraindications Project
Authors: Gugliucci Marilyn , Thieme Victoria 
Published: December 2021

Abstract
The University of New England College of Osteopathic Medicine (UNECOM) Geriatrics Education Mentors [GEM] program, established in 2014, pairs UNECOM students with older community living adults. GEM assignments focus on health review, medical humanities, and geriatrics training. Each year approximately 90 older adults participate in GEMs. In 2019, the GEM program was expanded with Geriatrics Workforce Enhancement Program (GWEP) grant funding to: include first year medical students, include 2 additional assignments (4 assignments over 10 months to 6 assignments over 18 months), and to create interprofessional student collaboration. In the new GEM Assignment 4: Medication Interactions/Contraindications, UNECOM students with their GEM compiled details on the GEM’s medication list (prescriptions, herbal, OTC); one of 4 Ms of Age Friendly Health Care. UNECOM students (84 pairs) were then assigned to UNE School of Pharmacy (SOP) students (42 SOP students had 2 UNECOM pairs) to conduct a “Lexicomp” (App) medication interactions and Beers Criteria review. UNECOM students documented findings with the SOP student partner; discussed the processes of review with their GEM and the resultant findings; documented the GEM’s questions and how the UNECOM student answered those questions; and discussed next steps for the GEM regarding options for different medications - especially follow up with their prescribing physician(s) for any noted interactions/contraindications. For GEMs with few medications, a mock medication list was assigned to ensure student experiences with medication reviews and GEM discussion. Although time intensive preparation is required, UNECOM & SOP students attained significant learning as did the GEM mentors.