bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differences in the Racial Contribution of Dementia and Chronic Conditions to Hospitalization, SNF Admission
Authors: Allore Heather 
Published: December 2021

Abstract
We estimate the contribution for experiencing hospitalization, skilled nursing facility admission and mortality using a measure of attributable fraction that incorporates both the prevalence, incidence and risk called Longitudinal Extension of the Average Attributable Fraction (LE-AAF). We estimate the LE-AAF for Non-Hispanic whites and Non-Hispanic Blacks for dementia and 10 chronic conditions, for three outcomes. This approach analyses the temporal relationships among conditions to estimate their population-level average attributable fractions. Unlike standard measures of attributable fraction, the sum of the contribution of each condition based on the LE-AAF will not exceed 100 percent, enabling us to compute the contribution of pairs, triads or any combination of conditions. Furthermore, in studying multimorbidity, the LE-AAF has the desirable feature of being based on all combinations of the risk factors and covariates present in the data with final values for the individual LE-AAFs obtained by averaging across these observed combinations of predictors.
Longitudinal Effects of Stress and Cognitive Fusion in Anxiety and Depressive Symptoms of Family Caregivers
Authors: Barrera-Caballero Samara , Carlos Vara-García Rosa Romero Moreno , Olazarán Javier , Pedroso Chaparro María del Sequeros , Jiménez-Gonzalo Lucía , Fernandes-Pires José Adrián , Losada-Baltar Andrés 
Published: December 2021

Abstract
Dementia caregiving has been commonly associated with negative psychological consequences in caregivers. Cognitive fusion, that is, the tendency for been overly influenced by cognition, has been linked to psychological distress in caregivers in cross-sectional studies. Female caregivers and those who are exposed to more stressors such as behavioral and psychological symptoms of dementia report higher levels of distress. However, longitudinal analysis of predictors of caregivers levels of distress are sparse, with no available study analyzing the longitudinal effect of cognitive fusion. The aim of this study is to analyze the longitudinal effect of cognitive fusion in depressive and anxiety symptoms of family dementia caregivers, after controlling for other relevant variables. Face to face interviews were conducted each year through a two-year period (three assessments) with 143 caregivers. Linear mixed models analysis were used to analyze the associations between time-varying values for cognitive fusion, frequency and reaction to care-recipient behavioral problems and depressive and anxiety symptoms, after controlling for caregivers’ age and gender, daily hours and time caring, care-recipient functional capacity and caregivers’ transitions (cessation of caregiving). Results suggest that increases in cognitive fusion and in reaction to behavioral problems, being a female caregiver and being younger, significantly predicted increases in anxiety symptoms over time. Also, increases in cognitive fusion and in reaction to behavioral problems, decreases in care-recipient’s functional capacity and ending of the caregiving role significantly predicted increases in depressive symptoms. Psychological strategies aimed at reducing cognitive fusion and stress levels may be especially helpful for reducing caregivers’ distress.
Met and Unmet Needs of Cognitively Impaired Older Adults and Burden and Benefits of Their Caregivers
Authors: Sung Pildoo , Suen Johan , Hashim Nawal , Malhotra Rahul , Chan Angelique 
Published: December 2021

Abstract
Previous studies typically assess caregiver needs when trying to interpret caregiver burden. We propose that both met and unmet needs of care recipients translate into different caregiving experiences with varying levels of benefits and burden combined. We use data on 263 caregivers of community-dwelling Singaporean older adults with cognitive impairment who participated in a community-based dementia care study conducted in 2018-2020. Our analysis produces three major findings. First, latent class analysis identifies three distinct types of caregiving experience based on caregiver-reported burden and benefits of caregiving: intensive (high burden and high benefits, 11% of caregivers), satisfied (low burden and high benefits; 54%), and dissatisfied (low burden and low benefits; 35%). Second, multinomial logistic regression shows that both met and unmet needs of care recipients are positively associated with the intensive caregiving experience, while only met needs are positively associated with the satisfied caregiving experience, in comparison to dissatisfied caregiving experience. Third, met needs in the areas of daytime activities, memory assistance, and mobility are positively related to the satisfied caregiving experience, compared to the dissatisfied caregiving experience. In other words, caregivers are more likely to be satisfied in their caregiving experiences (i.e., low burden and high benefits) if their care recipients’ problems with memory, mobility, and finding suitable and adequate daytime activities are properly managed. Our findings thus call for interventions to fulfill care recipients’ needs in a more tailored manner in order to increase satisfaction among caregivers.
Preliminary Findings of a National Survey of Black ADRD Family Caregivers
Authors: Robinson-Lane Sheria , Johnson Florence , Mazzara Nicholas , DeMarco Kayla , Dinov Ivaylo 
Published: December 2021

Abstract
The National Caregiver Survey aims to capture a representative sample of Black Alzheimer’s disease and/or related dementias (ADRD) family caregivers who are 55+ to better understand the relationships between adaptation to caregiving, coping, and health. Following targeted social media marketing, ADRD family caregivers (n=60) completed an electronic survey capturing over 200 data elements. Analysis was completed using Spearman correlation coefficients. Preliminary results suggest that 55% of participants were hypertensive (n=33) and 27% (n=16) had diabetes. Participants were generally overweight with an average BMI of 29. 28% (n=17) of the sample were smokers. A negative correlation was identified between the level of care needs of the recipients (IADLs) and alcohol use (p=0.037). There was also a correlation between identifying positive aspects of caregiving and adaptive coping (p=0.045). Caregiver support programs should facilitate development of effective coping strategies for new family caregivers, with particular attention on smoking cessation, brain-healthy diet, and exercise.
Racial Differences in the Pathway to Diagnosis of Alzheimer's Disease and Related Dementias
Authors: Xu Hanzhang , Burke James , Dupre Matthew , Min Se Hee , Anderson Ruth , Page David , Ostbye Truls 
Published: December 2021

Abstract
This study examined differences in the pathway to diagnosis of Alzheimer's disease and related dementias (ADRD) between Black and White older adults. Using electronic health records from a large health system, we included 2,085 non-Hispanic Black and 6,269 non-Hispanic White older adults with a final/primary diagnosis of ADRD between 2014 and 2020. Black older adults were more likely to receive the ADRD diagnosis from a primary care provider (35.4% vs. 29.8%), during a hospital admission (19.5% vs. 13.6%), or during an emergency department visit (4.2% vs. 2.0%); but were less likely to be diagnosed by an ADRD specialist (31.6% vs. 45.2%). Black older adults had nearly twice as many clinical encounters in the two years prior to the ADRD diagnosis than their White counterparts (43 vs. 26). Despite having more clinical encounters, Black older adults were more likely to be at a later stage when diagnosed than White older adults.
Older Adult Health and Remission of Risky Drinking and Alcohol Use Disorder: A Lifespan-Developmental Study
Authors: Lee Matthew , Yeung Ellen , Kwan Thomas , Sher Kenneth 
Published: December 2021

Abstract
Older-adult drinking is a growing public-health concern. As part of a larger project investigating older adulthood by contrasting this with other adult developmental periods, this study used longitudinal U.S.-representative data to test bidirectional associations between drinking and health, emphasizing aging-related health concerns as potential mechanisms of remission from risky/problem drinking. In multiple-group cross-lag models, we found that effects of poor self-reported health on drinking reductions increased with age, reached significance around midlife, and were strongest in older adulthood. However, a caveat revealed by additional Markov transition models was that these effects did not extend to relatively severe older-adult drinkers (indexed by DSM-5 AUD). In some instances, poor health even predicted less older-adult AUD remission. Altogether, findings support the notion of aging-related health concerns as important mechanisms of older-adult drinking reduction; but highlight a need to understand barriers to these mechanisms among severe older-adult drinkers, in part toward guiding lifespan-developmentally-informed interventions.
Presidential Symposium: Disruption to Transformation of Communities of Care: Key Issues and Opportunities in Health Sciences
Authors: Mueller Christine , Corazzini Kirsten , Wolff Jennifer 
Published: December 2021

Abstract
Consistent with the theme of the conference this year, this symposium explores the impact of the pandemic and our commitment to redress structural racism and health inequities on health of older adults, and our collective capacity to transform and innovate through our gerontological health sciences lens. Each presenter will focus on one sector of care: (1) the health system and healthcare workforce; (2) older persons; and (3) families and care partners. The first presenter provides a systems-level perspective on key disruptors in healthcare systems for care of older adults and the workforce, and emerging innovations to address increasingly transparent care inequities. Emerging research implications as a result of these disruptions will be highlighted. The second presenter highlights how the predominant features of the pandemic in older adults, loneliness and isolation, are co-occurring with significant resilience and innovation, and the resultant potential to create a paradigm shift in how we design and advance communities of care. The third presenter provides the perspective of family members and care partners of older adults during the time of the pandemic, focusing on disruptions that have informed changes going forward, innovations that have emerged, and implications for research to be addressed. Our discussant situates the presentations within the larger context of ‘the new normal’, with a particular focus on considering the global, inter-connected context of communities of care, a commitment to reducing inequities for older adults, and implications for health sciences education and policy.
Innovation During Disruption: Supporting What Matters Most to Older Adults Through Person-Environment Fit
Authors: Szanton Sarah 
Published: December 2021

Abstract
The fragile and improvised systems of care for older adults have been decimated by isolation and fragmented care during the pandemic. However, innovations are increasingly being offered to older adults to improve the fit between them and their environment. This includes fit within the home, the social environment, the policy environment, and with clinicians. Advancing these “fits” requires evidence-based solutions like CAPABLE, a 4 month self-efficacy and function program that provides an occupational therapist, nurse and handyworker to assess and address older adults’ functional goals. The older adult identifies what matters most and experiences a tailored program that taps into their purpose in life and supports engaging in meaningful activities. Starting in research sites, CAPABLE is now offered in 34 sites in 17 States and expanding through policy and insurers. Such efforts to leverage the strength of older adults and their families, builds capacity to evolve our communities of care.
Social Engagement and Well-Being Among Chinese Older Adults
Authors: Zhang Wei , Wu Bei , Wu Yan Yan 
Published: December 2021

Abstract
Social engagement is increasingly recognized as a protective factor to promote healthy aging. This symposium provides new findings on social participation and social isolation in relation to individuals’ health and well-being among the Chinese populations. Using the 2002¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬¬–2018 Chinese Longitudinal Healthy Longevity Survey, the first study examined the trends of leisure activity engagement among young-old adults aged 65–74 in China over a 16-year period. Findings revealed a general downward trend of engaging in any form of social leisure activity and upward trends for engaging in home-bound and solitary leisure activities. Similarly, the second study examined social participation patterns and individual factors associated with these patterns using three nationally representative data in China, UK, and US. Their findings highlighted several underlying participation patterns across these nations as well as differences in how socio-demographics were associated with these patterns. Using data collected among Chinese older adults in Hawaii, the third study examined the associations of social isolation with psychological well-being. Results showed that social isolation was positively related to psychological distress, and negatively related to life satisfaction and happiness. These associations were partially mediated by resilience. Their findings revealed the detrimental health effects of social isolation. Using the same dataset in Hawaii, the last study examined the associations between neighbourhood conditions and psychological well-being for Chinese older adults. Their findings revealed that both physical and social neighbourhood conditions were associated with psychological well-being, particularly for foreign-born older adults, and psychological resources such as self-management abilities could mediate the associations.
Correlates of Social Isolation Among Minority Older Adults During the COVID-19 Pandemic
Authors: Adepoju Omolola , Howard Daniel , Smith Kendra , Herrera Luz , Han Daikwon , Woodard LeChauncy 
Published: December 2021

Abstract
Background: Over the past year, engagement with older adults has been severely curtailed given the high rates of COVID-19 morbidity and mortality in this population. This study examined the correlates of social isolation among African American and LatinX older adults during the COVID-19 pandemic. Methods: Working with community-based organizations and senior living centers, we administered a survey to older adults 55+, in the Houston metroplex, between 11/2020 and 01/2021 (n=575). The survey assessed COVID-19 prevention behaviors and health-related social needs. Responses to “How often do you feel lonely or isolated from those around you?” were used to create a dichotomous social isolation dependent variable. The main independent variable, family/community support, was based on responses to the validated question "If for any reason you need help with day-to-day activities such as bathing, preparing meals, shopping, managing finances, etc., do you get the help you need?" Multivariate logistic regression adjusting for socioeconomic status, medical conditions, positive COVID test (for self or family), COVID-19 prevention behaviors, and emergency preparedness levels was used. Results: Limited family/community support was strongly associated with social isolation (OR=6.2; p&lt;0.01), as was having any chronic condition (OR=2.9, p=0.02). Females and seniors who reported daily social distancing were more likely to report being socially isolated (OR=2.4, p=0.04; OR=1.09; p=0.09, respectively). Of all chronic conditions examined, diabetes was the single strongest predictor of social isolation (OR=2.49, p=0.02). Conclusion: Being female, having diabetes and limited family/community supports are associated with COVID-19-induced social isolation in African American and Latinx communities.
Stress Related to COVID-19 and Loneliness Among Middle-Aged and Older Adults in the United States
Authors: Yoon Sukyung , Mahapatra Neely 
Published: December 2021

Abstract
Intensified levels of stress and loneliness have been attributed to the COVID-19 pandemic (Havnen et al., 2020; Luchetti et al., 2020). Moreover, loneliness has been reported to exacerbate psychological and physical health issues (Holt-Lunstad et al., 2015). The current research aims to investigate the impact of stress-related to COVID-19 on loneliness. The roles of age, sex, living arrangements, health, and resilience were also investigated. Data was collected on 267 middle-aged and older adults (ages 45 through 88) living in the U.S during COVID-19. A path analysis was employed. For both the direct and indirect effects, 95% confidence intervals were estimated using bootstrapping (a bootstrap sample of 1,000 was specified). Model fit was acceptable. X2 (5) = 7.913, p &gt; 0.05, CFI=0.972, RMSEA =0.047. Regarding direct effects, the results indicate that COVID-19 related stress (hereafter stress) was negatively associated with perceived good health (hereafter health) (β = -.213, p&lt;0.001). It was also found that health was positively associated with resilience (β = .324, p&lt;0.001). Being male was positively associated with resilience (β= .144, p&lt;0.05), and resilience was negatively associated with loneliness (β= .230, p&lt;0.001). Meanwhile, stress had negative indirect effects on resilience, whereas stress had positive indirect effects on loneliness. Finally, health and being male had negative indirect effects on loneliness. The findings indicate that health practitioners and service providers should develop programs to improve and maintain good health, resilience, and social support among middle-aged and older adults during the COVID-19 pandemic. Moreover, gender-based services are also needed.
Translational Geroscience: Human Models of Healthy Aging and Longevity
Authors: Milman Sofiya 
Published: December 2021

Abstract
While insulin like growth factor-1 (IGF-1) is a well-established modulator of aging and longevity in model organisms, its role in humans is less well understood. Previous ambiguities in part have been attributed to cohort characteristics and unawareness of interactions between age and IGF-1. Centenarians have emerged as an ideal model of healthy aging because they delay the onset of age-related diseases and often remain disease free for the duration of their lifespan. In cohorts of centenarians and generally healthy older adults, we demonstrated that reduced IGF-1 is associated with extended lifespan and health-span. Additionally, we confirmed that IGF-1 interacts with age to modify risk in a manner consistent with antagonistic pleiotropy: younger individuals with high IGF-1 are protected from dementia, vascular disease, diabetes, cancer, and osteoporosis, while older individuals do not exhibit IGF-1-associated protection from disease. These findings offer evidence for IGF-1 modulating health-span and lifespan in humans.
Intergenerational Relationships, Social Support, and Psychological Well-Being Among Korean Older Adults
Authors: Lee Yooumi , Wilmoth Janet 
Published: December 2021

Abstract
Using longitudinal data from the 2006 to 2018 Korean Longitudinal Study of Aging, this study explores depression trajectories among individuals who are 60 or older with at least one living adult child at baseline. We estimated linear growth curve models of depression trajectories separately for married, unmarried and widowed using the Center for Epidemiologic Studies Depression Scale (CES-D). Results indicate that declining health and recent widowhood are positively related to depressive symptoms. Satisfactory intergenerational relationships and social support in the form of caregiving decrease depressive symptoms of older parents, especially among the widowed. Having at least one son and a first-born daughter positively impact psychological well-being of older parents. A son was particularly important for those who are widowed. We conclude that the psychological benefits of intergenerational relationships and social support are contingent upon the vulnerability of Korean older adults and discuss the implications for public policy.
Dementia Caregivers' Trajectories of Well-Being Before and During the COVID-19 Pandemic
Authors: Mitchell Lauren , Albers Elizabeth , Birkeland Robyn , Peterson Colleen , Drake Anna , Gaugler Joseph 
Published: December 2021

Abstract
Residents of long-term care settings and their family caregivers have been severely impacted by the COVID-19 pandemic. The present mixed-methods study examines trajectories of well-being pre- and post-pandemic onset for caregivers of persons with dementia living in residential long-term care. Participants were taking part in, or had recently completed, an ongoing intervention trial to support families transitioning a relative into long-term care. Beginning in summer 2020, we started assessing caregivers’ COVID-19-related experiences and added three surveys spanning 4-months beyond the 12-month parent study period to capture caregivers' adjustment throughout the pandemic. Using latent growth curve models, we estimated caregivers' (N = 104) trajectories of depressive symptoms, burden, and self-efficacy before and during the pandemic. We also tested whether the counseling intervention had protective effects for participants in the treatment group, and examined moderators including long-term care facility size, care recipient's dementia and health status, and quality of staff interactions.
Does Personality Shape COVID-19 Responses in Older Adults?
Authors: Aschwanden Damaris , Sutin Angelina , Sesker Amanda , Lee Ji Hyun , Luchetti Martina , Stephan Yannick , Terracciano Antonio 
Published: December 2021

Abstract
Knowing how personality plays out in a pandemic can provide guidance to improve public health messaging. In a sample of 2066 participants (Mage = 51.42; 48.5% female), we examined whether personality is associated with concerns, precautions, preparations, and duration estimates of the COVID-19 pandemic. Personality traits were measured before the pandemic; responses were assessed in late March 2020. We investigated whether age moderates the trait-response associations because older adults are at higher risk for severe complications of COVID-19. Among the 65-96-year-olds, higher conscientiousness was associated with more preparations, higher openness was associated with greater concerns, and both higher openness and agreeableness were related to more preparations and longer duration estimates. This pattern has implications: If all older adults took COVID-19 seriously, individual differences in personality should not matter; however, our findings indicate that they do matter and could be considered in the development of personality-tailored communication to older adults.