bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaccine access shrinks disparities between long-term care and community rates of COVID-19 mortality.
Authors: Resciniti Nicholas , Kaplan Daniel , Sellner Joshua , Lohman Matthew 
Published: December 2021

Abstract
This longitudinal secondary data analysis examines differences in COVID-19 incidence and mortality among long-term care facility (LTCF) residents with those living in the community in South Carolina (SC) throughout the pandemic, including the time of vaccine availability. Data came from the SC Department of Health and Environmental Control (SCDHEC). Descriptive statistics and trends for cases of infections and deaths were calculated. Cox proportional hazards were used to compare COVID-19 mortality in LTC residents to community dwelling older adults, controlling for age, gender, race, and pre-existing chronic health conditions. Until early January of 2021, significantly greater incidence rates of infection (116.2 per 10,000 per month) and hazard of death after infection (HR=1.83, 95% CI: 1.70-1.98) were experienced among LTC residents as compared to older adults in the community even after statewide mask mandates and visitation guidance. Since vaccine availability, COVID incidence rates among LTC residents fell by half (59.5 per 10,000 per month after vaccines), and the relative hazard of death compared to older adults in the community was diminished (HR=1.44, 95% CI:1.29-1.61). Reducing the gap between LTCF and community-wide infection and mortality rates suggests that vaccination against COVID-19 is correlated with reduced disease spread in the greater community and in LTCF. Results indicate that policies and regulations addressing LTC resident and staff vaccination may effectively protect the most vulnerable older adults and the workforce providing their care while mask mandates and visitation guidance do not.
A Longitudinal Trajectory of Loneliness and the COVID-19 Pandemic Among the Oldest-Old Population
Authors: Cho Jinmyoung , Choi Shinae , Rahimighazikalayeh Gelareh , Martin Peter , Heinz Melinda , Ryou Yeon Ji 
Published: December 2021

Abstract
Loneliness is significantly associated with health and well-being among oldest-old adults. Due to the outbreak of the COVID-19, physical and social distancing policies might elevate loneliness among the oldest-old population. This study examined the trends and changes in the prevalence of feeling lonely using the 2020 HRS COVID-19 module merged to the 15 waves of the HRS RAND longitudinal datasets from 1992 to 2018. A total of 14,371 respondents, including 614 respondents aged 80 years and older were included. Generalized linear models compared age group differences within the 2020 module. Generalized estimating equations assessed the longitudinal change at the individual level and the trend of feeling loneliness among oldest-old adults from 1992 to 2020. Loneliness was assessed with one item of the CES-D scale (i.e., during the past week, felt lonely). After adjusting for demographic characteristics and health, the results showed that oldest-old adults were more likely to feel lonely compared to younger age groups (18% for 80’s vs. 14% for 50’s) during the early months of the pandemic. A longitudinal trajectory also showed that they feel lonelier than in prior years (19% in 2020 vs. 14% in 2018). However, compared to same-age groups from earlier years, a significantly lower prevalence of feeling lonely was observed (18% in 2020 vs. 27% in 1994). The results show that the outbreak of the COVID-19 may elevate feeling lonely, but the recent cohorts be less lonely than earlier cohorts. Future research should continue to explore protective factors for loneliness among oldest-old adults.
Advance Care Planning Among Healthcare Professionals During COVID-19
Authors: Hahne Jessica , Carpenter Brian 
Published: December 2021

Abstract
The COVID-19 pandemic is bringing healthcare professionals face to face with gravely ill patients in complex clinical situations. Caring for patients experiencing lengthy intubation, heavy sedation, rapid decline, and significant distress at the end of life has the potential to shift the perspectives of healthcare professionals regarding their own end-of-life care. This study explored advance care planning (ACP) among medical professionals and whether COVID-19 experiences altered their healthcare preferences and planning. Ninety-eight professionals (mean age = 45.6, 75% female) completed an online survey about ACP conversations, behavioral intentions to pursue ACP, openness to life-prolonging interventions, and ACP resource needs. ACP conversations were most extensive with spouse/partner (89% had talked about care preferences “some” or “a lot”) and to a lesser extent with parents (64%) and other healthcare providers (69%). Two-thirds (67%) of respondents had an ACP conversation since the start of COVID. Among respondents who had not completed ACP documents, 64% had taken some step toward ACP. When asked whether their preferences for life-prolonging medical interventions had changed, 70% reported no change, 16% reported being less open, and 14% reported being more open. A majority (60%) requested resources to help them pursue ACP on their own, although many (42%) were interested in assistance at their workplace. Given that only 37% of our sample had themselves completed an advance directive, our results suggest now may be a critical moment to engage professionals in ACP, considering how their experience during the pandemic has motivated ACP conversations and a reconsideration of preferences.
As Women Live Longer, What Do They Need Most?
Authors: Yahner Jennifer , Hussemann Jeanette 
Published: December 2021

Abstract
Women in the United States can live into their 80s, 90s, and even 100s—outliving men nearly five years on average. Over the next four decades, the number of women aged 85 years and older will nearly triple in size. Many will live alone and in poverty, with increasingly fewer supports on which to rely as they age. Although women can spend their lives caring for children, partners, and parents, often while working multiple jobs, as they grow older, many find their physical, emotional, and financial needs cannot be met. Using data recently collected for the Urban Institute’s EMPOWER: Building Late-Life Resilience study, with funding from the National Institute of Justice, we examine the needs of low-income women aged 85 years and older (N=35) living alone in Arizona communities. We explore issues of home safety perceptions and social isolation and study their relationship to women’s physical, emotional, and financial wellbeing.
Associations between PACS symptoms and risk factors among Long Haulers in the Rutgers Post-COVID Recovery Program
Authors: Dawson Alice , Hu William 
Published: December 2021

Abstract
At least 2/3 of people with mild to moderate COVID-19 infection will experience long-haul COVID symptoms that persist for weeks or months, however, risk factors that modify the likelihood that one develops these symptoms are unknown. Patients referred to the Post-COVID Recovery Program at Rutgers in New Brunswick (n= 108) through primary care referral or self-submitted online request and experiencing a wide variety of Post-Acute COVID-19 Syndrome (PACS) symptoms were stratified by those without self-reported cognitive complaints (n=54), those with self-reported cognitive complaints who scored well on cognitive testing (n=29), and those with self-reported cognitive complaints who scored poorly on cognitive testing (n=25). Comparisons between groups were made using ANOVAs and Chi Squared: for COVID-19 disease severity, COVID-19 disease treatment, comorbid COVID-19 symptoms during infection, comorbid PACS symptoms post-infection, pre-existing health conditions, levels of depression and anxiety, level of fatigue, and social determinants of health (access to healthcare, economic stability, housing stability). Preliminary analyses indicated that whereas people without complaints were normally distributed according to age (p&gt;0.200 for Kolmogorov–Smirnov test), people with complaints and deficits were skewed towards the older age group (p&lt;0.001 for K-S test) suggesting age to be a risk factor for cognitive impairment in PACS. Participants that reported cognitive complaints also reported increased symptoms of depression, anxiety, and fatigue, compared to participants without cognitive complaints. These data provide insight into associations between PACS symptoms and risk factors relevant in understanding this novel disease.
Associations of Adverse Childhood Experiences with Executive Function and Brain-Derived Neurotrophic Factor
Authors: Tsotsoros Cindy , Stout Madison , Hawkins Misty 
Published: December 2021

Abstract
Adverse childhood experiences (ACEs) may predict markers of neurocognitive performance (i.e., executive function; EF) and brain health/plasticity (i.e., brain-derived neurotropic factor; BDNF). This pilot examined the magnitude of effects between: 1) ACES and EF performance, 2) ACEs and BDNF levels, and 3) EF performance and BDNF levels. We hypothesize that higher ACEs will be associated with poorer EF scores and lower BNDF levels and that lower EF scores will be associated with lower BDNF levels. Given the pilot nature of the study, an emphasis is placed on effect size vs. significance. Participants were 36 middle-aged women enrolled in the NICE SPACES trial (age=31.4 years, BMI=34.2, racially minoritized=37.9%). ACES were quantified using the 10-item Adverse Childhood Experiences Scale. EF was measured using the fluid cognition composite from the NIH Toolbox – Cognition Battery. BDNF was estimated using proBDNF levels estimated from serum collected via venipuncture. Higher ACEs levels were not directly associated with EF scores (b = 0.03, p = .854); but did show a meaningful negative beta coefficient with BDNF levels (b = -0.34, p = .053). EF scores and BDNF showed a positive coefficient that did not reach significance (b = .26, p = .122). In a modest pilot of middle-age women, higher ACEs were associated with lower BDNF, indicating greater adversity in childhood is linked to lower neurotrophins levels in adulthood. The lower BDNF levels may help explain poorer performance on cognitive tasks. Larger follow-up studies in more powered samples are warranted given the size of detected coefficients.
Best Practices for Living Labs When Studying Older Adults Living in Rural Communities
Authors: Nakagawa Ashley , Freeman Shannon , Koopmans Alanna , Ross Chris , McAloney Richard 
Published: December 2021

Abstract
There are two core concepts that make living labs distinguishable: involvement of users as co-creators and evaluation in a real-world setting. Living labs increase the potential for product acceptance and adoption due to testing and tailoring with target users. Currently, there is a lack of a universally accepted guideline for best practices. The objective of this review is to identify the best practices of living labs that can be recognized by the scientific community and followed in future labs. A 5-stage scoping review, following Arksey and O’Malley’s (2005) framework, was used to map out the coverage of different aspects of living lab methodology. A systematic search for articles involving living lab framework and older adults published between 2016-2021, was conducted in seven databases. Nine articles were included after review, the majority of which were published in health journals and were from Italy and the United States. An overview of consistent user involvement in the innovation process, real-world testing vs. laboratory testing, and participant scope findings will be shared. Multiple rounds of user feedback, real-world testing, and a small but diverse participant group were the most successful in increasing positive sentiments about the products tested in a living lab environment. The lack of published articles on living lab frameworks studying older adults indicate a gap in the literature. Creating a universally accepted definition for living labs and guidelines for best practices will allow for scientific validity and comparisons of studies and may increase the use and popularity of living labs.
Delirium Duration Predicts 1-Month And 6-Month Mortality In Septic Patients From an Acute Geriatrics Unit
Authors: Mazzola Paolo , Zambon Antonella , Bellelli Giuseppe 
Published: December 2021

Abstract
Sepsis is highly prevalent in the older population compared to younger age groups. We showed that the SOFA score predicts the risk of death at 30 days in patients discharged from an acute geriatrics unit (AGU). We aim at comparing the ability of both delirium duration and SOFA to predict 1-month and 6-month mortality among septic patients. We performed an observational cohort study recruiting all patients consecutively admitted to San Gerardo hospital AGU (Italy) between March 2017 and January 2020, aged ≥70, who were diagnosed with sepsis according to 2016 Sepsis-3 criteria. All patients underwent a comprehensive geriatric assessment, including delirium twice a day with the 4AT. Outcomes were 1- and 6-month mortality rates. From 3,326 hospitalized patients, 235 were included in the study (median age 84 years, 42% females). Delirium accounted for 71.9% (169 patients, median duration 3 days). One-month and 6-month mortality rates were 32.3% and 55.3%, respectively. Age, albumin, hemoglobin, and PCR levels were associated with mortality and included as covariates in our Base Model. We performed pairwise comparison between c-indexes of the Base Model vs. Base+delirium duration (days) vs. Base+SOFA. The increment of predictive performance of model including delirium duration was statistically significant (c-index: 0.67 vs. 0.75 when considering 1-month mortality; 0.70 vs. 0.75 for 6-month mortality). Base+delirium duration performed better than Base+SOFA, but the difference not significant. Delirium duration performs as well as SOFA score in predicting 1- and 6-month mortality, with practical implications for the management of these patients in the continuum of care.
Disability & Sleep Quality of Custodial Grandparents During Fall 2020 of the COVID-19 Pandemic
Authors: Mayfield Kellie , Clark Karen , Anderson Raeda 
Published: December 2021

Abstract
Disability of custodial grandparents, grandparents who are the primary caretakers of their grandchildren often in parent absent households, are not frequently examined. One in four adults in the U.S. lives with a disability with the highest percentage of disabilities reported in the South. Quality sleep is integral for overall wellbeing and is altered with age. Sleep complaints of older adults are associated with multiple adverse health outcomes such as dementia, stroke and obesity. The objective of this study was to examine the relationship between disability and sleep quality amongst custodial grandparents during the COVID-19, Fall 2019 in Georgia. Thirty-four custodial grandparents were recruited from the Georgia Division of Aging Kinship Care Support Groups, ages 42 to 78, with most identifying as African American. Disability status and the Pittsburgh Sleep Quality Index were measured. Results showed a significant negative relationship for custodial grandparents’ disability status and sleep quality (χ2= 9.167, p=0.027; Γ=-0.683, p=0.002), sleep disturbance (χ2= 12.150, p=0.002; Γ=-0.897, p&lt;.001), and use of sleeping medication (χ2= 9.645, p=0.022; Γ=-0.785, p&lt;.001). Custodial grandparents with a disability had worse sleep quality, more sleep disturbances, and took more sleeping medication compared to custodial grandparents without a disability. Results have implications for kinship care providers and medical practitioners when engaging with custodial grandparents about their health, disability and impacts on their sleep quality.
Effects of a multiple chronic condition (CC) remote monitoring program on clinical outcomes among older adults
Authors: Dzubur Eldin , Yu Jessica , James Roberta , Hoffman Julia , Shah Bimal 
Published: December 2021

Abstract
Older adults are faced with an increased risk of comorbid chronic disease such as diabetes. While multiple health behavior change interventions (MHCIs) are known to improve clinical outcomes more than targeted interventions, less is known whether such effects persist in older populations. The objective of the study was to examine the effects of multiple chronic condition (CC) remote monitoring program enrollment and mental health program enrollment on glucose and blood pressure reduction, adjusting for self-monitoring behaviors. In a sample of 594 older adults (age 55+, 14% 65+ years, 46.8% female) evaluated over a 12-month period, statistical models showed that older adults with uncontrolled diabetes (A1c &gt;= 7.0%) had a 7.9 pt. reduction in blood glucose for each additional program enrolled and a 22.7 pt. reduction in blood glucose when enrolled in mental health compared to those not enrolled. Similarly, older adults with uncontrolled hypertension (BP &gt;= 130/80) had a 4.8 pt. reduction in systolic blood pressure for each additional program enrolled and a 7.2 pt. reduction in systolic blood pressure when enrolled in mental health compared to those not enrolled. The findings indicate the potential for multiprogram digital health interventions that incorporate mental health to further improve clinical outcomes in older adults suffering from multiple chronic diseases, namely diabetes and hypertension.
Examining Different Types of Sleep Among Custodial Grandparents During COVID-19
Authors: Clark Karen , Mayfield Kellie , Anderson Raeda 
Published: December 2021

Abstract
Sleep is associated with healthy living. With increased age, sleep is harder to initiate and maintain. Currently, over two million grandparents have become primary caregivers to their grandchildren and are at risk for poor sleep outcomes. Research shows that grandparent caregivers are at risk for depression due to poor sleep quality. Thus, this study aimed to identify the sleep quality of custodial grandparents to gain a better understanding of sleep patterns during COVID-19 in 2020. Thirty-four custodial grandparents were recruited from the Georgia Division of Aging Kinship Care Support Groups from September through October 2020. Participants were between 42 to 78 years old with a mean age of 57. Participants completed the Pittsburgh Sleep Quality Index. Stata statistical software was used to analyze the relationship between the sleep quality subscales. Results showed a significant positive relationship for custodial grandparents between sleep quality and daytime dysfunction (χ2=25.993, p=0.002; Γ=0.495, p=0.039) as well as sleep quality and sleep disturbance (χ2=11.129, p=0.084; Γ=0.751, p&lt;0.001). There is a significant positive relationship between daytime dysfunction and sleep duration (χ2=14.984, p=0.091; Γ=0.681, p&lt;.001), where grandparents with daytime dysfunction have longer sleep duration. Findings suggest grandparents with poor sleep quality are more likely to experience daytime dysfunction and have more sleep disturbances in the COVID-19 environment. Our study will benefit researchers and practitioners caring for custodial grandparents and contribute to future research focused on custodial grandparents and sleep quality.
Loneliness and Isolation as Barriers to Mental Health Services in a Rural Community
Authors: Maiden Robert , Gagne Danielle , Hayslip Bert 
Published: December 2021

Abstract
As America grapples with COVID-19, issues regarding mental health have been of rising concern, particularly among those who are isolated. According to the May 2021 American Perspectives Survey, “Americans report having fewer close friendships than they once did, talking to their friends less often, and relying less on their friends for personal support1.” Additionally, 49% have three or fewer close friends in 2021, compared to 27% in 1990. 17% have no friends in their core social network. Loneliness has been associated with physical and mental health risks. We sought to explore whether loneliness was also a barrier to seeking mental health services. 90 surveys were collected from rural New York. Respondents were aged 51 to 90, Caucasian (96.6%), and female (73.3% vs, 26.7%). Overall, 34.8% said they lived alone. 29.2% would seek mental health services for feelings of loneliness, while 75.4% would do so if isolated from family. Those who felt detached or isolated from others were significantly less likely to seek help from a counselor (r = - 0.25) or MD (r = - 0.37). Isolation also negatively related to measures on the resiliency scale (Purpose: - 0.22, Perseverance: - 0.33, being ok alone: - 0.32), and positively related to depression (r = .65). Those scoring higher on the “okay with being alone” scale had an increased likelihood of seeking counseling (r = 0.22). Thus, isolation and loneliness are complex topics. Intervention ought to be based on perceptions of being alone. Further research is needed.
Measuring Mindfulness: Assessing the Utility of the FFMQ in the Older Veterans With Dementia and Their Caregivers
Authors: Clawson Brian , Block Phoebe , Durkin Daniel , Collins Amber , Jacobs Lindsey , Hilgeman Michelle 
Published: December 2021

Abstract
Mindfulness is increasingly popular as a low cost, convenient, and accessible way to address mental health and chronic health conditions. Despite its popularity, best practices in measuring mindfulness in clinical settings and intervention research are still being defined. The Five Facet Mindfulness Questionnaire (FFMQ-15) measures mindfulness traits; however, its use has been limited in older adults, those with dementia, and caregivers. Method: Caregivers (N=82) and veterans with dementia (N=62) enrolled in a randomized pilot intervention study completed the 15-item FFMQ at baseline, 6-month, and 12-month assessments. Veterans were mostly male (98%), White/Caucasian (65%), and living with a partner/spouse (79%). Caregivers (M=65 years old) were mostly female (89%) and White/Caucasian (66%). FFMQ response options were simplified to a 3-point Likert-scale for individuals with dementia (0=rarely true to 2=often true). Results: Internal consistency statistics (Cronbach’s alphas) at the scale-level were acceptable among caregivers at baseline and 6-months (.71-.75) but questionably reliable at 12-months (.59, N=46). For individuals with dementia, the simplified version of the FFMQ (with 3 response options) achieved questionable reliability at baseline (.57, N=56) and 6-months (.67, N=32), but improved to acceptable at 12-month assessments (.75, N=15), after significant attrition. Conclusion: Researchers should apply caution when using the FFMQ total score with caregivers and those with cognitive impairments. Though simplified response options eased administration, utility of the tool may be limited in those who are more impaired. Before mindfulness measures can be used meaningfully, reliability of available tools like the FFMQ-15 need to be examined in more diverse samples.