bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intergenerational Exchanges In Aging South Asian Muslim Families: An Intersectional Lifecourse Perspective
Authors: Khan Mushira , Kobayashi Karen , Smith Andre 
Published: December 2021

Abstract
International migration flows are increasing at a rapid pace and are often accompanied by emergent global realities, (re)negotiation of identities and familial bonds, anticipated challenges, and unforeseen exigencies. Concomitantly, advances in public health have resulted in longer lives with an increasing proportion of the global population now 65 years and older. While these demographic shifts have received considerable research attention, little is known about aging South Asian Muslim families in the US and the ways in which they adjust and adapt to shifting social realities. To address this gap, this qualitative study explores the intersections of faith, culture, gender, age, and immigrant status, and how these seminal life course events shape intergenerational care and support exchanges in South Asian Muslim families. Building on findings from 30 in-depth narrative interviews with three generations of immigrant South Asian Muslim women, and using an intersectional lifecourse perspective, this study explores the (re)negotiation of familial bonds and the enactment of religious beliefs and practices such as those around filial expectations in a transnational Islamic context. It shows how, for the grandmothers, daughters, and granddaughters in the study, their Islamic faith was a part of both the public sphere and a collective ideology, as well as a deeply personal and intimate attachment that provided structure and continuity in their everyday lives. Finally, the implications of these findings in the broader context of Islamophobia and salient structural barriers to accessing available health and social support services for aging South Asian Muslim families are discussed.
Psychometric Testing of the BRI Unmet Need Instrument: A Comprehensive Measure of Dementia Caregivers' Needs
Authors: Minyo Morgan , Bass David , McCarthy Kate , Judge Katherine 
Published: December 2021

Abstract
Compared to non-dementia caregivers, family/friend caregivers of individuals with dementia experience more negative caregiving consequences. One reason is the myriad of negatively impacted life domains including: managing symptoms; family communication; financial and legal matters; and finding and coordinating services. Few psychometrically tested measures exist for assessing the range of potential unmet needs of dementia caregivers. Such a measure would describe the frequency and correlates of unmet needs and provide a key outcome for intervention research. This study tested the psychometric properties of a comprehensive measure of unmet needs, the BRI Unmet Need Instrument. Data from 192 family/friend dementia caregivers was used to test reliability and four validity types. Results showed total unmet needs, as well as its nine subscales, had good reliability (Cronbach’s alpha .70 - .95). Discriminant validity was confirmed through factor analyses of the 45 unmet needs and items in measures of depression and care-related strain. Unmet need items loaded on separate factors that were deemed acceptable (.72-.38). Predictive validity was assessed by the association with depression, which was significant and an acceptable range (r = .22, p &lt; .01). Convergent validity was confirmed by significant associations with three caregiver strain measures, mastery (r = .40, p &lt;.01), emotional strain (r = .19, p &lt; .01), and relationship strain (r = .15, p &lt;.05). Good structural validity for nine predetermined unmet needs subscales was found using principal component analysis (loadings = .82-.39). Results suggest the BRI Unmet Needs Instrument is a ready-to-use, reliable and valid comprehensive measure.
Geriatric Comanagement Reduces Hospital-Acquired Geriatric Syndromes in Older Vascular Surgery Inpatients
Authors: Thillainadesan Janani , Aitken Sarah , Monaro Sue , Cullen John , Kerdic Richard , Hilmer Sarah , Naganathan Vasi 
Published: December 2021

Abstract
Aims Based on our meta-analysis, surveys and qualitative studies of geriatricians in Australia and New Zealand, we designed and implemented a novel inpatient model to co-manage older vascular surgical inpatients at a tertiary academic hospital in Sydney. This model, called Geriatrics co-management of older vascular surgery patients (Gerico-V), embedded a geriatrician into the vascular surgery unit who introduced a range of interventions targeting older people. Here we evaluated this model of care. Methods We undertook a prospective before-and-after study of consecutive patients aged ≥65 years admitted under vascular surgery. One hundred and fifty-two GeriCO-V patients were compared with 150 patients in the pre- GeriCO-V group. The primary outcomes were hospital-acquired geriatric syndromes, delirium, and length of stay. Results The GeriCO-V group had more frail (43% vs 30%), urgently admitted (47% vs 37%), and non-operative patients (34% vs 22%). These differences were attributed to COVID-19. GeriCO-V patients had fewer hospital-acquired geriatric syndromes (49% vs 65%; P =.005) and incident delirium (3% vs 10%; P = .02), in unadjusted and adjusted analyses. Cardiac (5% vs 20%; P &lt;.001) and infective complications (3% vs 8%]; P = .04) were fewer in the GeriCO-V group. LOS was unchanged. Frail patients in the GeriCO-V group experienced significantly less geriatric syndromes and delirium. Conclusions The Gerico-V model of care led to reductions in hospital-acquired geriatric syndromes, delirium, and cardiac and infective complications. These benefits were seen in frail patients. The intervention requires close collaboration between surgeons and geriatricians, and may be translated to other surgical specialties.
Intergenerational Learning: An Opportunity to Transform Nursing Students’ Perspectives of Older Adults
Authors: Thornton Marleen , Burns Kathryn , Street Lara 
Published: December 2021

Abstract
The purpose of this pilot project was to explore the experience of an intergenerational learning environment focused on healthy aging for nursing students and older adults. Intergenerational learning experiences provide opportunities for individuals from different age groups to communicate and participate in learning activities together. The growing population of older adults calls for increased geriatric nursing expertise. Nursing students’ attitudes toward older adults are often negative though, and result in decreased interest in geriatric nursing. The opportunity to transform nursing students’ perspectives on older adults has the potential to improve nursing care for older adults, and the number of nurses focused on geriatric nursing care. This qualitative inquiry used a convenience sample of 10 participants from a cross-listed university course on healthy aging for baccalaureate nursing students and older adult members of a lifelong learning institute. Semi- structured focus group interviews were conducted. Narrative transcripts were analyzed using an inductive approach. Analysis illustrated improved nursing students’ perspectives of older adults and aging. A similar theme was noted for older adults’ perspectives of younger adults. The importance of social interaction within an intergenerational learning environment and the need for opportunities to challenge ageist perspectives was illustrated. Increased exposure to healthy older adults, personally and professionally, may increase nursing students’ interest in geriatric nursing and improve nursing care for older adults. Future research should examine more specifically how intergenerational learning experiences can decrease ageism, improve nursing students’ and nurses’ perspectives on older adults, and improve nursing practice for older adults.
Inequities in Access to High-Quality Home Health Agencies Among Racial and Ethnic Minorities With and Without Dementia
Authors: Ma Chenjuan , Wu Bei , Brody Abraham 
Published: December 2021

Abstract
There are rising concerns of inequities in access to high-quality home health agencies (HHA). Using multiple national data sources that included 574,682 individuals from 8,634 HHA, we examined access to high-quality HHA care among racial and ethnic minorities with and without dementia. Approximately 9.9% of the individuals were Black, 6.2% Hispanic, and 3.3% other race/ethnicity. Over one-third (36.3%) had been diagnosed with dementia. Black and Hispanic individuals were 5.5 percentage points (95% CI, 5.2% - 5.9%) and 7.4 percentage points (95% CI, 7.0% - 7.8%) respectively more likely to receive care from agencies defined as having low-quality compared to White counterparts. Persons living with dementia were 1.3% less likely to receive care from high-quality agencies. Having dementia increased the inequity in accessing high-quality HHA between Black and White individuals. Racial and ethnic minorities, particularly those with dementia were at a disadvantaged position to receive care from high-quality HHA.
Understanding the Link Between Discrete Negative Emotions and Empathic Accuracy
Authors: Wieck Cornelia , Gerstorf Denis , Schilling Oliver , Katzorreck Martin , Lücke Anna , Kunzmann Ute 
Published: December 2021

Abstract
Extant theories have suggested that negative emotions generally harm cognitive processes. However, adopting a discrete emotion perspective, in this study, we predicted that only anger and fear but not sadness should be negatively associated with empathic accuracy, a process that has been shown to be cognitively highly demanding. Over 100 participants (Mage = 66.66 years, SDage = 1.00) reported their emotional reactions in response to a negative film in the laboratory, documented their everyday momentary emotions six times a day over seven consecutive days, and completed a film-based empathic accuracy test. Initial findings suggest that only fear but not anger or sadness was related to empathic accuracy. More specifically, high levels of fear both in the laboratory and in everyday life predicted low empathic accuracy. This pattern of findings will be discussed in the context of discrete emotions theories.
Nursing Facility and Health Care Service Use and Costs Under the CMS Financial Alignment Initiative
Authors: Palmer Lauren , Toth Matt , Wang Joyce , Schneider Emily , Dorneo Allison , Chiri Giuseppina , Walsh Edith 
Published: December 2021

Abstract
The Centers for Medicare & Medicaid Services created the Financial Alignment Initiative (FAI) to test the impact of integrated care and financing models for dually eligible Medicare-Medicaid beneficiaries. Using Medicare claims, the Minimum Data Set 3.0, and state-provided enrollment files, we evaluated demonstration impacts on long-stay nursing facility (NF) use, other health care service utilization, and costs for the overall eligible population in two FAI demonstration States with managed fee-for-service models, Colorado and Washington. We used quasi-experimental, difference-in-differences regression models for the impact analyses. In Colorado, there was a 7.2 percent decrease (p&lt;0.001) in long-stay NF use, relative to the comparison group. Otherwise, the demonstration showed unfavorable service utilization results—increases in preventable emergency department (ED) visits and declines in 30-day follow-up after mental health discharge (MHFU)—and no impact on Medicare costs. In Washington, there was also a decrease in long-stay NF use (12.4 percent, p&lt;0.001) and skilled NF admissions (21.7 percent, p&lt;0.001). However, the demonstration resulted in decreases in physician visits and 30-day MHFU. There was a favorable decrease in Medicare costs. The impact of the FAI demonstrations on NF use was favorable for both States, while the impact on service utilization and Medicare costs was mixed and more favorable in Washington. Washington’s care coordination model was intensive and targeted to high-cost individuals while Colorado provided minimal care coordination. Coordinated care and integrated long-term services and support may help postpone NF institutionalization, but there is no evidence these activities reduced preventable hospitalizations or ED visits.
Detecting a Novel Walking-Based Performance Fatigability Marker With Accelerometry in Older Adults
Authors: Qiao Yujia (Susanna) , Harezlak Jaroslaw , Boudreau Robert , Urbanek Jacek , Moored Kyle , Schrack Jennifer , Simonsick Eleanor , Glynn Nancy W 
Published: December 2021

Abstract
Walking-based performance fatigability measures (e.g., lap-time difference) may not adequately capture performance deterioration as self-pacing is a common compensatory strategy in those with low activity tolerance. To overcome this limitation, we developed a new approach with accelerometry (ActiGraph GT3X+, sampling=80 Hz, non-dominant wrist) during fast-paced 400m-walk (N=57, age=78.7±5.7 years, women=53%). Cadence (steps/second) was estimated using raw accelerometer data (R “ADEPT”). Penalized regression splines (R “mgcv”) were used to estimate the individual-level smoothed cadence trajectories. “Time-to-slow-down” was defined as first time-point where the full confidence interval of change in cadence&lt;0. Five participants were censored at stopping time (not slowdown or complete walk). Median “time-to-slow-down” was 1.86 minutes (IQR=0.98-2.73, range=0.57-6.25). Participants with longer “time-to-slow-down” had slower starting cadence, longer 400m-walk time, and greater perceived fatigability (Pittsburgh Fatigability Scale), p’s&lt;0.05 (linear regression). Our preliminary findings revealed that detecting accelerometry-based performance fatigability/deterioration in older adults is feasible and needs to account for initial pace.
Novel Approaches Examining Sleep Health as a Marker of Successful Aging
Authors: Lee Soomi , Wallace Meredith 
Published: December 2021

Abstract
Sleep is a modifiable determinant of health. It changes with advancing age and in response to diverse contexts (e.g., related to work or one’s health). Previous studies have often used single measures of sleep duration or sleep quality. However, a recent paradigmatic shift towards multidimensional sleep health emphasizes the importance of examining how multiple sleep measures are simultaneously associated with health. This approach presents many opportunities for understanding sleep phenotypes and their potential contributions to health. Yet it also presents methodological challenges in analyzing multidimensional sleep data. This symposium showcases the most recent approaches and novel ideas examining the role of sleep health in successful aging. Paper 1 examines sleep profiles (i.e., latent groups with varying sleep characteristics) in middle-aged adults and their linkages to psychological well-being and chronic conditions with differences by age groups. Paper 2 investigates 24-hour patterns of sleep-activity rhythms and their associations with physical functioning performance in older men and women. Paper 3 showcases the utility of a sleep health composite score in examining sleep disparities and their drivers in middle- and later-adulthood. Paper 4 examines whether and how a composite sleep health measure based on actigraphy data is associated with specific characteristics of adult bipolar disorder patients. These papers use different cohorts, such as the Midlife in the United States Study, Osteoporotic Fractures in Men study, and Multi-Ethnic Study of Atherosclerosis. At the end, Dr. Wallace will discuss key findings from these studies, their methodological contributions and implications for aging, and directions for future research.
Rest-Activity Rhythm Patterns and Physical Functional Performance in Community-Dwelling Older Men
Authors: Chen Dorothy , Tranah Gregory , Bradshaw Patrick , Blackwell-Hoge Terri , Zeitzer Jamie , Ancoli-Israel Sonia , Yaffe Kristine , Stone Katie 
Published: December 2021

Abstract
Sleep and activity patterns have been linked to physical performance in older adults. Traditional parametric models of 24-hour activity rhythms fail to adequately capture specific diurnal sleep and wake patterns; functional principal components analysis (fPCA) is a non-parametric approach that addresses this limitation. Using fPCA, we modeled accelerometry data from n = 2,960 participants in the Osteoporotic Fractures in Men (MrOS) ancillary sleep study (mean age 77y) and examined cross-sectional associations with gait speed and grip strength measurements. Lower daytime activity (expected difference = -0.049 [-0.072, -0.028] m/s), increased sleep duration and a reduced midday dip in activity (-0.015 [-0.035, 0.006] m/s) were modestly associated with worsening gait speed. A modest association between both later sleep and wake times and increased sleep duration with worsening grip strength outcomes was observed (-1.11 [-1.90, -0.32] kg). Specific daily activity patterns may serve as predictive biomarkers for changing physical function in aging populations.
Physical Activity and Sedentary Behavior Patterns Prior to and During the COVID-19 Pandemic
Authors: Gell Nancy , Rosenberg Dori , LaCroix Andrea 
Published: December 2021

Abstract
Understanding patterns in the types of activities older adults engage in during physical activity and sedentary time could help shape intervention designs. Few studies have adequately described the physical activity and sedentary pursuits older adults undertake, including during the COVID-19 pandemic. To answer these questions, this symposium uses data from three recent studies: Adult Changes in Thought (ACT),an epidemiologic study with self-reported and device-based measures of physical activity and sedentary time including time spent in various domains of activity; Objective Physical Activity and Cardiovascular Disease Health in Older Women (OPACH), an epidemiologic study with device and self-report measures of sedentary behavior; and an ongoing clinical trial, the Healthy Aging Resources to Thrive (HART) study with device and self-reported data on sitting time and patterns as well as physical activity. The first session in this symposium will present a description of the rates of meeting the aerobic, strength, and balance recommendations among older adults in the ACT study. Next, we will have a presentation describing sedentary activities in older adults by age, sex and device-based sitting patterns in the ACT study. In the third presentation we will use OPACH data to examine patterns and context of sedentary in relation to aging-related outcomes. Finally, we will describe changes in physical activity and sedentary time in the HART trial in the cohort enrolled prior to the COVID-19 pandemic vs. those enrolled during the pandemic. Our Discussant will provide new insights on the roles of sedentary behavior and physical activity in aging and health.
Crime and Perceived Neighborhood Safety Across Racial-Ethnic Groups
Authors: Velasquez Alfredo , Guo Fangqi , Robinette Jennifer 
Published: December 2021

Abstract
Crime often increases safety concerns for residents, and safety concerns are generally associated with worse health. Despite that marginalized racial/ethnic groups are more likely than non-Hispanic Whites to live in areas with more crime, prior studies have documented that these groups differentially view crime as a threat to safety. Furthermore, older adults are more likely to report safety concerns than younger adults, despite a lesser chance of being victimized. Using multiple waves of data from the Health and Retirement Study, a representative sample of US adults aged 51 years and older (n= 11,161, mean age of 66 years), we conducted weighted repeated cross-sectional linear regressions to examine whether the association between crime and perceived neighborhood safety varies by racial/ethnic group, by age, or by wave of data collection. Study results indicated that higher crime rates consistently predicted more safety concerns among non-Hispanic Whites, Hispanics, and “Others,” but were inconsistently associated with safety concerns among non-Hispanic Blacks, adjusting for age, household wealth, and census tract-level concentrated disadvantage, population density, and racial/ethnic heterogeneity. Furthermore, among non-Hispanic Whites, greater crime predicted more safety concerns before, but not after including a measure of racial/ethnic heterogeneity. These patterns persisted across the full age span. Racial/ethnic differences in the crime-safety link could be explained by additional sociopolitical and environmental variables including diversity that vary over time. Follow-up analysis is needed to determine if the racial/ethnic differences in crime-safety links extend to health.
Testing Implementation of FFC-AL-EIT
Authors: Resnick Barbara , Boltz Marie 
Published: December 2021

Abstract
Residents in assisted living settings engage in limited amounts of physical activity and decline functionally more rapidly than peers in nursing homes. To address the persistent functional decline and increased time spent in sedentary activity Function Focused Care was developed. Function Focused Care involves teaching caregivers to evaluate residents’ underlying functional capability and physical activity and engage them in physical activity during all care interactions. Prior research has demonstrated that implementing function focused care improves or maintains function and increases physical activity, improves mood and decreases behavioral symptoms among residents. To optimize implementation of Function Focused Care a theoretically based implementation strategy, Function Focused Care for Assisted Living Using the Evidence Integration Triangle (FFC-AL-EIT), was developed. FFC-AL-EIT combines the social ecological model, social cognitive theory and the Evidence Integration Triangle. The social ecological model includes intrapersonal, interpersonal, environmental, and policy factors that influence behavior. Social cognitive theory guides the interpersonal interactions that motivate caregivers and residents to engage in function focused care. Lastly, the Evidence Integration Triangle facilitates systemic implementation of function focused care. A total of 85 facilities from three states were randomized (FFC-AL-EIT versus Education Only) and 794 residents consented. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) model was used to evaluate outcomes. This symposium will provide the implementation outcomes and value of the Evidence Integration Triangle, the effectiveness of FFC-AL-EIT on function and physical activity and the effectiveness on psychosocial outcomes and care interactions.
Major Discrimination, Race-Ethnicity, and Inflammation Among Older Adults
Authors: Cobb Ryon , Parker Lauren , Thorpe, Jr. Roland 
Published: December 2021

Abstract
This study examines the relationship between self-reported instances of major discrimination and inflammation among older adults, and explores whether this relationship varies in accordance with race/ethnicity. Data from 2006/2008 Health and Retirement Study was used to collect measures of self-reported instances of major discrimination and high-risk C-reactive protein (CRP), which was assayed from blood samples. Modified Poisson regression with robust standard errors was applied to estimate the prevalence ratios of self-reported instances of major discrimination, as it relates to high-risk CRP (CRP ≥ 22 kg/m2), and test whether this relationship varies by race/ethnicity. Respondents who experienced any instances of major discrimination had a higher likelihood of high-risk CRP (prevalence ratio [PR]: 1.14, 95% confidence interval [CI] = 1.07–1.22) than those who did not report experiencing any instances of major discrimination. This relationship was weaker for blacks than whites (PR: 0.81, 95% CI = 0.69–0.95).