bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multifaceted sleep health score is associated with frailty in a national sample of older adults in Taiwan: Sex matters
Authors: Chen Tuo Yu , Lee Soomi , Buxton Orfeu 
Published: December 2021

Abstract
Although individual sleep characteristics are related to frailty, these characteristics do not occur separately. A multidimensional measure of sleep might provide a better estimation of frailty compared to isolated sleep characteristics. This study investigated the association of a multidimensional measure of sleep health with frailty and examined whether such relationship differed by sex. Data were from the Taiwan Longitudinal Study on Aging (2011), a survey with a nationally representative sample of Taiwanese older adults (N=2,015). Frailty was defined using the Fried-criteria. Self-reported sleep during the past month was used to conceptualize the five sleep health dimensions in the SATED model (satisfaction-alertness-timing-efficiency-duration; higher scores representing better sleep health). Their relationship was estimated using logistic regression analysis adjusting for sociodemographic (age, sex, education), health (chronic conditions, cognitive function, pain, depressive symptoms [excluding items overlapping with frailty and sleep]), and lifestyle (drinking, smoking, exercise) characteristics. The results showed that having a better sleep health composite score was significantly related to lower odds of being frail in both sexes adjusting for sociodemographic information. Such effect remained significant among females but not males after adding health and lifestyle characteristics to the models. Sleep satisfaction and daytime alertness in both sexes and sleep duration among females were significantly associated with frailty adjusting for sociodemographic information. Only alertness among males was significantly related to frailty in model with all covariates. Our findings show that having a better sleep health across multiple dimensions is related to a lower risk of being frail, and the association differs by sex.
Nutrition Program Improves Health-Related Outcomes of Non-Diabetic Elderly at Nutritional Risk
Authors: Brunton Cory , Venegas-Sanabria Luis Carlos , Gomez Gabriel , Misas Juan Diego , Sulo Suela 
Published: December 2021

Abstract
Malnutrition or its risk affects up to 1 in 3 older adults receiving outpatient care post a hospitalization or for chronic disease management. Although malnutrition poses a negative burden on someone’s recovery and health preservation, it can be effectively addressed through cost-effective nutrition interventions delivered as comprehensive quality improvement programs (QIPs) aiding to advance healthcare professional’s nutrition education/training and improve quality of care for at-risk/malnourished individuals. Although evidence from US and Europe demonstrates nutrition-focused QIPs are effective in delivering high-quality nutrition care and improve health outcomes of outpatients at-risk/malnourished, to date, no evidence has been reported from Latin American countries. We assessed effectiveness of a comprehensive, nutrition-focused QIP in a Colombian outpatient clinic. Between 09/2019-03/2020, 504 (of total 618) QIP participants were classified at-risk/malnourished and non-diabetics. Participants were followed for 90-days either in-person or via telehealth mechanisms (during COVID-19-imposed lockdown period). QIP interventions included healthcare professional nutrition education; QIP participant continuous nutrition and exercise counselling and 60-day supply of oral nutrition supplement (Ensure®, Abbott). QIP participants were 69% female, with &gt;2 comorbidities, and mean age of 73. Improvement or maintenance of good mental health/well-being, frailty status, cognition and quality of life was reported for 90.7% (456/503), 87.3% (407/466), 86.7% (405/467) and 47% (237/504) participants, respectively (p-values&lt;0.05). Results support QIP effectiveness in driving improved health-related outcomes for non-diabetic, at-nutritional-risk participants. These findings highlight the importance of nutrition-focused QIPs with ONS for older adults during their recovery phase post a recent hospitalization and/or for chronic disease management.
Perceived Everyday Discrimination and C- Reactive Protein Influence on Cognition of Older Black Adults
Authors: Kirven Sydney , Farmer Heather , Thierry Amy 
Published: December 2021

Abstract
Black adults and women are more likely to experience serious cognitive decline in older age than their white and male counterparts. Evidence suggests perceived discrimination is associated with poor cognition in older adults, though the mechanisms remain unclear. Perceived discrimination has been linked to elevated inflammatory markers, such as C-reactive protein (CRP), which increases risk for worse cognitive functioning. Yet, little research has investigated whether CRP is implicated in the association between discrimination and cognition among Black older adults or if this relationship differs by gender. Using 2006-2016 data from Black adults ≥65 years old(N=1343) in the nationally representative Health and Retirement Study, random effects linear regression models (1) tested the association between discrimination and cognitive functioning; (2) explored whether this relationship differed for women and men; and (3) assessed whether elevated CRP mediated the association between discrimination and cognitive functioning. More frequent discrimination was associated with worse cognitive functioning (b= -0.24, SE=0.11, p&lt;0.05), though gender did not moderate this relationship. Elevated CRP was significantly associated with worse cognitive functioning (b= 0.40, SE=0.18, p&lt;0.05). Discrimination remained statistically significant in this model, indicating no mediation by CRP. Of note, inclusion of depressive symptoms and cardiometabolic conditions accounted for the association between both discrimination and CRP with cognitive functioning. These findings demonstrate the need for more within-group research on older Black adults documenting the complex relationship between discrimination, inflammation, and cognitive health. This approach will provide greater understanding of the biopsychosocial mechanisms underlying disparities in cognitive functioning in Black adults.
The Effects of Mid-life Stress Exposure on Black-White Differences in Cognitive Decline
Authors: Mitchell Uchechi 
Published: December 2021

Abstract
Cognitive decline is a precursor to cognitive impairment and dementia. Recent research suggests that cognitive decline may begin earlier in the life course for Blacks and that Black-white disparities in cognitive function emerge in midlife. Disproportionate exposure to chronic and acute stressors during mid-life may explain Black-white differences in trajectories of cognitive function over time. In this study we use data from approximately 3,700 Black and white respondents age 51-64 from the Health and Retirement Study to examine race differences in cognitive decline and the role mid-life stress exposure play in these differences. Initial findings suggest that mid-life Blacks have lower levels of cognitive function, but their rates of cognitive decline do not differ significantly from mid-life whites. Financial strain and everyday experiences of discrimination are inversely associated with cognitive decline and only partially explain differences in cognitive decline between mid-life Blacks and whites.
Perceptions of Partner Cognitive Ability During the COVID-19 Pandemic
Authors: Reese-Melancon Celinda , Margrett Jennifer , Russell Dan , Turner Rachael , Harrington Erin , Stratton Lauren , Savla Jyoti 
Published: December 2021

Abstract
Media reports provide anecdotal evidence of increased forgetfulness during the COVID-19 pandemic (Cushing, 2021; Purtill, 2020). Scientific evidence suggests social isolation can impact on cognition (Evans et al., 2018), but the question remains whether those living with a partner experience similar deficits. The present study examined whether middle-aged and older adults’ perceptions of their own and their partner’s memory abilities were related to self-reported impact of the pandemic on daily life (e.g., limited social interactions, delayed health care, and disruption to routine). In a sample of 80 married individuals (49% female; age range 40-86 years), we found that participants’ beliefs about the impact of the pandemic on daily life and their depression ratings significantly predicted (p&lt;0.05) their perceptions of their partner’s prospective memory abilities. Specifically, pandemic impact on daily life predicted 9.3% of the variance in participants’ reported perceptions of their partners’ prospective memory abilities, and participant depression ratings predicted an additional 5.1% of the variance. Surprisingly, these variables did not predict perceptions of participants’ own cognition or perceptions of partners’ retrospective memory abilities. In sum, people who reported greater impact of the pandemic on their lives were more likely to believe that their partner frequently forgot to carryout prospective memory intentions (e.g., failed to pass along a message or take medication), and depression further clouded their perception of their partner’s cognition. These findings should be extended to consider relationship quality and whether individuals consider their partners a reliable source of external memory support during times of life disruption.
Problem-Drinking Across the Lifespan: Cross-Sectional Versus Longitudinal Effects Among Midlife and Older Adults
Authors: Kady Annabel , Li Yimei , DiBello Angelo , Lee Matthew 
Published: December 2021

Abstract
When considering problem drinking from a lifespan-developmental perspective, an often-stated premise is that problem drinking escalates during adolescence, peaks around early young adulthood, and then declines throughout the remainder of the lifespan. However, while there is a strong empirical basis for such changes throughout adolescence and young adulthood, the notion of continued declines throughout midlife and older adulthood is less firmly established and based primarily on cross-sectional data. Thus, this study contrasted cross-sectional versus longitudinal age effects on problem-drinking changes across the lifespan, with particular focus on midlife and older adulthood. Analyses used data from a large, two-wave, U.S.-representative sample. We generated descriptive “porcupine figures” graphically depicting both cross-sectional and longitudinal age effects simultaneously, and we estimated mixed-ANOVAs to partition, test, and contrast cross-sectional versus longitudinal age effects. As expected, analyses confirmed the well-known rise and fall of problem drinking across young adulthood in both cross-sectional and longitudinal age effects. In contrast, in midlife and older adulthood, only cross-sectional age effects were consistent with the notion of continued age-related declines throughout these ages, whereas the longitudinal data showed a mixture of stability and escalation at these ages. Age-confounded cohort effects are one plausible explanation for how cross-sectional data can lead to spurious conclusions about developmental change. By potentially yielding a more accurate understanding of lifespan-developmental change in midlife and older adulthood, findings like ours could help guide lifespan-developmentally-informed interventions for midlife and older-adult problem drinkers; an objective of increasing importance in light of the ongoing aging of the U.S. population.
Residential Care in California: Spatial and Temporal Trends in Facility Development and Care Capacity
Authors: Frochen Stephen , Ailshire Jennifer , Rodnyansky Seva , Sheehan Connor 
Published: December 2021

Abstract
The U.S. is aging, and the older adult population and number of long-term care services are growing but not at corresponding rates and concentrations depending on location. Insufficient research has analyzed residential care at the neighborhood or city level of analysis, where geographical trends in growth often reveal notable patterns of long-term care unobserved at county and state levels of analyses. We merged the California Department of Social Services Residential Care for the Elderly Dataset with census place and tract data to chart the growth of facilities and beds per older adults in all of California and its three largest cities, including 805 facilities licensed from 1996 to 2015. During the study timeframe, residential care steadily increased in California by the number of facilities and beds relative to older adults. However, due to a consistently increasing older adult population, the Cities of San Diego and San Jose experienced gradual and intermittent decline in capacity per older adults, respectively, even as they added many beds to their inventories from the sporadic development of large assisted living and continuing care retirement communities. Additionally, San Jose and Los Angeles exhibited the most overlap in mapping densities of facility development and oldest old adults, with San Diego showing less intersection in cartographic analysis. Understanding facility development and care capacity trends can help local agencies and jurisdictions in the U.S. and other countries discern whether planning policies and other geographical and development factors appropriately encourage the development of residential care and other long-term care facilities.
Systems aging clock: A novel epigenetic aging clock modeled from organ & bodily function based mortality indices
Authors: Sehgal Raghav , Levine Morgan 
Published: December 2021

Abstract
A diverse array of aging clocks, derived from a variety of omics data and clinical biomarkers, have been developed to describe aging and predict age-related disease. As such, these biomarkers are particularly applicable for use in observational studies, basic science and clinical trials focused on tackling biological aging. However, ongoing research suggests significant heterogeneity in aging, with deterioration and disease occurring in different organ systems or functional domains at various rates across individuals. Existing aging clocks only measure heterogeneity in the degree of aging, not in the manner of aging (e.g. different organ systems or functional domains). We hypothesize these unique trajectories exist and that they can be captured using a systems based approach. In our work, using clinical chemistry biomarkers from participants in the Health and Retirement Study (HRS), Framingham Heart study (FHS) and Women’s Health Initiative (WHI) , we modeled unique epigenetic aging trajectories from distinct groups of biological processes (such as Immune function, metabolic function, hepatic function, cardiac function, renal function and more). Interestingly, these biological system specific scores when combined gave an aging clock with superior mortality prediction than any published aging clock. We further validate the system aging scores and aging clock in different clinical studies to show the added advantage of such a measure, such as the fact that people with similar epigenetic age may have very different system scores. Overall, this method introduces the potential for quantitative and multi-dimensional, personalized aging scores that are indicative of an individual’s disease and disorder risk.
The Challenge of Identifying Representative Samples in Research Involving Minority Participants
Authors: Pilonieta Giovanna , Geldmacher David 
Published: December 2021

Abstract
Determining participants' demographics, cognition, and functional performance by race is crucial to understanding disparities in clinical research on Alzheimer’s disease. We compared demographic and performance variables between Black/African American (B/AA; N=30; 41%) and White participants (N=43, 59%) in the UAB Alzheimer's Disease Center. Among 73 participants, 38 (52%) were women, mean age was 65.7 (SD 9.47), and mean education was 16 (2.31) years. Significant differences in gender proportions across race groups were observed. B/AA women represented 70 % of their race group, white women represented 39.5 %. There were no statistically significant differences in age, education, cognitive or functional severity, reasons to participate in research, referral source, objective measures of cognition, or informant-rated daily function by race group. In conclusion, despite 50% oversampling of B/AA participants compared to the State population, no differences in cognitive and functional performance at the time of enrollment were associated with race.
Using Team-Based Learning in an Online Synchronous Gerontology Course
Authors: Janssen Leah 
Published: December 2021

Abstract
Team-based learning (TBL) was chosen for its learner-centered approach to intentional engagement and purposeful application of course material in a cross-listed, upper-level gerontology class (i.e., Social Forces in Aging). Intedashboard, an online TBL platform, was utilized to support the online synchronous course, which is especially useful for its integration of class material, module assessments, peer/course evaluations, and dashboard display of live team activity. From the perspective of an emerging scholar, this symposia session will explore the application of TBL as a tool for developing teams, helping students personally connect with course material, and support inclusive teaching initiatives. More specifically, this presentation examines how a scaffolded TBL exercise on cumulative advantage/disadvantage, intersectionality, and social identities led to increased identification and awareness of students’ social location, and the perceived impacts on their later lives.
Innovation in Times of Uncertainty: Clinical Trials in Nursing Homes During SARs-CoV-2
Authors: Carpenter Joan 
Published: December 2021

Abstract
In March 2020 the Centers for Medicare & Medicaid Services (CMS) announced restrictions on visitors and nonessential personnel in nursing homes to protect residents and facilities from SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) outbreaks. At the time, these measures were “temporary” but they continued well into 2021 resulting in a prolonged pause on in-person study activities in a palliative care clinical trial in 12 nursing homes. This session will address the impact of this pause and decisions made to overcome the potential failure of the trial. Of utmost importance was respecting nursing homes rapidly changing context, continued communication with the site leadership, transitioning to phone and video-conference study activities, and designing a retrospective study using existing data to answer a different but similar research question. As clinical researchers move forward implementing trials and complex interventions in nursing homes, we must use the lessons learned to design flexible trial protocols.
Timing and Support Matter: Caregiving Demands at the Intersection of Stress Process and Life Course Perspectives
Authors: Lee Yeonjung , Bierman Alex , Penning Margaret 
Published: December 2021

Abstract
Extensive research documents the outcomes of family caregiving. However, perspectives differ, with some suggesting that caregiving provides psychological rewards and others suggesting that the stress of caregiving carries psychological costs. We argue that both of these perspectives are correct, but their applicability will differ based on the timing of caregiving and the availability of social support. A life course perspective suggests that the timing of a stressor in the life course will create variations in its mental health impacts, whereas a stress process perspective suggests that the consequences of a given stressor for mental health will vary based on the availability of social support. A synthesis of these two perspectives then suggests that social support will act as stress buffer differently depending on the age of caregiver. To examine these questions, we use a subsample of respondents who reported caregiving (N=20,441) in the 1st wave of the Canadian Longitudinal Study on Aging. Analyses provide evidence of different outcomes of caregiving, according to both the timing of caregiving and the availability of support. In particular, a high level of caregiving demands are associated with greater depression and lower life satisfaction. Social support inhibits both associations, and the association between high demands and life satisfaction is stronger in older caregivers. Social support does not buffer high caregiving demands more strongly at older ages, though, showing two distinct process. Demanding caregiving appears particularly detrimental for psychological well-being as people age, and the efficacy of social support resources do not increase to compensate.
Curricular Approach to IPE: Preparing Health Professions Students to Deliver Team-Based Care
Authors: Barnes Stacy , Horton Kelly 
Published: December 2021

Abstract
Interprofessional education (IPE) is essential to prepare students for future healthcare careers and to meet accreditation requirements for health profession schools. After surveying successful IPE programs across the country, Marquette University developed a curricular approach. Over 1,500 students from 10 health professions (Athletic Training, Medical Laboratory Science, Counseling Psychology, Dentistry, Medicine, Nursing, Occupational Therapy, Physical Therapy, Physician Assistant Studies, Speech-Language Pathology) currently participate in a series of four interactive, half-day courses which are aligned with the Interprofessional Education Collaborative (IPEC) core competencies. Courses were moved online in response to the pandemic and are currently delivered using Microsoft Teams. Feedback from learners and faculty is gathered using post-event surveys and has been overwhelmingly positive. Learner outcomes are measured using the Interprofessional Collaborative Competencies Attainment Survey. Overall, this approach has proven to be an effective and efficient model for delivering IPE to large numbers of students.
Adapting A Project-Based Aging Laboratory During a Pandemic
Authors: Andersen Troy , Edelman Linda 
Published: December 2021

Abstract
Aging Well in Utah is a competitive 2-semester project-based Honor’s College Praxis Laboratory for 9 students from different degree programs dedicated to deepening understanding of the aging process through a broad gerontological lens. This session will address how the course was adapted during the COVID-19 pandemic, including: 1) scheduling virtual class times with guest lecturers; 2) conducting older adult interviews via Zoom to provide students experience in communicating “what matters most”, one of the 4Ms of Age Friendly HealthCare; 3) adapting a student-designed medical narrative project highlighting stories of transition and healing through the dying process for previously unsheltered residents of a hospice program to focus on the lived experience of hospice patients during COVID-19; and 4) utilizing virtual technology to interview hospice patients, family members and hospice staff. In spite of challenges, student evaluations were above average and reported increased interest in incorporating age-friendly concepts into future careers.