bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding and Measuring Frailty: Insights From the Canadian NuAge and CLSA Cohorts
Authors: Gaudreau Pierrette , Cohen Alan 
Published: December 2021

Abstract
Frailty is one of the most central concepts in geriatrics; nonetheless, multiple definitions and operationalizations abound, and the underlying biology remains a topic of much discussion. Here, we bring together four talks that join questions of understanding with questions of measurement, in order to explore how answering each is necessary to make progress on the other. We cannot measure frailty if we have not understood and defined it, but we cannot understand if we cannot measure it and study it. Turcot et al. present work on operationalizing frailty in the NuAge cohort. Mayo et al. establish a scale to test the extent to which frailty can be operationalized as a ladder rather than a condition, again using the NuAge cohort. Mendo et al. use mediation analyses to understand how grip strength and other aspects of frailty may play a role in the relationship between diabetes and atherosclerosis. Ghachem et al. test the relationship between physiological dysregulation of different systems and different criteria of the Fried model, in order to assess the evidence for frailty as an emergent physiological state. Together, these talks will push the boundaries of how we think about frailty at levels ranging from biological to clinical to operational.
Involving Older Adults in the Data Analysis Process
Authors: Nolte Julia , Turker Hamid 
Published: December 2021

Abstract
Because involvement of older adults in the research process continues to be low, we review existing approaches to engaging older adults in qualitative and quantitative data analysis. In doing so, we examine in which contexts older adults have or could serve as analysis consultants, collaborators, or even leaders. We also discuss the benefits and challenges associated with inviting older adults into the analysis process: On the one hand, this age group can contribute unique viewpoints and draw on a lifetime of experience and expertise. On the other hand, involving older adults in data analyses typically requires resources and time while bearing the risks of health-related attrition, tokenistic treatment, and power imbalances between researchers and older adults. As a result, we close with recommendations on how to navigate this process effectively and respectfully (e.g., building trust, reducing hierarchies, being mindful of older adults’ needs, and assessing their satisfaction throughout the collaboration).
The Role of Community Support and Social Networks Among Marginalized Groups in Later Life
Authors: Van Vleet Samuel 
Published: December 2021

Abstract
As the aging population in the United States continues to grow, so does the need for advancement and critical research to better understand later life experiences. The presence of cumulative disadvantages among racial minorities can often lead to later life health disparities. The goal of this study is to assess the role that social networks and community support play in later life health for marginalized communities. Data from the National Health and Aging Trends Study were analyzed using general linear regression techniques. This allowed for better understanding into the relationships between community support, social networks, race/ethnicity and self-reported health. The final sample included 3,857 participants aged 65 and older. After controlling for other variables, community support and social networks had statistically significant positive relationship with later life health. Race/ethnicity was the strongest predictor of worse later life health. The results of this study show the importance of later life social support for predicting health scores. White participants not only maintained higher health scores as compared to Black and Hispanic participants, but they also reported higher levels of social networks and community support. Findings from this study help build upon the literature regarding community support and social networks in later life.
All in the Family? Age, Period, and Cohort Differences in Kinship Ties Among Older U.S. Adults
Authors: Compernolle Ellen , Howard Khoa Phan , Hedberg Eric 
Published: December 2021

Abstract
In general, older adults’ social networks—characteristics of which (e.g., size, type, frequency) have been linked to important health and well-being outcomes--tend to be kin-centered, although this has changed over time. Disentangling these changes, however, is difficult given typical mobility decline and shrinking networks in old age (age), the rapid social and demographic changes that occurred during the 20th century (cohort), and, in recent decades, the 2008 Recession and technological advances (period). This study uses data from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative sample of older adults (ages 57-85; 2005-2016), to examine patterns in older adults’ social networks, with particular emphasis on the role that family plays. Specifically, we ask: 1) Have older adults’ social networks become less kin-centered over the past decade (2005-2016)? 2) Are they less kin-centered among younger cohorts? And 3) Does the recession explain part of these period effects? We find that, between 2005 and 2016, family still comprises the majority of older adults’ social networks, although their network size and range have grown larger and become less family-centric. They also report fewer close family members and friends, living with fewer family members, and less frequent interaction with network ties. Results from multi-level regression models suggest that age, and to a much lesser extent, cohort, plays a key role in many of these changes, although this varies between the first and second 5-year intervals of data collection, underscoring older adults’ adaptivity to current social and economic circumstances.
Stressful Family Contexts and Health in Divorced and Married Mothers
Authors: Klopack Eric , Wickrama Kandauda 
Published: December 2021

Abstract
Using prospective data over 25 years from a sample of 416 women, the first objective of the current study was to investigate the biopsychosocial process over the second-half of the life course comparing mothers with diferent marital histories. The second objective was to investigate this biopsychosocial process for 296 maried mothers focusing on their marital quality over middle years. The results suggested that, compared to being married, divorcing in early-midlife launched an adverse biopsychosocial process for women leading to physical pain, physical limitations, and depressive symptoms over their mid-later years, largely through early-midlife financial stress, regardless of later recoupling. However, subsequent financial stress did not influence divorced mothers’ later-life health problems, suggesting their development of resilience. For consistently married mothers, both marital stress and financial stress uniquely influenced all three health problems throughout their mid-later years. For all mothers, these health problems progressed over mid-later years, as indicated through their stabilities and mutual influences, and these health problems also selected mothers into further escalating financial and marital stress over their mid-later years. Elucidating differential short- and long-term health influences of marital and financial stressors for divorced and married mothers provides a potentially useful information for targeted early preventive intervention efforts and policy formation. Such interventions can promote and develop resiliency factors, thereby aiding middle-aged mothers to prevent from adverse biopsychosocial processes.
A Systematic Review of Effects of Physical Activity of Family Caregivers of Older Adults With Chronic Disease
Authors: Baik Dawon , Song Jiyoun , Tark Aluem , Coats Heather , Jankowski Catherine 
Published: December 2021

Abstract
More than 17 million family caregivers (FCGs) provide care for older adults with chronic illness in the US. Caregiving for older adults with chronic disease places a considerable burden on FCGs and they tend to neglect their personal health. Generally, physical activity (PA) programs benefit the physical and psychological health of FCGs. However, no review of PA randomized clinical trials (RCTs) focused on FCGs of older adults with chronic disease. In this systematic review, we analyzed the most recent trends (2010-2020) in RCTs identifying the effects of PA in this population. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases (PubMed, CINAHL, Embase, PsycInfo, Cochrane Library) were searched for publications dated from 2010 to 2020. All studies included were appraised for quality using the Cochrane Collaboration Risk of Bias Tool. Of the resulting 16 studies, most studies (n=11) targeted FCGs of older adults with dementia or cancer. Most FCGs were non-Hispanic white. PA interventions with mixed modes (e.g., aerobic and resistance exercise), mixed delivery methods (e.g., in-person and telephone) and mixed settings (e.g., supervised gym- and unsupervised home sessions) were used most frequently. PA interventions significantly improved psychological health but had inconsistent effects on physical health. Tailored PA programs, designed based on FCGs’ goals, preferences and limitations, may improve upon physical health outcomes. Future PA studies should include samples of racially and ethnically diverse FCGs of older adults representing a broader range of chronic diseases.
At-Homeness: Rethinking Personhood-in-Community Through the Lens of Social Identity
Authors: Gan Daniel R Y , Rowles Graham , Chaudhury Habib 
Published: December 2021

Abstract
Since Chaudhury’s seminal work (2008), spatial ethnographies of the everyday lives of people living with dementia(PLWD) have proliferated. From an experiential perspective, geographies of home (Blunt & Varley, 2004) and geographies of dementia may overlap significantly. We conducted a meta-ethnographic synthesis of n=28 articles to identify points of convergence and divergence in these literatures using comparative thematic analysis with NVivo 12. Whereas geographies of home highlight at-homeness (e.g., ontological safety and daily activities), geographies of dementia underscore communal and civic participation (e.g., social relationships). These themes converge around “social identity” which may be an important construct that helps PLWD feel at home. The quality of life of PLWD in the community may be influenced by prior (and present) experiences of at-homeness. These become more pertinent as older adults shelter in place. We discuss the implications of these findings in relation to relational models of personhood-in-community (Swinton, 2020) and community gerontology.
Investigating Barriers and Facilitators to Congruence in Place of Care Among Unhoused Palliative Care Patients
Authors: Johnson Ian , Light Michael 
Published: December 2021

Abstract
An important quality marker for end-of-life services is congruence with patient’s preferred place of care, but this congruence in place of care is less likely for those facing structural inequalities (Grunier et al., 2007). As homelessness among older adults in the United States grows (Culhane et al., 2013), the urgency in understanding place of care in palliative care with unhoused patients grows. This presentation illustrates results from an organizational case study (Yin, 2014) of a novel homeless palliative care team and focuses on a qualitative content analysis of charts of patients over 50 receiving care both before and during the COVID-19 pandemic (n=27). Findings highlight (1) the interplay between environmental factors, psychosocial resources and constraints, and medical acuity in determining where care can take place, (2) facilitators for care in marginal settings such as emergency shelters and encampments, and (3) where opportunities for more equitable age-friendly healthcare system interventions exist.
Patterns Among Same-Sex Spousal Couples: Diverse Sociocultural Representation in Alzheimer’s Research
Authors: Stites Shana 
Published: December 2021

Abstract
Emerging evidence shows that understanding characteristic patterns between study partners (SP) and subjects can inform initiatives to diversify representation of sociocultural groups in ADRD research. This study examined same-sex spousal dyads with the goal of identifying bellwethers of opportunities to build diversity in ADRD research. Descriptive analysis of The Aging, Demographics and Memory Study (ADAMS), which enrolled a subset of subjects from the Health and Retirement Study and a SP for each subject. Eight same-sex spousal couples were among 718 SP-subject dyads (1.1%). Gay men were 3 times as likely to be spousal SPs (n=6) than lesbians (n=2), even though women far outnumber men overall. Patterns in caregiving and other characteristics also differed. Same-sex couples are underrepresented in ADRD research. Patterns among those enrolled suggest masculine and feminine norms may drive research engagement. This is discussed in the context of increasing sociocultural diversity in ADRD research across key social groups.
COVID-19 in German Nursing Homes: A Panel Study on Morbidity, Burden of Care, and Social Isolation
Authors: Seibert Kathrin , Domhoff Dominik , Heinze Franziska , Preuss Benedikt , Rothgang Heinz , Wolf-Ostermann Karin 
Published: December 2021

Abstract
Germany was hit by the second wave of the pandemic much harder than by the first wave. The study aims to describe the extent to which nursing homes (NH) are affected by COVID-19. About 8,000 NHs were invited to participate in two waves of an online survey, with a share of 5-10% participating. The share of all deceased NH-residents with COVID-19 is about 50% (04/2020-02/2021). Factors that increase the risk of an outbreak in NH are the spread of the virus in the population, the size of the institution and staff-resident-ratio. The initial lack of protective equipment has decreased during the second wave, but the facilities have to cope with massive additional care needs with reduced staff. NHs have partly banned contacts between residents and relatives. As a conclusion the support of NH in their attempt to fight the impact of this and further pandemic situations requires highest attention.
Food Insecurity and Mental Health Trajectories During the COVID-19 Pandemic: Longitudinal Evidence
Authors: Kong Dexia , Lu Peiyi , Kozlov Elissa , Shelley Mack 
Published: December 2021

Abstract
The extent to which food insecurity impacts changes in mental health outcomes over time in the context of Covid-19 remains unknown. Using longitudinal data from a nationally representative survey, the objectives of the present study were to: (1) assess the prevalence of food insecurity among U.S. adults amid the Covid-19 pandemic; and (2) investigate the relationships between food insecurity statuses and changes in mental health outcomes over time as the pandemic unfolds. Longitudinal data from the Internet-based Understanding Coronavirus in America survey collected bi-weekly between April and December 2020 were used (n=4,068, 15 repeated measures). Adult respondents (aged ≥18) were asked about their food insecurity experiences and stress/anxiety/depressive symptoms. Linear mixed-effect models examined changes in mental health outcomes over time among groups with various food insecurity statuses. Overall prevalence of food insecurity was 8%. Food insecurity was consistently associated with higher levels of stress/anxiety/depressive symptoms (p&lt;0.001). Stress/anxiety/depressive symptoms declined over time among food-secured U.S adults. However, mental health trajectories of respondents with various food insecurity categories, including food insecurity status, persistent food insecurity, and food insecurity of higher severity and longer duration, remained stable or worsened over time. Moreover, the mental health gap between food-secured and food-unsecured participants widened over time. Food insecurity represents a pressing public health problem during the Covid-19 pandemic with substantial mental health implications. Persistent and severe food insecurity may contribute to mental health disparity in the long term. Food insecurity reduction interventions may alleviate the estimated alarming mental health burden as the pandemic unfolds.
Good Trouble Along the Winding Road: Disruption and Accomplishment
Authors: Sterns Harvey , Ruby Joseph 
Published: December 2021

Abstract
The establishment of a accreditation body for gerontology degree programs was seen as disruptive. Many key leaders were against creating such a body and wanted this to be delayed or to never happen. In 2012, the AGHE Accreditation Task Force was established with a Competency Work Group and an Organization Work Group..There have been 5 programs evaluated with a number of schools/university currently in process. The task force filed documents for creating a legal entity and obtaining non-profit status for the new Accreditation for Gerontology Education Council. The Task Force developed the dimensions for program evaluation based on the Competencies and shared information with AGHE members. The Task Force obtained start-up funding for the organization and identified the first programs for accreditation and has been providing outreach and guidance to new programs. There is continual refinement of the process.
Factors Affecting the Sustainment, Sustainability, and Spread of Practice Changes in Canadian Long-Term Care Homes
Authors: MacEachern Lauren , Song Yuting , Ginsburg Liane , Doupe Malcolm , Wagg Adrian , Spiers Jude , Berta Whitney 
Published: December 2021

Abstract
Our understanding of the post-implementation sustainment, sustainability, and spread (SSS) of complex quality improvement interventions is limited. We explored factors that influenced the SSS of a care aide-led quality improvement initiative (Safer Care for Older Persons (in residential) Environments [SCOPE]) implemented in 6 Manitoba long-term care homes two years after the conclusion of SCOPE in 2017. We analyzed small group interview data collected from all unit- and facility-level managers who participated in SCOPE and were still working in these facilities. We asked about SCOPE implementation, post-SCOPE quality improvement activities, factors that influenced them, and about inter-unit spread of SCOPE following the project’s conclusion. The interviews were audio-recorded, transcribed verbatim, de-identified, and analyzed using thematic analysis. Five of the 6 facilities reported sustained SCOPE quality improvement activities, tools, and facilitative structures. In the same 5 facilities, SCOPE benefits (e.g., increases in care aide empowerment and self-efficacy, manager belief in care aide capacity) continued post-implementation. Spread beyond the original SCOPE units had occurred in 3 facilities. Factors that influenced the SSS of SCOPE were related to the team (e.g., care aides' quality improvement capacity), to the unit and facility (e.g., culture of innovation and change), and to the long-term care system (e.g., competing imperatives). Some factors influencing SSS differ from factors known to influence implementation. The identified factors affecting SSS highlight the influence of social dynamics (i.e., interactions, communication, relationships) among staff on SSS. Further research is warranted to explore interactions among these influencing factors and how they lead to SSS.
Does Bridge Employment Mitigate or Exacerbate Inequalities Later in Life?
Authors: Cahill Kevin , Giandrea Michael , Quinn Joseph , Sacco Lawrence , Platts Loretta 
Published: December 2021

Abstract
This paper explores how gradual retirement impacts inequality later in life, with a focus on transitions from career to bridge employment. We use 26 years of longitudinal data from the Health and Retirement Study to document the various pathways that older Americans take when exiting the labor force, and examine how bridge employment impacts non-housing wealth and total wealth, including the present discounted value of Social Security benefits. We find that gradual retirement in the form of bridge employment neither exacerbates nor mitigates wealth inequalities among Americans who held career jobs later in life. We do find evidence that wealth inequalities grow among the subset of older career workers who transition from career employment to bridge employer at older ages. These findings provide quantitative evidence that bridge employment at older ages is taken by those who need to continue working financially and those who continue working for nonpecuniary reasons.
Presidential Symposium: Stories of Struggle and Resilience: Expert Interdisciplinary Reflections of the Past Year
Authors: Waldron Danielle , Johnson Kalisha Bonds 
Published: December 2021

Abstract
Are you an ESPO member curious about what the “new normal” means for your future career in the field of aging? Or are you a GSA member interested in hearing from your colleagues about their experiences over the past year? Welcome to the ESPO Presidential Symposium! During this session, speakers will share honest and candid insights about their careers in the field of aging amidst the pandemic, racial discrimination/social unrest, and economic insecurity. Speakers in the ESPO Presidential symposium include: Dr. Thomas K.M Cudjoe, Dr. Candace S. Brown, and Dr. Marnin J. Heisel. Dr. Cudjoe, a physician, will discuss his clinical experience treating older adults with COVID-19, the shift to tele-health, and his research on the impact of social isolation on older adults. Dr. Brown, an academician, will discuss how the new attention to the longstanding issues of social injustice in the U.S. shaped her teaching pedagogy, research, student mentorship, and provide critical context regarding the impact of COVID-19 on Black and Indigenous People of Color (BIPOC) professors. Dr. Heisel, a clinical psychologist, will share how his intervention research on resiliency and well-being in older adulthood shifted amidst the “new normal,” as well as how older adults in his clinical practice encountered and coped with difficulties over this past year. As our society confronts social injustice, tackles health implications of COVID-19, and adjusts to a new way of life, we must consider how these factors, together, inform the interdisciplinary stories of struggle and resilience in the field of aging.
Peer Mentoring to Foster Resilient Age-Friendly Rural Communities in Maine
Authors: Oh Patricia , Crittenden Jennifer , Lee Laura 
Published: December 2021

Abstract
Maine has a growing number of age-friendly community initiatives (AFCIs); 116 communities are actively working to adapt the social, service, and built environments for aging and 71 have formally joined the AARP Network of Age-Friendly States and Communities. During COVID, rural municipalities were faced with dynamic changes that limited older resident’s access to services and social engagement. To overcome these limitations, it is critical for emergent AFCIs to have tools and strategies to maintain and further enhance healthy environments and resilient communities. This study uses group interviews with 6 leaders of established AFCIs and 6 leaders of emergent AFCIs to explore how the Lifelong Fellows Program, a peer mentoring model that matches experienced leaders with newly formed initiatives, was able to spur development of new strategies to build community resilience. Prominent themes were (1) engaging new local and regional partners; (2) intergenerational volunteerism; (3) fun and flexibility; and (4) relationship-building.