bluuebunny/crossref_metadata_2025_split huggingface dataset:
Energy Decline May Predict Mild Parkinsonian Signs in Community-Dwelling Older Adults
Authors: Ehrenkranz Rebecca , Tian Qu , Rosso Andrea , Glynn Nancy W , Chahine Lana , Hengenius James , Zhu Xiaonan , Rosano Caterina 
Published: December 2021

Abstract
Mild Parkinsonian Signs (MPS) are common in older adults without overt neurological disease. MPS are often progressive and predict disability and dementia, yet little is known about predictors for MPS. Low self-reported energy is associated with mobility impairment, which is a hallmark of MPS. Yet whether self-reported energy relates to MPS is unknown. We explored the association of changes in self-reported energy with MPS in 293 participants (aged 83 ± 2.8 years, 58% women, 61% White) free of dementia and Parkinson’s Disease in the Health, Aging and Body Composition Study. Self-reported energy was assessed on a 0-10 scale annually between Year 2 and Year 10 (mean follow-up: 8 years) and its slope was estimated via linear mixed effects models. MPS were evaluated at Year 10 based on the Unified Parkinson Disease Rating Scale motor component. On average, self-reported energy declined 0.06 points per year. In a linear regression model adjusted for age, fatigue, and comorbidities, those with MPS had steeper SEL decline (β [Standard Error] = -0.358 [0.119]) in the prior eight years than those without MPS. Thus, declining self-reported energy may be a risk factor for MPS. Self-reported energy is easily evaluated in routine clinic visits, and may be a modifiable risk factor that can be targeted to reduce the incidence of MPS.
Patient Cognitive Impairment Associated With Greater Care Intensity During Medicare Home Health Care
Authors: Burgdorf Julia , Bowles Kathy 
Published: December 2021

Abstract
Medicare beneficiaries with cognitive impairment are more likely to access home health care than those without such impairment, and an estimated 1 in 3 Medicare home health patients has diagnosed dementia. However, recent changes to the Medicare home health payment system do not adjust for patients’ cognitive impairment. To the extent that cognitive impairment prompts higher intensity care, this could create a financial disincentive for providers serving this patient population. We draw on a nationally representative sample of 1,214 (weighted n=5,856,333) community-living Medicare beneficiaries who received home health care between 2011-2016. We measure care intensity by the number and type of visits received during an index home health care episode. We model care intensity as a function of patient cognitive impairment during the episode, measured via clinician reports in standardized patient assessment data. In propensity score adjusted, multivariable models holding all covariates at their means, home health patients with identified cognitive impairment received a significantly greater number of visits. During the index home health episode, cognitively impaired patients received an additional 2.82 total visits (95% CI: 1.32-4.31; p&lt;0.001), 1.39 nursing visits (95% CI: 0.49-2.29; p=0.003), 0.72 physical therapy visits (95% CI: 0.06-1.39; p=0.03), and 0.60 occupational therapy visits (95% CI: 0.15-1.05; p=0.01). Findings suggest that recent changes to Medicare home health care reimbursement do not reflect the more intensive care needs of patients with cognitive impairment, and may threaten access to care for these individuals.
Deploying Implementation Strategies to Facilitate Professionals’ Use of the Home Care Frailty Scale
Authors: Juckett Lisa , Oliver Haley , Bunck Leah , Kurzen Crystal , Devier Andrea , Page Fannisha 
Published: December 2021

Abstract
Home- and community-based service (HCBS) organizations play an instrumental role in maximizing the independence of older adults, ages 60 and over. HCBS clients typically have multiple health complications, placing them at great risk of frailty—a complex condition associated with health decline and institutionalization. However, despite their frequent contact with older adults, HCBS professionals are not required to assess the frailty levels of their clients, creating a missed opportunity to monitor the needs of this at-risk population. The purpose of this quality improvement study was to test a package of five implementation strategies designed to support HCBS professionals’ use of the evidence-based Home Care Frailty Scale (i.e., Frailty Scale) with all new clients at one large HCBS organization. Implementation strategies included (a) selecting one professional to serve as the organization’s Frailty Scale “champion,” (b) holding three training sessions with 25 HCBS professionals, (c) modifying client charts to allow professionals to document Frailty Scale results, (d) pilot testing the Frailty Scale with a small group of clients, and (e) completing monthly chart audits to monitor rates of Frailty Scale implementation. During the first three months of Frailty Scale use, HCBS professionals administered the Frailty Scale to 414 out of 467 eligible clients (88.6%). For Month 1, 87.4% of eligible clients were administered the Frailty Scale, followed by 90.8% in Month 2, and 85.6% in Month 3. This quality improvement study suggests that a multifaceted package of implementation strategies can support professionals’ use of an evidence-based frailty instrument in the HCBS setting.
Decoding TikTok: Utilizing Social Media for Difficult Conversations About Ageism
Authors: Bouchard Lauren 
Published: December 2021

Abstract
Understanding ageism is a key aspect of gerontological curriculum. Media examples (e.g., television and movies) can be effective tools, and yet gerontological educators should stay updated on new media trends to encourage student interest. This presentation will explore a new social media application (i.e., TikTok) to help students recognize and dismantle their own ageist beliefs. The presenter will describe and explain the classroom activity, instructions for finding and downloading content, as well as the social media application itself. In this activity, students brainstorm their preconceived notion of older adults to catalyze open discussion regarding societal beliefs. Next, a few video examples, with both positive and negative portrayals of older adults are presented for discussion. Students may also bring other examples for participation credit to this class. This symposium presentation will include an interview activity guide, additional breakout group instructions, and other tips for creating impactful class discussion on ageism.
Memory Problems During COVID in Low-Income Older Adults
Authors: Zanjani Faika 
Published: December 2021

Abstract
Prevention, with widespread lifestyle risk reduction at the community-level, is considered an effective method to decrease Alzheimer’s disease (AD). Diverse low-income older adults in Virginia managing either diabetes/cardiovascular symptoms, were offered weekly lifestyle telephone-health coaching for 12-weeks, providing education, motivations, self-efficacy, and referral services for AD lifestyle risk. Participants provided positive anecdotal feedback and the need for continued health coaching during COVID-19. Thirty participants (predominantly African American/Black female) consented for continued health coaching during the pandemic with 47% reporting memory problems. Findings indicated poorer health status associated with reporting memory problems for poor physical health days, poor mental health days, total mental/physical health poor days, sad days, worried days, tired days, feelings of emptiness, feelings of rejection, feelings of failure, little interest/pleasure, and feeling down. This preliminary work creates the impetus for future large-scale AD prevention investigations to improve the lives of AD-risk, low-income, diverse older adults reporting memory problems.
Transparency, Documentation, and Open Science
Authors: Isaacowitz Derek 
Published: December 2021

Abstract
Some GSA journals are especially interested in promoting transparency and open science practices, reflecting how some subdisciplines in aging are moving toward open science practices faster than others. In this talk, I will consider the transparency and open science practices that seem most relevant to aging researchers, such as preregistration, open data, open materials and code, sample size justification and analytic tools for considering null effects. I will also discuss potential challenges to implementing these practices as well as reasons why it is important to do so despite these challenges. The focus will be on pragmatic suggestions for researchers planning and conducting studies now that they hope to publish later.
Oral Health, Cognitive Function, and Mortality: Findings From National Surveys
Authors: Wu Bei , Keepper Susie , Saunders Michele 
Published: December 2021

Abstract
Poor oral health, diabetes mellitus (DM), and cognitive impairment are common problems in older adults. Using national surveys, this symposium aims to present new findings regarding the impact of the co-occurrence of DM and poor oral health on cognitive function, cognitive decline, and mortality. This symposium will also cover the topic of dental care use among adult populations in the U.S. Using data from the Health and Retirement Study (HRS) (2006- 2018), the first study shows that adults with both DM and edentulism had the worst cognitive function, followed by those with edentulism alone, and those with DM alone. Using the same HRS data, the second study found that co-occurrence of DM and edentulism had a higher risk of more rapid cognitive decline with advancing age than the presence of each condition alone. The third study used data from the 2006-2016 HRS linked with mortality files, and revealed that the risk of diabetes and edentulism on mortality may vary across racial/ethnic groups. Using the Behavioral Risk Factor Surveillance System survey (2002-2018), the fourth study examined disparities of dental service utilization among racial/ethnic groups (Whites, Hispanics, Blacks, Asians, American Indians or Alaska Natives, and Native Hawaiian or other Pacific Islanders). Age differences in dental services were also compared between older adults and other younger and middle-aged populations. This symposium highlights the role of oral health in improving cognitive health. Policies and programs are needed to increase dental care access, a critical way to help maintain good oral health.
Longitudinal Association Between Perceived Fatigability and Brain Volumes in Community-Dwelling Older Adults
Authors: Schrack Jennifer , Liu Fangyu , An Yang , Wanigatunga Amal , Gross Alden , Simonsick Eleanor , Ferrucci Luigi , Resnick Susan 
Published: December 2021

Abstract
Perceived fatigability is linked to declining physical and cognitive performance, yet whether fatigability reflects early subclinical change in brain structure is unknown. Using mixed effects models, we assessed the longitudinal association of 3T MRI-derived brain volumes with perceived fatigability after a 5-min treadmill walk (0.67 m/s, 0% grade) using the Borg Rating of Perceived Exertion scale (range 6-20) in 802 BLSA participants (age 68.2+/-12.4 years, 45% men 66% White). In models adjusted for intracranial volume, demographics, chronic conditions, and CESD score, declining gray matter volumes in the frontal (β=-0.01) and temporal (β=-0.02) lobes, as well as the hippocampus (β=-0.25), precuneus (β=-0.10) and thalamus (β=-0.19) were associated with higher fatigability. Larger ventricular volumes were also associated with higher fatigability (β=0.02). Brain atrophy, particularly in gray matter and the hippocampal region, is longitudinally associated with increased fatigability in cognitively normal older adults, making it a potential marker of brain atrophy.
Monitoring the Effectiveness and Safety of ARNI vs. Angiotensin Receptor Blocker by Frailty Status
Authors: Kim Dae , Patorno Elisabetta , Gopalakrishnan Chandrasekar 
Published: December 2021

Abstract
Using Medicare data 2015-2017, we conducted 5 sequential 1-to-1 propensity score-matched analyses of ARNI initiators and angiotensin receptor blockers (ARB) initiators, mimicking the accrual of new data every 6 months. Primary effectiveness endpoint was a composite of heart failure hospitalization or all-cause mortality and primary safety endpoint was a composite of hospitalization or emergency department visits for hypotension, acute kidney injury, hyperkalemia, and angioedema. Among non-frail patients (n=5,014), the rates (per 100 person-years) for ARNI vs ARB were 12.7 and 9.2 (rate difference: 3.4, 95% CI: 0.8 to 6.1), respectively, for the effectiveness endpoint and 5.2 and 3.6 (rate difference: 1.5, 95% CI: -0.1 to 3.2), respectively, for the safety endpoint. Among frail patients (n=2,694), the corresponding rates were 19.8 and 21.6 (rate difference: -1.8, 95% CI: -7.0 to 3.4) for the effectiveness endpoint and 10.9 and 8.0 (rate difference: 2.9, 95% CI: -0.6 to 6.4) for the safety endpoint.
Life Course Stressors and Functional Limitations in Later Life Among White, Black, and Hispanic Adults
Authors: Sauerteig Madison , Ferraro Kenneth , Bauldry Shawn 
Published: December 2021

Abstract
Although striking racial and ethnic disparities in health are manifest during later life, they may be rooted in early-life exposures. Drawing from cumulative inequality theory, we investigate whether experiencing life course stressors increases the risk of later-life functional limitations and whether this relationship differs by race and ethnicity. This study utilizes longitudinal data from the Health and Retirement Study to test whether six indicators of child stressors and eleven indicators of adult stressors predict trajectories of the onset and severity of functional limitations in later life among a diverse sample of adults. We find that child and adult stressors are associated with earlier onset and greater severity of functional limitations during later life. Mediation analyses reveal the indirect influence of child stressors via adult stressors on onset and severity of functional limitations; however, the indirect effects are slightly stronger for Black and Hispanic adults than their White counterparts (i.e., moderated mediation). In sum, child stressors, in and of themselves, do not increase functional limitations among Black and Hispanic people but are associated with greater adult stress exposure, leading to more functional limitations in later life. Disparities in functional limitations are also partly due to lower education and less wealth among Black and Hispanic adults.
Uncovering Pet Issues: A Survey of Professionals Working With Older Adults and Care Partners
Authors: Bibbo Jessica , Johnson Justin , Drost Jennifer , Sanders Margaret 
Published: December 2021

Abstract
Pets can play an important role in older adults’ health behaviors and decisions. However, the degree to which these issues are encountered or addressed by professionals working with this population remains unknown. An interdisciplinary (e.g., healthcare, social services) sample of professionals (N=72, 93.05% female, Mage=48.82, SDage=12.57) completed an online survey focused on the pet ownership issues they have encountered while working with older adults, persons with dementia, and care partners. The professionals (n=66) estimated 42.86% of their clients had been pet owners, and 45.58% regularly asked their clients about pets. Issues raised to the professionals varied by type of client. Older adults most often brought up exercising the pet, routine veterinary care, and the financial aspect of ownership (all 37.50%). Persons with dementia most often discussed accessing pet care items (12.50%), exercising the pet (9.72%), and basic pet care (8.33%). Care partners brought up basic pet care (33.33%), planning for the pet due to their care recipients’ housing transition (26.38%), and exercising the pet (25.00%). Professionals reported talking to clients about planning for the pet due to housing transition, concerns about falling, and concerns about the pet’s behavior (all 31.94%). The professionals (n=69) were very favorable toward pet ownership in general (M=4.43, SD=0.78) (1=extremely unfavorable, 5=extremely favorable), less favorable about older adult pet ownership (M=4.15, SD=0.72, p=.002), and even less favorable about persons with dementia owning pets (M=3.51, SD=0.93, p&lt;.001). The results provide evidence that pet ownership issues are likely encountered in geriatric service settings and may shape healthy aging.
Preferred Communication Channels Among Older Adults During COVID-19
Authors: Der Ananian Cheryl , Doebbeling Brad , Mejía G Mauricio , Wine Hallie , Houchins Michelle , Infurna Frank , Pishko Claire 
Published: December 2021

Abstract
Social distancing measures put in place during the COVID-19 pandemic limited in-person interactions and may have increased the risk for social isolation and loneliness in older adults. Purpose: The purpose of this study was to understand the communication channels used by older adults (age 50+) during the COVID-19 pandemic to mitigate social isolation and loneliness. Methods: Older adults (n=22) who were selected from a longitudinal study, ‘Aging in the time of COVID,’ and who had self-reported they successfully avoided loneliness, participated in a semi-structured online interview. Participants were asked to describe the communication techniques and efforts they used to stay connected to family and friends during the pandemic. All interviews were recorded and transcribed verbatim. A thematic analysis approach was used to identify common approaches. Results: Participants were primarily female and white (100%) with a mean age of 64.7 years. Preliminary findings (n=5) suggest older adults relied heavily on technology to facilitate communication with family and friends including texting, phone calls, email, video calls or conferences (e.g., Zoom), WhatsApp and social media, primarily Facebook. In-person communication strategies, including one-on-one and small group gatherings following social distancing guidelines, were preferred, but used less often than technology-based approaches. Living close to friends and family, and previous experience with technology were facilitators. Competing work and family demands, distance, and technology challenges limited communication. Conclusions: While older adults may adopt technology at a lower pace, they relied on digital communication technology to maintain social connections during COVID.
Learn, Engage, and Act to Advance Age Inclusivity in Higher Education
Authors: Montepare Joann 
Published: December 2021

Abstract
Shifting age demographics are reshaping our social structures with far-reaching implications for higher education. Aging populations mean more older adults are looking to higher education to meet their professional needs and personal interests, and the longevity economy is calling for a trained workforce to provide services to support the health and functioning of individuals as they age. As well, there is a need to improve students’ aging literacy, along with developing synergistic age-friendly campus-community partnerships to address aging issues. How can institutions explore, create, develop, and sustain more age-friendly programs, practices, and partnerships? This presentation will introduce the toolkit specially designed by the GSA-AGHE Workgroup for use by faculty, students, administrators, and other campus leaders, and will provide an overview of the Age-Friendly University (AFU) initiative and its 10 guiding principles for creating more age-inclusive campuses.
Positive Psychology and Disability Studies: Directions for Research on Aging With IDD
Authors: van Heumen Lieke , Heller Tamar 
Published: December 2021

Abstract
This presentation outlines future directions for research on aging with intellectual and developmental disabilities (IDD) informed by positive psychology and disability studies theory. Research on aging with IDD often focuses on losses in functioning that come with age and on ways to prevent such decline. When applying a positive psychology lens to the experience of aging with IDD the focus shifts to determinants of positive emotions and strength and on ways of increasing meaningfulness in life as one ages. A positive psychology lens also relies on the assumption that people can self-direct and organize their lives, which is essential for individuals aging with IDD who historically have lacked opportunities to exercise self-determination. Positive psychology as applied to disability aligns with disability studies perspectives that emphasize that different ways of being in the world can be ‘sources of knowledge, satisfaction, creativity, and happiness’ (Chivers, 2011 p.9).
Brief Alcohol Interventions With Older Adults: Results of a Systematic Review of Literature
Authors: Lemieux Catherine , Purser Gregory 
Published: December 2021

Abstract
Older persons are especially vulnerable to the negative effects of alcohol misuse. National reports show that the older-adult population is the least likely group to perceive a need for treatment and be screened for alcohol-related problems. Little research has examined the impact of brief interventions on different drinking outcomes in at-risk older adults. To address this gap, the current study sought to systematically review empirical literature examining the effectiveness of brief alcohol interventions (BAI) implemented with adults (≥50) engaged in at-risk drinking. The authors developed specific a priori inclusion criteria (e.g., alcohol-related outcome measures, randomized controlled trials, RCT) before beginning the search process. Key terms were entered into 9 databases to yield an initial pool of 5,909 articles, from which 5,572 were excluded. A total of 337 articles remained, from which an additional 89 were excluded. Next, the authors independently reviewed 248 full-text, empirical articles and subsequently excluded 237 that did not satisfy inclusion criteria. Thus, the current systematic review yielded 11 studies representing RCT or experimental designs that employed random assignment. Findings of the review indicated that 7 (63.6%) studies showed a positive effect, with only 1 showing no positive effect of the intervention. For the remaining 3 (27.2%), the positive effect of the intervention was not conclusively determined due to study design issues. Overall findings suggest that BAI are effective in reducing alcohol consumption in the older-adult population. Additional evidence is needed to further knowledge consistent with recent initiatives (e.g., Age-Friendly Health Systems, 4Ms) that promote healthy aging.