bluuebunny/crossref_metadata_2025_split huggingface dataset:
Loneliness and Behavioral Changes During the COVID-19 Pandemic
Authors: Cudjoe Thomas , Li Qiwei , Drazich Brittany , Hladek Melissa , Samuel Laura , latkin carl , Boyd Cynthia 
Published: December 2021

Abstract
Concerns for the health impact of loneliness, a risk factor for morbidity and mortality, have risen amid the COVID-19 pandemic. However, relationships between loneliness and behavioral changes remains unclear. Utilizing data from the National Health and Aging Trends Study COVID-19 Supplement, we examine the cross-sectional relationship between loneliness and self-reported increase in each of the following behaviors during the pandemic (n=2,924): walking, vigorous activity, eating, use of alcohol and tobacco, watching television and sleeping. Adjusting for age, race, education, activity of daily living limitations, and chronic conditions, loneliness was significantly associated with a higher odds of more eating (odds ratio- OR: 1.42, confidence intervals-CI: 1.24,1.62), sleeping (OR: 1.35, CI: 1.18,1.56), and watching television (OR: 1.45, CI: 1.30,1.61). These results indicate that during stressful times like our current pandemic, loneliness may lead to morbidity and mortality through sedentary behaviors.
Predicting Technology Use Among Older Adults During the COVID-19 Pandemic With Community Participation
Authors: Li Qiwei , Drazich Brittany , Samuel Laura , Cudjoe Thomas , Hladek Melissa , Szanton Sarah 
Published: December 2021

Abstract
Technology use is important for older adults, particularly in the pandemic. The pattern of technology use among older adults varies significantly. We hypothesized that limitations of activities of daily living (ADL), wellbeing, and community participation of community-dwelling older adults before the pandemic would predict technology use during the pandemic. National Health and Aging Trends Study data on 2924 older adults were utilized. Adjusted for age, gender, race, education, marital status, and chronic conditions, previous well-being predicted more online social activities (OR=1.03, p =.03); previous ADL limitations predicted more telehealth use (OR=1.11, p=.014); and previous community participation predicted: learning new technologies (OR=1.46, p &lt;.001), more telecommunication (OR=1.12, p=.007), more online social activity (OR=1.58, p&lt;.001), and more telehealth use (OR=1.09, p= .04). The results of this study imply that high community participation promotes older adults’ transition to technology use. Older adults with low participation may need extra attention for such a transition.
Health and Working Beyond Retirement Age: Exploring Racial and Gender Intersectionality
Authors: Rooks Ronica , Leanage Allison 
Published: December 2021

Abstract
Little longitudinal research exists on health and working among older racial and ethnic minority adults. Following previous cross-sectional research, we examine the Health, Aging, and Body Composition (HABC) study comparing working vs. not working overtime among older adults. We hypothesize: 1) Black vs. White adults are more likely to work; 2) Black vs. White differences in working are greater among women than men; and 3) Working relates to fewer prevalent health problems than not working. We used gender-stratified descriptive statistics and generalized mixed-effects logistic regression with covariate adjustments to analyze the HABC cohort study, with community-dwelling, well-functioning Black (42%) and White older adults aged 70-79 in year 1 (n=3,069) to year 6 (n=2,091). We found support for all three hypotheses. Black vs. White adults were more likely to work overtime. Women were less likely to work overtime compared to men. White women were less likely to keep working compared to men and Black women. Lastly, older adults with fewer chronic conditions were more likely to continue working. Our study finds racial and gender differences among older adults working overtime. Intersectionality plays a role in older adults’ health and work disparities, leading us to explore the needs and/or benefits of working past retirement in specific groups. Our policy implication is for society to pro-actively invest in older adults’ health and productive activities, which may act as social determinants of health solutions to reduce disparities and growing social safety net program costs.
8-Year Changes in Frailty in Adults: Links to Cognitive and Physical Function and Mortality
Authors: Simpson Felicia , Justice Jamie , Bahnson Judy , Evans Joni , Hayden Kathleen , Krtichevsky Stephen , Johnson Karen , Espeland Mark 
Published: December 2021

Abstract
Deficit accumulation frailty indices are being evaluated as clinical markers of biological aging. In this context, it is to be expected that changes over time in such indices should be predictive of downstream changes in cognition, physical function, and mortality. We derived a frailty index (FI) based on deficit accumulation in 38 functional, behavioral, and clinical characteristics and examined associations between 8-year changes in FI and subsequent standardized measures of cognitive and physical function and mortality collected over years 8-18. We drew data from the Look AHEAD clinical trial of a multidomain intensive lifestyle intervention (ILI) in 3841 adults, aged 45-76 years at baseline with overweight/obesity and type 2 diabetes mellitus. Greater FI increases tended to occur among individuals who were older, non-Hispanic White, heavier, and who had greater baseline multimorbidity. Greater increases in FI were associated with subsequently worse levels of composite cognitive function and 400m walk speed (all p&lt;0.001). Additionally, compared with the lowest tertile of FI change, hazard ratios [95% confidence intervals] for 10-year mortality for the middle and highest tertiles of FI change were 1.28 [1.03.1.58] and 1.56 [1.24,1.96], respectively. While assignment to ILI was associated with smaller 8-year increases in FI, this did not translate overall to better cognitive functioning compared to the Diabetes Support and Education control condition across years 8-18. Increase in FI over 8 years predicts subsequent reduced function and greater mortality. However, whether interventions generally targeting FI reduce risks for downstream outcomes remains to be seen.
Frailty and Mortality in a Community-Dwelling Relatively Healthy Older Population
Authors: Ekram A R M Saifuddin , Ryan Joanne , Espinoza Sara , Ernst Michael , Murray Anne , Woods Robyn 
Published: December 2021

Abstract
This study examined factors associated with frailty and studied the association between frailty status and mortality in healthy community-dwelling older persons. Participants included 19,114 individuals from the “ASPirin in Reducing Events in the Elderly” (ASPREE) trial. Frailty was defined using modified Fried phenotype comprising exhaustion, body mass index, grip strength, gait speed and physical activity. A deficit accumulation frailty index (FI) using 66 items was also developed. Correlates of frailty were examined using multinomial logistic regression. The association between frailty status at baseline and mortality was analyzed using Cox regression. At baseline, 39.0% (95% CI: 38.3, 39.7) of participants were prefrail, and 2.2% (95% CI: 2.0, 2.4) were frail according to Fried phenotype, while 40.6% (95% CI: 40.0, 41.3) of participants were pre-frail and 8.1% (95% CI: 7.7, 8.5) were frail according to FI. Older age, female sex, lower education, African-American and Hispanic ethno-racial status, smoking, alcohol use, comorbidities, and polypharmacy were associated with frailty status. Pre-frailty increased risk of all-cause mortality significantly (Fried HR: 1.48; 95% CI: 1.28, 1.71; FI HR: 1.54; 95% CI: 1.31, 1.81); and the risk was even higher for frailty (Fried HR: 2.24; 95% CI: 1.67, 3.00; FI HR: 2.34; 95% CI: 1.83, 2.99) after adjustment for covariates. Cardiovascular disease (CVD) and non-CVD-related mortality showed similar trends. These results highlight a considerable burden of pre-frailty among a large group of community-dwelling, initially healthy older adults. Both Fried phenotype and deficit accumulation FI similarly predicted all-cause, CVD and non-CVD-related mortality in relatively healthy older adults.
Impact of Physical and Social Frailty on the Utilization of Nursing Care Services in Very Old Adults
Authors: Zimmermann Jaroslava 
Published: December 2021

Abstract
Frailty, characterized by increased vulnerability to external stressors, has been found to increase the risk of healthcare utilization and nursing home admission. As the age group of 80 years or older remains frequently underrepresented in previous research, this study examined the impact of physical and social frailty on the utilization of nursing care services in very old population of North Rhine-Westphalia. Using data from a representative cross-sectional study, 1,577 community-dwelling and institutionalized individuals aged ≥80 years were included. Physical frailty was defined according to Fried’s criteria (exhaustion, weight loss, low handgrip strength, low physical activity). Social frailty was measured with self-reported loneliness, social isolation, and time spent with others. The use of outpatient care services, day care, informal and inpatient care were considered. Multinomial regression was applied to investigate the impact of physical and social frailty on the use of outpatient and inpatient care services, controlling for relevant sociodemographic and health related characteristics. Compared to very old adults who did not use any care services, no association was found between frailty and the use of outpatient or informal care. Comparing nonusers of care services with institutionalized individuals, nursing home residents were less likely to experience physical frailty and pre-frailty, but were more likely to be socially isolated and to feel lonely. These findings suggest that physical frailty might have been successfully prevented in the context of institutional inpatient care. However, early identification and intervention focused on social inclusion of the institutionalized very old individuals are needed to reverse social frailty.
From Day to Day to Year to Year: Developmental Antecedents and Outcomes of Changes in Emotion
Authors: Hamm Jeremy , Barlow Meaghan 
Published: December 2021

Abstract
Research shows that emotions play an important role in successful aging. However, less is known about how day-to-day fluctuations and multi-year changes in positive and negative emotions are implicated in adaptive development. Thus, the present studies address the developmental antecedents and outcomes of micro- and macro-longitudinal changes in different positive and negative emotions. Blöchl, Oertzen, and Kunzmann use 12-year data from the Health and Retirement Study to examine whether socioeconomic resources influence trajectories of positive emotion and physical functioning and their interrelations. Hamm, Wrosch, Barlow, and Kunzmann investigate psychosocial and health-related resources that predict two-year stability and change in adaptive and maladaptive daily patterns of calmness, excitement, sadness, and anger. Pauly et al. examine the extent to which health status moderates the association between daily fluctuations in seven affective states and corresponding changes in stress-related cortisol secretion. Turner, Mogle, Hill, Bhargava, and Rabin study how positive and negative emotions experienced in response to daily challenges (memory lapses) mediate the association between age-related challenges and life satisfaction in a coordinated analysis of two datasets. Finally, Barlow addresses the extent to which variations in daily experiences of positive and negative emotions exhibit age-differential associations with daily satisfaction with life (i.e., emotion globalizing). This symposium thus integrates new research on emotional aging and contributes to a deeper understanding of how adaptive development shapes and is shaped by day-to-day fluctuations and long-term changes in different emotions.
Linking Older Adults’ Daily Activities With Well-Being and Cognition: Examining Moderators and Mediators
Authors: Roecke Christina , Luo Minxia , Hess Thomas M 
Published: December 2021

Abstract
Increasingly more studies are showing that daily activities can be beneficial to wellbeing and cognitive abilities of older adults, but discussions about through which psychological mechanisms daily activities are associated with wellbeing and cognitive health have been scarce. This symposium, including three ambulatory assessment studies and one cross-sectional study, presents emerging theoretical hypotheses and recent empirical findings on this matter. Specifically, with 5-6 days of observations from 313 older adults, Brown and colleagues show that greater daily activity diversity is related to older adults’ higher overall cognitive functioning (executive functioning, memory, and crystallized intelligence). Hueluer and colleagues examine the moderating role of interaction modality on the relation of daily social interactions with wellbeing using data from 116 older adults over 21 days. Their results show that more face-to-face interactions — but not telephone or digital interactions — are associated with higher positive affect and lower loneliness. With data from 153 older adults over 15 days, Luo and colleagues show the mediating effect of positive affect in the association between momentary working memory performance and subsequent social activity engagement. Sharifian and colleagues show the mediating effects of solitary-cognitive activities in the association between depressive symptoms and global cognition, using cross-sectional data from 453 older adults, and also examine the moderating role of race. Finally, Tom Hess will serve as a discussant and provide an integrative discussion of the papers, informed by his extensive work on daily activities, motivation, and aging.
Understanding the Role and Value of Process Quality Indicators in Hospitalized Older Surgical Patients
Authors: Thillainadesan Janani , Hilmer Sarah , Mudge Alison , Aitken Sarah , Naganathan Vasi 
Published: December 2021

Abstract
Background Despite the development of geriatrics surgery process quality indicators (QIs), few studies have reported on these QIs in routine surgical practice. Even less is known about the links between these QIs and clinical outcomes, and patient characteristics. We aimed to measure geriatrics surgery process QIs, and investigate the association between process QIs and outcomes, and QIs and patient characteristics, in hospitalized older vascular surgery patients. Methods This was a prospective cohort study of 150 consecutive patients aged ≥ 65 years admitted to a tertiary vascular surgery unit. Occurrence of geriatrics surgery process QIs as part of routine vascular surgery care was measured. Associations between QIs and high-risk patient characteristics, and QIs and clinical outcomes were assessed using clustered heatmaps. Results QI occurrence rate varied substantially from 2% to 93%. Some QIs, such as cognition and delirium screening, documented treatment preferences, and geriatrician consultation were infrequent and clustered with high-risk patients. There were two major process-outcome clusters: (a) multidisciplinary consultations, communication and screening-based process QIs with multiple adverse outcomes, and (b) documentation and prescribing-related QIs with fewer adverse outcomes. Conclusions Clustering patterns of process QIs with clinical outcomes are complex, and there is a differential occurrence of QIs within older vascular surgery patients, suggesting process QIs alone may be unreliable targets for quality improvement. Prospective intervention studies are needed to understand the causal pathways between process QIs and outcomes to help prioritize care processes that are most clearly linked to improved outcomes.
The Corporeality of Late Age
Authors: Gilleard Chris 
Published: December 2021

Abstract
In a study of over a thousand Germans, Paul Baltes and his colleagues observed that most respondents saw age 80-84 as the preferred age to reach before dying. Living beyond 85 was only desired by a minority. Perhaps this is because this age seems to many the point when bodily disease and physical weakness render life not just unpleasant but actively burdensome. Such views underpin the social imaginary of an undesirable fourth age. This paper discusses the significance of corporeality as both representation and lived experience, raising the question of whether the disparity between real and imagined corporealities resides as much from an ‘other’ within as without.
A Multi-Method Examination of Ageism in Children Before and During the Pandemic
Authors: Bellingtier Jennifer , Jaquet (née Bauer) Jenny , Schenker Lena-Emilia 
Published: December 2021

Abstract
The pandemic has made age more salient. Access to vaccines, mandates to wear masks, and recommendations for contact restrictions have all varied by age. Developmental intergroup theory proposes that greater salience of a feature can lead to greater stereotyping and prejudice. We investigated this with a multi-method assessment of ageism in children (N = 57, ages 4-8), where data collection occurred both before and during the pandemic. In simulated behavioral measures, children preferred to sit closer to younger adults (mean distance = 1.8 seats) versus older adults (mean distance = 2.8 seats), and, for a simulated treasure hunt, they chose 3.36 younger, versus 1.63 older, teammates. Explicit (picture ratings) and implicit (IAT) ratings also significantly favored younger adults. These preferences were not exacerbated by the pandemic. Although ageism is present at young ages, we found no evidence that this has thus far worsened in the pandemic.
Are Stakeholder Prioritized Post-Acute Care Practices Documented and Do They Improve Outcomes?
Authors: Leland Natalie , Rouch Stephanie , Skidmore Elizabeth 
Published: December 2021

Abstract
The receipt and intensity of rehabilitation services, such as occupational and physical therapy, have been associated with lower risk of readmissions. Yet, little is known about the care. This study quantified the frequency of documented post-acute care (PAC) stakeholder-prioritized practices and their associations with hospital readmissions. A PAC stakeholder advisory board (e.g., physicians, rehabilitation providers across settings) prioritized key practices to evaluate. Medicare claims and electronic medical records were used to construct an episode of care for patients age 65 or older. Eligible patients were discharged from one of nine acute hospitals to a PAC setting (i.e., inpatient rehabilitation, skilled nursing, home health) within one large health system between August 2016 and August 2018. Descriptive statistics characterized the cohort and frequency of documented practices. Logistic regression examined associations among the practices and readmissions, by setting. Stakeholders prioritized (a) education, (b) cognition assessment and treatment, and (c) medication management. Among these PAC patients (n=3,227) there was variation in documentation for each practice by setting. Documentation of medication management at any point during the stay ranged from less than 1% to 54% of patient stays among settings. There was a significant relationship between the practices and readmissions. Within inpatient rehabilitation, every additional day patient and caregiver education was documented by occupational therapy was associated with 21% lower odds of readmission (p&lt;0.05). This study highlights the variability in documentation of stakeholder-prioritized practices across PAC and their associations with readmissions. Future work is needed to enhance the systematic delivery and documentation of these practices.
Assessing Frontline Personnel’s Recognition of and Response to Cases of Abuse in Later Life
Authors: Marrs Sarah , O'Hara Courtney , Young Ruth Anne , Yelvington Miranda , Patterson Deijah , Rhodes Annie , Ansello Edward 
Published: December 2021

Abstract
Abuse in later life is experienced by 10% of adults over age 60 (Acierno et al., 2010). Unfortunately, it is estimated that for every one reported case, around 20 remain unreported (APA, 2012). A primary reason for this disparity is the absence of training provided to professionals working at the frontline of elder abuse, such as law enforcement professionals, health care professionals, and aging and victim service providers (e.g., Rose et al., 2016). This leaves the workforce best positioned to intervene in cases of abuse in later life lacking knowledge around what constitutes the different types of abuse and what they should do if they suspect abuse (Rosen et al., 2018). A critical first step to developing the evidence-based training needed to reconcile this gap is to gain a better understanding of the current landscape within this workforce. This qualitative study explored the knowledge and attitudes towards abuse in later life as well as current practices and policies for reporting abuse among law enforcement professionals (n = 1), health care professionals (n = 2), and aging (n = 5) and victim (n = 4) service providers. Participants (N = 12) represented urban (n = 4), suburban (n = 5), and rural settings (n = 2). Themes emerging from the focus groups highlight a number of barriers to identifying and reporting abuse for professionals in each discipline. Our findings also provide strong evidence of the need to intervene and diminish the impact ageist attitudes and behaviors can have on older adults.
Neighborhood Deprivation and Incident Alzheimer's Disease: A Regional Cohort Study of Electronic Medical Records
Authors: Dalton Jarrod , Pfoh Elizabeth , Berg Kristen , Gunzler Douglas , Mourany Lyla , Krieger Nikolas , Kahana Eva , Perzynski Adam 
Published: December 2021

Abstract
The prevalence of Alzheimer’s disease (AD) is anticipated to increase drastically. Neighborhood socioeconomic position (SEP) has been related to multiple processes of health. Understanding whether SEP is related to AD can inform who is at greatest risk of developing this disease. We analyzed electronic medical records of 394892 patients from the two largest health systems in Northeast Ohio to evaluate the relationship between Ohio Area Deprivation Index quintiles (defined at the census tract level) and hazard for a composite outcome of AD diagnosis or primary AD death. We included residents of Cuyahoga and neighboring counties, and used the first outpatient visit beyond age 60 occurring between 2005 and 2015 as study baseline. Outcome data were censored at the earlier of a) the beginning of any 3-year time period without visits or b) non-AD death. We estimated a Cox proportional hazards regression model, adjusting ADI quintile effects for the interaction between age at baseline, sex and race as well as birth year. We used quadratic terms for continuous predictors. After adjusting for these factors, ADI quintile was significantly related (χ2 = 83.0 on 4 d.f.; p &lt; 0.0001) to the composite time-to-event outcome. Compared to the lowest-deprivation quintile, ADI quintiles 4 (adjusted hazard ratio [95% confidence interval]: 1.18 [1.10, 1.26]) and 5 (1.37 [1.28, 1.47]) had significantly higher hazard for the composite outcome. In conclusion, neighborhood deprivation may be a risk factor for AD independent of demographic factors. Preventive efforts should target individuals living in neighborhoods with high levels of deprivation.