bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Brain Aging Center
Authors: Lin Feng , Conwell Yeates , Simmons Janine 
Published: December 2021

Abstract
Evidence indicates an association between emotional well-being (EWB) and underlying brain processes, and that those processes change with both normal and pathological brain aging. However, the nature of these associations, the mechanisms by which EWB and its component domains change with brain aging, and how those changes may be associated with common neuropathologies like Alzheimer’s disease and related dementias (ADRD), are largely unexplored. The NIA-funded Network for Emotional Well-being and Brain Aging (NEW Brain Aging) has the goal of developing a nationwide community of investigators dedicated to research that identifies and tests mechanisms by which brain aging influences EWB and how EWB may impact risk for and progression of ADRD. Synthesizing human and animal literature, our premise is that relationships between EWB and ADRD are bidirectional – normal and pathological changes in aging brain influence EWB and EWB contributes to brain health and illness, such as ADRD. NEW Brain Aging will identify and coalesce resources for interested investigators and provide pilot funding opportunities to stimulate research and development of the field. Component presentations of this symposium will include (1) an overview by Dr. Robert Kaplan of the current state of research on EWB; (2) the role of animal studies (Kuan Hong Wang) and (3) human subjects research (Feng Vankee Lin) in EWB and aging; and (4) design of NEW Brain Aging and resources it will provide (Yeates Conwell). Janine Simmons will explain NIA’s vision for EWB research and lead open discussion.
Monitoring Utilization Trends of Glucose-Lowering Drugs for Type 2 Diabetes in Older Adults by Frailty Status
Authors: Gopalakrishnan Chandrasekar , Kim Dae , Kutz Alexander , Patorno Elisabetta 
Published: December 2021

Abstract
Using Medicare fee-for-service data from 2013-17, we identified a cohort of patients with type 2 diabetes (T2D) who initiated a glucose-lowering drug (mean [SD] age, 74.8 (6.9) years). Amongst frail patients (CFI≥0.20), metformin use remained stable from 29.1% to 29.4%, whereas sulfonylureas (25.8% to 22.1%) and insulin (21.2% to 19.0%) use declined. Amongst non-frail patients (CFI &lt;0.20), metformin (35.3% to 33.1%) and sulfonylurea (26.2% to 22.2%) use decreased whereas insulin (11.7% to 10.6%) use remained stable. DPP-4i and glitazones use remained stable whereas the use of newer agents such as SGLT-2i and GLP-1 RA increased steadily over the study period in both frail and non-frail patients, though their use remains low ( &lt;8%). In conclusion, sulfonylureas and insulin accounted for about one-third of initiated glucose-lowering medications and were more frequently used by frail patients, though their use declined steadily over time with the availability of newer agents.
Advancing the Study of Loneliness and Health in Older Adults Through the Use of Integrative Data Analysis
Authors: Ong Anthony , Graham Eileen , Jackson Kathryn , Beck Emorie , Luo Jing , Atherton Olivia , Willroth Emily , Mroczek Daniel 
Published: December 2021

Abstract
Recent work has shown the importance of studying loneliness and social isolation across adulthood for understanding healthy aging. This project explored loneliness trajectories across multiple independent samples. Using coordinated IDA, we estimated and meta-analyzed identical multilevel growth models in loneliness using three samples (ELSA, SHARE, HRS). We found u-shaped change, suggesting that loneliness may decline from young adulthood to midlife, then increase after midlife. These trajectories were significant across all three datasets and not fully explained by demographics or depression. We found that divorce, widowhood, social isolation, and functional limitations were associated with higher overall loneliness. Additionally, divorce and functional limitations, and sex (being male) were associated with deeper dips in loneliness in midlife and steeper increases in old age. These findings suggest that loneliness increases across the second half of life and point to the need for evidence-based strategies for addressing social disparities in midlife and later adulthood.
Stress Processes Over 2 Decades: Findings From the National Study of Daily Experiences
Authors: Almeida David , Mroczek Daniel 
Published: December 2021

Abstract
Daily experiences of stress and the associated sequelae of affective and physiological changes represent the multiple dimensions of a complex, time-dependent process of how stressors unfold in daily life. Daily diaries capture these time-sensitive processes as they occur under real world conditions. Longitudinal changes in stress processes can then be tracked using a measurement burst design: daily diaries repeated longitudinally. Using this design, the National Study of Daily Experiences (NSDE) has generated more than 35,000 days of data from a national sample of over 2,500 adults assessed repeatedly across 20 years of adulthood. The NSDE features details of more than 10,000 reports daily stress including exposure, appraisal and affective responses from adults ranging in age from 24 to 95 years. The current symposium leverages this unique and influential dataset to examine age differences and aging-related changes in daily stress processes with four presentations from the NSDE. First, Dr. Robert Stawski will discuss longitudinal change and age-related differences in exposure to multiple types of daily stressors. Next, Dr. Susan Charles will examine age differences and change in a key element of the stress process: negative affect. Third, Dr. Eric Cerino will describe longitudinal change in appraisals of daily stressors focusing on stressor control. Finally, Dr. David Almeida will examine changes in negative affect reactivity to daily stressors across the 20 years of the NSDE. Dr. Dan Mroczek will discuss the picture these presentations provide of how aging and age-differences impact the daily stress process and future directions for understanding these trajectories.
Age Differences and Longitudinal Change in Exposure to Daily Stressors: Three Waves of Diary Data Across 20 Years
Authors: Cerino Eric , Stawski Robert , Rush Jonathan 
Published: December 2021

Abstract
Exposure to daily stress is an important risk factor for healthy aging. We examined cross-sectional age-related differences and longitudinal aging-related change in stressor exposure across three waves of the National Study of Daily Experiences (N=2,914, M=51.53 years, SD=13.55, 56.35% Female) spanning 20 years. Exposure to six types of stressors (arguments, avoided arguments, work overloads, home overloads, network stressors, other) were obtained from telephone interviews over 8 consecutive days in waves conducted in ~1996, ~2008, and ~2017. Longitudinal analyses revealed declines in stressor exposure across 20 years (p &lt;.01), driven by declines in arguments, work overloads, and network stressors specifically. Cross-sectional analyses indicated that older individuals reported stressors less frequently (p &lt;.01), driven by decreases in arguments, avoided arguments, work overloads, and home overloads specifically. Rates of longitudinal decline did not depend on age at baseline. Results suggest that aging-related changes and baseline age differences inform daily stress trajectories in mid- and later-life.
Perceptions of Social Support Sufficiency Among Older Adults With HIV in Sub-Saharan Africa
Authors: Brennan-Ing Mark , Kaufman Jennifer , Porter Kristen , MacPhail Catherine , Seeley Janet , Karpiak Stephen 
Published: December 2021

Abstract
Globally, the greatest number of older people with HIV (OPWH) are in sub-Saharan Africa (3.7 million). This population will continue to expand with greater access to anti-retroviral therapy. Compared to OPWH in high income counties, these OPWH have constrained access to government and community-based services and largely rely on assistance from family, friends, and neighbors for their social support needs. We examined factors related to perceptions of instrumental and emotional support sufficiency (availability and adequacy) among OPWH age 50 and older in Uganda (n = 101) and South Africa (n = 108). Significant covariates of instrumental support sufficiency included not having an AIDS diagnosis, greater support from family, and less support from friends. Significant covariates of emotional support sufficiency were fewer depressive symptoms, greater support from family, and geographic location (Uganda). Explanation of these findings based on social network characteristics and implications for policy and program development will be discussed.
Stigma Impacts Health Disparities and Inequities in LGBTQ and People of Color Aging With HIV
Authors: Egbert Anna , Nash Paul , Brennan-Ing Mark , Karpiak Stephen 
Published: December 2021

Abstract
The impact of stigmatizing attitudes and discriminatory behaviors on health disparities and inequities in non-heterosexual individuals, people of color (PoC), older adults, and persons living with HIV becomes increasingly recognized. This quartette of stigmatized characteristics elevates the risk of barriers to medical services, burden of disease and unfavorable health outcomes in LGBTQ-PoC aging with HIV. Using data from ROAH 2.0 study (N=723), we explored facets of stigma, barriers to medical services and health status in racial/ethnic minorities of older adults with HIV (OAH) living in California, New York, and Illinois. Stigma was evident in &gt;50% of OAH who expressed reservation to self-disclose HIV status. Importantly, 20%-24% of Asian, Black/African-American, Hispanic/Latinx and Multiracial vs. 7% White OAH withheld this information from at least one health care provider. Over 10% of OAH experienced prejudice/discrimination while accessing service. Non-disclosure and prejudice/discrimination were linked to lower self-rated health status, thus, evidencing stigma-related health burden.
Transition Into LTRC During the COVID-19 Pandemic: An Ethnographic Case Study
Authors: Davies Megan , Zúñiga Franziska , Verbeek Hilde , Staudacher-Preite Sandra 
Published: December 2021

Abstract
COVID-19 has affected long-term residential care (LTRC) disproportionally due to the high-risk population, lack of resources and insufficient preventative measures. Protective measures, including quarantine and strict visitation restrictions have made transitions into LTRC more challenging. Further insight is needed to understand how residents, relatives and staff have experienced this during the COVID-19 pandemic. During four months of fieldwork in a LTRC facility in Switzerland, a rapid ethnography consisting of interviews, observations, informal conversations and document analysis was conducted. This study included a total of 14 residents, 21 healthcare staff from varying departments and 7 relatives of residents. First results indicate that protective measures interfere with a resident’s ability to find meaningful activities and interactions within LTRC as well as the possibility to maintain mobility. This and limited family contact following a move into LTRC prevents a smooth transition from home to LTRC and impacts overall resident quality of life.
Assessing and Tracking Success of Advancing Age Inclusivity
Authors: Silverstein Nina , Gugliucci Marilyn 
Published: December 2021

Abstract
Assessment is an important component of advancing age inclusivity on your campus, and the AFU Principles are a useful guiding framework. Assessment helps move the campus from making a commitment to endorse the principles to actually taking stock of current campus practices and movement toward achieving the vision of an age-friendly institution of higher education. To establish a baseline of campus practices, assessment can be done before or after an institution joins the AFU Global Network. Evaluation also follows periodically to assess how well a campus is adhering to the AFU Principles once measurable goals are established and priorities are integrated within an institution’s strategic plan. The toolkit contains examples from multiple campuses of mapping the principles, conducting an audit, doing a photovoice evaluation, holding listening tours, and using the newly developed AFU Inventory and Campus Climate Survey (ICCS).
Risk of Alzheimer’s Disease and Related Dementia Among Adults With Congenital and Acquired Disabilities
Authors: Mahmoudi Elham , Lin Paul , Kamdar Neil , Khan Anam , Peterson Mark 
Published: December 2021

Abstract
Objective: Adults with congenital (cerebral palsy or spina bifida (CP/SB)) or acquired disabilities (spinal cord injury (SCI) or multiple sclerosis (MS)) have higher incidence of age-related health conditions. There is a gap in the literature about the risk of dementia among adults living with these disabilities. This study aimed to examine time to incidence of Alzheimer’s disease and related dementia (ADRD) among these disability cohorts. Method: Using national private payer claims data from 2007-2017, we identified adults (45+) with diagnosis of CP/SB (n=7,226), SCI (n=6,083), and MS (n=6,025). Adults without disability diagnosis were included as controls. Using age, sex, race/ethnicity, cardiometabolic, psychologic, and musculoskeletal chronic conditions, and socioeconomic variables, we propensity score matched persons with and without disabilities. Incidence of ADRD was compared at 4-years. Cox Regression was used to estimate adjusted hazard ratios (aHR) for incident early and late onset ADRD. Results: Incidence of early and late onset ADRD were substantially higher among people with disabilities compared to their non-disabled counterparts. Adults with CP, SCI, and MS had higher risk for early [CP/SB: aHR= 3.35 (95% CI: 2.18-5.14); SCI: aHR=1.93 (95% CI:1.06-3.51); and MS: aHR=4.49 (95% CI:2.62-7.69)] and late [CP: aHR=1.68 (95% CI:1.38-2.03); SCI: aHR: 1.77 (95% CI:1.55-2.02); and MS: aHR=1.26 (95% CI:1.04, 1.54)] onset ADRD. Conclusions: Risk of ADRD was higher among adults with CP/SB, SCI, and MS compared to their matched cohort without disability. Investment in early screening and use of therapeutic or rehabilitative services that may help preserving cognitive function among these patient cohorts is warranted.
Excellence in Rehabilitation of Aging Persons Award: Developing a Function-Focused Approach to Pain Management for Older Adults with Chronic Low Back Pain
Authors: Hicks Gregory 
Published: December 2021

Abstract
The overarching goal of our research program is to improve physical function and participation in older adults with chronic musculoskeletal conditions, particularly low back pain (LBP). Despite the fact that LBP is a common problem for older adults and is associated with poor outcomes in this vulnerable age group, little research has focused on LBP in people over age 65. With minimal research available, clinicians do not have clear evidence-based guidance regarding management of older adults with LBP. This presentation will focus on our pathway towards developing a focused treatment algorithm designed to prevent and address the pain-related disability found in older adults with LBP. Our work has largely focused on the identification of potentially modifiable "rehabilitation risk factors" that are associated with pain and functional limitations, as well as the development of interventions to address these risk factors. Specifically, we will discuss our findings relative to trunk muscle impairments and clinical hip impairments in the context of the older adult with low back pain.
Undergirding CNAs in LTC: The Experience of Collaborative LN-CNA Caregiving Pairs
Authors: Beynon Cynthia , Supiano Katherine , Siegel Elena , Edelman Linda , Madden Connie , Hart Sara 
Published: December 2021

Abstract
This research explores support provided by licensed nurses (LNs) to certified nurse aide (CNA) coworkers in the nursing home (NH). Using purposive sampling, we interviewed 12 LN and 12 CNA participants individually and as part of an LN/CNA caregiving pair. Semi-structured interviews were recorded, transcribed verbatim, and coded for meaning using NVivo software. LN and CNA participants described anticipated and unanticipated holistic support for CNAs. We applied the term undergirding to this phenomenon , and we present descriptions and examples of undergirding in nine categories: listen and respond, show respect, help with resident care and answer call lights, protect the CNA, support physical needs, and provide emotional support. Undergirding promotes work success for the CNA and the LN, as the LN job includes oversight of CNA responsibilities. Most notably, participants report undergirding facilitates high-quality resident care. These findings may be helpful for educators and administrators, but perhaps are most important for policymakers. CNAs need additional support to decrease turnover, improve retention, and elevate NH residents' quality of care. The study design identified and explored optimal collaboration as it is possible in the current NH setting. It does not represent all LN/CNA caregiving pairs.
Nursing Homes and COVID-19: Staff Experiences
Authors: Cimarolli Verena , Reinhardt Joann , Zimmerman Sheryl 
Published: December 2021

Abstract
Nursing homes (NHs) faced an unprecedented crisis during the rapid spread of COVID-19. This pandemic has had a devastating impact on both NH residents and workers who are often on the frontlines providing hands-on care. These workers are vulnerable to the health risks of COVID-19 due to daily exposure to residents with COVID-19, residence in areas with high infection rates, and challenges specific to low-income workers (e.g. reliance on mass transportation). Research has highlighted the experiences of NH workers during the pandemic to learn how to better support them now and during future pandemics. This symposium will add to this research and present new findings from studies conducted in the United States to capture the unique experiences of NH employees. First, Bryant illustrates specific COVID-19-related challenges that NH frontline workers faced and how these workers’ experiences compare to workers in other long-term services and support settings. Reinhardt reports findings from a qualitative study examining the multi-level challenges experienced by nursing assistants during the pandemic. Cimarolli examines if quality of employer communication and workers’ perceived COVID-19-related preparedness mitigate the impact of work-related stress on NH workers’ decision to resign. Franzosa shares recommendations based on priorities identified by nursing assistants and administrators to build future resilience based on lessons learned. Finally, Simpson identifies factors associated with states’ decisions to adopt COVID-19 testing mandates for workers in NHs. Dr. Zimmerman discusses study findings and their contributions for creating supportive NH work environments to ensure most optimal NH worker and resident quality of life.
Racism and the Life Course: Social and Health Equity for Older Black Americans
Authors: Chatters Linda , Taylor Harry , Taylor Robert 
Published: December 2021

Abstract
Racism and the Life Course: Social and Health Equity for Older Black Americans examines the impacts of systemic racism on adult development and the aging trajectories of Black Americans. Using the life course perspective (e.g., socio-historical events, linked lives), we discuss systemic racism as a structural driver of practices and policies (e.g., racial residential segregation) that have shaped the social and health circumstances of older Black Americans. These life circumstances include high rates of poverty, poor housing and neighborhood conditions, worse health profiles, and relationship loss and social isolation—conditions that, for too many older Black adults, represent the ‘normal’ state of affairs. Creating a ‘new normal’ of social and health equity for older Black Americans requires recognizing and disrupting the operation of systemic racism in our policies and practices. Selected recommendations and actions for achieving health and social equity for older Black Americans are discussed.
Sense of Purpose in Life Promotes Resilience to Memory Deficits Related to Depressive Symptomatology
Authors: Lewis Nathan , Hill Patrick 
Published: December 2021

Abstract
Individuals higher in depressive symptoms commonly present with neuropsychological deficits including poorer memory performance. Sense of purpose in life, a component of psychological well-being, has been shown to promote resilience to cognitive impairment in older adulthood, but it is unclear whether it may also protect against cognitive deficits associated with higher depressive symptoms. This study examined whether purpose in life moderated the effect of depressive symptoms on cognitive functioning in a large longitudinal study of 4599 American older adults (Mage = 74.33 years, range = 65–104 years, 56.84% female) across a 12-year follow-up period. Depressive symptomatology was assessed at each wave using the 8-item Center for Epidemiologic Studies Depression Scale. Multilevel models assessed the influence of depressive symptoms and the interaction with sense of purpose in life on changes in word recall and mental status. Higher depressive symptoms were associated with poorer recall at baseline, but not rate of change over time. A negative interaction was observed between sense of purpose in life and depressive symptoms such that individuals higher in purpose experienced a less negative impact of depressive symptoms on word recall. No significant interaction of sense of purpose and depressive symptoms was observed on mental status. Having a sense of purpose in life may help protect older adults from memory deficits associated with higher depressive symptoms. The present findings underscore the potential for sense of purpose to promote cognitive reserve in older adulthood, allowing individuals to maintain cognitive performance in the face of accruing neuropsychological challenges.
Feasibility and Considerations for Remote Interviewing of Persons Living With Dementia: Adaptations for COVID-19
Authors: Yonashiro-Cho Jeanine , Avent Elizabeth , Mosqueda Laura , Gassoumis Zachary 
Published: December 2021

Abstract
The continuing COVID-19 pandemic has necessitated changes to research protocols and approaches to mitigate health risks to both study participants and researchers. This is particularly true of studies exploring the biopsychosocial well-being and personal perspectives of older adults and those at elevated risk of COVID-19 complications. While videoconferencing platforms have enabled remote work and social activities, reliance on them may potentially exclude some individuals (e.g., those without digital devices, access to high speed internet or proficiency with technology). Persons living with dementia (PLWD) may experience difficulties navigating videoconferencing systems and building rapport with interviewers, though the inclusion of PLWD in research is necessary to ensuring their equitable representation. This presentation disseminates promising practices and lessons learned from a longitudinal study conducting remote interviews on sensitive topics with PLWD and their care partners (CP). Findings are drawn from a case study of the Better Together Dementia Care Study, an 18-month longitudinal study of PLWD (N=8) and their CPs (N=13), which implemented remote interviewing in Summer 2020 to gather data on the quality-of-life, resilience, relationship quality, adverse childhood experiences, mistreatment, and health status of PLWD. Researchers were able to interview most enrolled PLWD (n=7) via videoconferencing. Paper surveys were mailed to phone-interviewed participants, enabling them to view questions and answer choices in concordance with verbal queries. Researchers also tested a protocol asking CPs to leave the room while PLWD answered questions on sensitive topics. Findings support the use of remote interviewing with PLWD and provide insights to guide replication of these approaches.