bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age, Body Mass Index (BMI) And Cognitive Difficulties In Appalachian West Virginia
Authors: Romero Camila , Jacobs Moyosoreoluwa , Schreurs Bernard 
Published: December 2021

Abstract
Several known factors exacerbate the risk of cognitive difficulties among older adults. In addition to place-based disparities, body weight also predicts cognitive health. In fact, overweight and Obese BMI (Benito-Leon et al., 2013) and underweight BMI (Xiang & An, 2015) are risk factors for cognitive difficulties. Whether the effect of BMI operates similarly across age among adults facing place-based disparities is not clear. In order to better understand the role of BMI among adults already at-risk for health disparities, we used the 2018 BRFSS data to examine the relations among these variables among the 4817 West Virginian adults in the BRFSS database. Approximately 16.5% had difficulty making decisions or remembering. Approximately 73% were overweight or obese, 26% were healthy BMI, and 1% were underweight. A multinomial logistic regression was conducted to examine cognitive difficulties. Healthy BMI and ages 25 – 44 years were the reference groups. The omnibus test was significant, χ2 (5, N = 4817) = 38.71, p &lt; 0.0001. Age and BMI uniquely contributed to the classification. Post hoc inspection of the Odds Ratios showed that adults ages 60 years and older with obesity were 1.27 times more likely to report cognitive difficulties, while those who were underweight were 3.74 times more likely to report cognitive difficulties. That individuals over age 60 with an obese or underweight BMI report more cognitive difficulties highlights the intersection among age, obesity and location on cognitive health disparities in West Virginia.
Are Genetic and Environmental Contributions to Verbal Fluency and Episodic Memory Solely Moderated by Sleep?
Authors: Vo Tina , Pahlen Shandell , Kremen William , Gue Matthew Mc , Nygaard Marianne , Reynolds Chandra 
Published: December 2021

Abstract
Decreases in sleep duration and cognitive functioning often occur and co-occur in aging although these patterns are not universal. Underlying etiologies, i.e., genetic and environmental factors, contribute to why people differ on cognitive functioning at shorter versus longer sleep durations. The current study tested whether sleep duration alters the genetic and environmental contributions to why middle-aged and older adults vary on cognitive functioning. Using 4 twin studies from the Interplay of Genes and Environment Across Multiple Studies (IGEMS) consortium (Mage=56.5, range=35.0-91.2, N=5,210, 1,083 complete MZ pairs, 1,522 complete DZ pairs) we tested quantitative genetic twin models considering sleep, depressive symptoms, and age as moderators of verbal fluency (i.e., Animal Naming) and episodic memory (i.e., Word List). For verbal fluency, sleep duration and depressive symptoms were significant when dropped together from the model (χ2(6)=15.22, p=0.02) but not individually (χ2sleep(3)=7.17, p=0.07; χ2dep(3)=5.81, p=0.12), indicating that both moderators may affect differences in verbal fluency performance. For episodic memory, sleep duration moderation was only significant via the shared environmental factor (χ2(1)=5.26, p=0.02), indicating that sleep may affect differences in episodic memory performance via environmental influences that make siblings more similar to one another. Overall, results illustrate patterns of higher genetic influences on cognitive function at short sleep (4 hours) and higher shared environmental influences on cognitive function at long sleep (10 hours). These findings may align with associations of upregulation of neuroinflammatory processes at short sleep and common reporting of mental fatigue at long sleep, both of which are associated with poorer cognitive functioning.
Bias Against Older Adults in Young Children and Their Parents
Authors: Jaquet (née Bauer) Jenny , Bellingtier Jennifer 
Published: December 2021

Abstract
Parents are an important source of social learning for their children. However, little is known about whether they play a role in shaping ageist attitudes in children. We investigated how parents’ biases against older adults would relate to those of their children and how preferences would differ depending on the child’s age. Participants were 56 parent-child dyads with the children’s age ranging from four to eight years (parents mean age = 36.95, SD = 5.49). Children were divided into three age groups, preschool (n = 18), early school-aged (n = 18), and middle school-aged (n = 20). Children and parents completed a picture rating task, which included the evaluation of 28 images of younger and older adults faces. Children used a smiley-face rating scale on a touch-screen computer, and parents used a sliding preference scale for their ratings. It was found that both, children (t(55) = 5.47, p &lt; .001, d = 0.73) and their parents (t(55) = 2.05, p = 0.045, d = 0.27), gave significantly more positive ratings to younger than to older adults, which is consistent with an underlying bias for younger adults. Contrary to our expectations, this preference in children held across age groups and was not associated with parental preferences. Nevertheless, it has been shown that ageist preferences can already be detected in childhood. Further longitudinal research is needed to track the development of ageism from childhood on, and efforts to combat ageism should be addressed not only to adults, but to children as well.
Caregiving Patterns and Their Association with Caregiving Burden and Gains
Authors: Ali Talha , McAvay Gail , Monin Joan , Gill Thomas 
Published: December 2021

Abstract
Family and friend caregivers play a critical role in helping older adults live long and healthy lives. Using the construct of "care types" we examine whether caregivers providing more intense care experience higher burden and lower gain compared to caregivers providing less intense care. Data are from the 2015 and 2017 rounds of the National Study of Caregiving (N=2,146), a study of the caregivers of older adults enrolled in the National Health and Aging Trends Study. In a previous analysis, we derived five care types at baseline (2015), that varied in the number and type of care activities, care duration, and regularity of care provided. Caregivers reported whether caregiving was financially, emotionally, and physically difficult for them. Participants were also asked whether caregiving made them more confident, taught them to deal with difficult situations, brought them closer to the recipient, and gave them satisfaction that the recipient was well cared for. We estimated the association between care types derived at baseline and caregiver burden and gains at follow-up using logistic regression. Compared to caregivers in the least intense care type, those in the more intense care types were significantly more likely to report financial and physical burden, as well as increased ability to deal with difficult situations and increased satisfaction that their loved one was well cared for. These associations remained significant after adjusting for confounders. Care types can be used to predict burdens and gains experienced by caregivers and to effectively target caregiver support services and interventions.
Early Clinical Utility Data of a Blood Biomarker Test in the Evaluation of Mild Cognitive Impairment
Authors: Monane Mark , Snider Joy , Drake Jonathan , West Tim , Fogelman Ilana , Braunstein Joel , Holtzman David , Bateman Randall 
Published: December 2021

Abstract
There is an important unmet need for timely, noninvasive, low-burden evaluation of patients presenting with mild cognitive impairment (MCI). The PrecivityAD™ blood test quantifies plasma concentrations of amyloid-β 42 and 40 and apolipoprotein E-specific peptides that are combined with age in an algorithm to identify the likelihood of amyloid plaques in the brain as measured by amyloid PET scans. This test has previously demonstrated 92% sensitivity and 77% specificity. The study objective was to evaluate the clinical utility of the test and the Amyloid Probability Score (APS), the test output value. Eighteen patients (median age 72, 55% male, 88% white) with MCI received the PrecivityAD blood-based biomarker test. The mean APS was 31 (range 0-91): 13 patients had low scores (APS 0-35), 2 had high scores (58-100) and 3 had intermediate (inconclusive) scores (APS 36-57). The mean probability of Alzheimer’s disease (AD) diagnosis was rated by clinicians as 63% (range 25-80) pre-test and 31% post-test (range 5-95) (p &lt; 0.0005). AD probability rated by clinicians was decreased in 12/13 low APS patients and increased in 2/2 high APS patients. Donepezil was discontinued in 5/8 low APS patients on therapy and initiated in 1/1 high APS patients not on therapy, representing a change in treatment management in 33% (6/18) of study patients. In summary, this blood-based biomarker test showed clinical utility in its association with physician decision-making around diagnostic certainty and drug therapy management in MCI patients.
Effects of Relationship Type on Quality of Life in Older Adults with Cognitive Impairment and the Informal Caregivers
Authors: Lai Aiping , Richardson Julie , Griffith Lauren , Kuspinar Ayse , Smith-Turchyn Jenna 
Published: December 2021

Abstract
Purpose: The purpose of this study was to assess whether there was an association between care-recipient relationship type and the QoL of older adults and their informal caregivers, and whether this association pertained to older adults’ cognitive function. Methods: This was a secondary data analysis. Older adults (n=1230) and their informal caregivers (n=1871) were identified from participants in the National Health and Aging Trends Study (NHATS) Round 5 and the National Study of Caregiving (NSOC) II. A series of bivariate and multivariable regression models examined the associations among the care-recipient relationship type and QoL in older adults and their informal caregivers, adjusted for socio-demographic variables as well as cognitive functioning. Results: Both older adults and caregivers’ QoL outcomes varied by the type of relationship. Recipients cared for by adult-child caregivers or multiple caregivers experienced higher functional limitation than those cared by spousal caregivers (β=.79, CI [.39, 1.19]; β=.50, CI [.17, .82], respectively). “Other” caregivers, such as siblings, friends, etc., had lower odds of experiencing negative emotional burden than spousal caregivers (OR=.26, CI [.13, .52]; OR=.53, CI [.35, .81], respectively). "Other" caregivers were also 51% less likely to experience social strain than spousal caregivers. Lower odds of experiencing negative emotional burdens were also found with multiple caregivers. The association between adult-child caregivers and social strain was explained by the recipients’ cognitive function. Conclusions: Care-recipient relationship type impacts the QoL in both recipients and their informal caregivers. This association appears to be affected by care recipients' cognitive function level.
Egg Consumption and 4-Year Change in Cognitive Function: The Rancho Bernardo Study
Authors: Kritz-Silverstein Donna , Bettencourt Ricki 
Published: December 2021

Abstract
The role of dietary cholesterol in cognitive decline is unclear. Eggs are a rich source of nutrients and dietary cholesterol. This study examines the association of egg consumption with 4-year change in cognitive function in 890 older, community-dwelling adults. Participants were 357 men and 533 women aged □55y (means=70.1□8.4 and 71.5□8.8, respectively, p=0.016), from the Rancho Bernardo Cohort who attended a 1988-91 clinic visit. Egg intake was obtained with a food frequency questionnaire. Cognitive function was assessed with the Mini-Mental Status Exam (MMSE), Trails B and category fluency, and reassessed in 1992-96. In this sample, rates of egg consumption ranged from never (14.0% of men, 16.5% of women) to □5/week (7.0% of men, 3.8% of women; p=0.0013). Mean 1988-91 cognitive function scores for men vs. women were 27.5 vs. 27.7 on the MMSE (p=0.08), 105.9 vs. 121.6 on Trails B (p&lt;0.0001), and 20.2 vs. 18.2 on category fluency (p&lt;0.0001). Sex-specific regression analyses examined associations of egg consumption with change in cognitive function. In women, after adjustment for age and education, egg intake was associated with less decline over time in category fluency (beta=-.10, p=0.01), which remained significant after adjustment for smoking, alcohol, exercise, cholesterol, calorie intake, and protein intake (p=0.02). No other associations were found in women, and no associations were observed in men before and after adjustment for covariates. Results suggest that while high in dietary cholesterol, egg consumption is not associated with decline in cognitive function. For women, there may be a small beneficial effect for verbal memory.
Examining the Relationship Between Hospice Agency Characteristics and Complaint Deficiencies
Authors: Wang Xiaochuan , Beltran Susanny , Gammonley Denise , Conner Norma , Leon Milo 
Published: December 2021

Abstract
The U.S. hospice industry has expanded over the last decade. Similar to nursing homes, research guided by the Donabedian framework has documented quality differences in hospice based on agency characteristics, including profit status and rural status. Yet, compared to nursing homes, quality oversight and transparency in hospice remain limited. When families report substandard care, a complaint survey is launched to investigate allegations. Using publicly available regulatory oversight data (e.g., CMS QCOR, Medicare PACPUF, CAHPS HIS, Hospice Compare), and guided by the Donabedian framework, this study describes hospice agency structure and process characteristics associated with care complaint deficiencies (outcome). Of the 4,415 hospice facilities examined, 453 (or 10.3%) have had complaint survey deficiency citations between January 2018 and December 2020. Chi-square and ANOVA tests were conducted to compare facility characteristics (e.g., ownership status, percentage of Medicare beneficiaries in rural zips), nursing and social work involvement, and CAHPS scores between hospices with and without complaint survey deficiencies. Results indicated that the average proportion of beneficiaries with a rural zip for Medicare correspondence was significantly lower in hospices with deficiencies (p&lt;.001). Finding also suggested that weekly total nursing and social work minutes were significantly higher in hospices with deficiencies. Additionally, family ratings of hospice team communication, symptom management, and overall satisfaction were higher in facilities without complaint survey deficiencies. Future research and practice implications will be discussed.
Family Caregiver Health in a Pandemic
Authors: Cassie Kimberly 
Published: December 2021

Abstract
Each year family caregivers provide care and services worth billions of dollars to support the needs of older Americans. Their support is invaluable to keep individuals in the community for as long as possible and to allow individuals to attain and maintain their highest practicable level of well-being. But what impact does caregiving have on one’s health? Does caregiver health decline with the assumption of caregiving duties? Did caregiver health change during the pandemic? If so, how and what factors are associated with declines in caregiver health? To answer these questions, an exploratory survey was conducted among a convenience sample of 195 family caregiver. Almost a third of those sampled reported excellent or very good health, while 44% reported good health, and almost a quarter reported poor or fair health. Forty-eight percent reported their health had declined since they assumed caregiving duties and 29% reported their health had declined during the pandemic. Employed caregivers and those experiencing less depression/anxiety reported better health. Those experiencing a decline in health with caregiving were more likely to be female, not employed, experienced more stress and more depression/anxiety. Those experiencing a decline in health during the pandemic reported less spirituality, greater attachment related avoidance, and greater depression/anxiety. Findings from this research can be used to inform future research on the effect of the pandemic on family caregiving and to plan interventions to protect caregiver health as they provide vital services to maintain individuals in the community for as long as possible.
Adverse Neighborhood Environments and Health Behaviors among Older Americans
Authors: Choi Yeon Jin 
Published: December 2021

Abstract
Maintaining healthy lifestyle, including healthy diet and physical activity, in adverse neighborhood environments may be more difficult for older adults because of changes linked to aging, which make them more vulnerable to their environments. This study aims to investigate the association of neighborhood disorder with diet quality and physical activity in a national sample of older Americans. For this study, we used data from the Health and Retirement Study. Neighborhood disorders include vandalism, boarded houses, abandoned cars, demolished houses, trash, litter, or junk, poorly kept communal areas, homeless people, prostitution, winos or junkies, and drug use or drug dealing near residents’ housing unit (range: 0-11). Diet quality and physical activity were assessed using the Healthy Eating Index 2015 (HEI-2015; range:0-100) and the metabolic (MET) equivalent activity points (range: 0-31 in this sample). Ordinary least squares regression models were estimated to examine an association between neighborhood disorder, diet quality, and physical activity. Neighborhood disorder was associated with poor diet and physical inactivity. For one additional negative neighborhood feature, HEI-2015 scores and MET-equivalent activity points decreased by 0.55 (95% CI: -1.09. -0.01) and 0.69 (95% CI: -1.05, -0.33). Findings of this study suggest that older adults living in adverse neighborhoods are at a greater risk of poor diet and physical inactivity, which are important risk factors for poor health and chronic diseases. Promoting neighborhood environments and perceived neighborhood safety would increase access to health food, encourage healthy diet and physical activity, and support healthy aging.
Age Discrimination and Perceived Work Ability: The Mediating Effect of Self-Efficacy
Authors: Kang Hyun , Kim Hansol 
Published: December 2021

Abstract
As the number of older workers in the U.S. workforce increases, perceived work ability, which indicates a worker’s capacity to perform job-related tasks or to remain employed, becomes increasingly important. However, age discrimination may undermine the ability of older adults to remain active in the workplace as it poses a significant barrier to their work ability. The purpose of this study was to examine how age discrimination affects perceived work ability among older workers. We also evaluated the role of self-efficacy as a potential mediator between age discrimination and perceived work ability. Self-efficacy can contribute to older adults’ productive aging since it helps them view age-related situations more positively. Using 2,011 respondents (aged 50+) data from the 2018 Health and Retirement Study, structural equation modeling analysis was conducted. Our findings indicated that age discrimination had a direct negative effect on perceived work ability (B = -.230, p &lt; .001). Older workers who experienced more age discrimination were more likely to have low levels of perceived work ability. The indirect effect of self-efficacy (B = -.177; 95% CI = -.240, -.135) was significant. Older workers who experienced more age discrimination were more likely to have low levels of self-efficacy, and this relationship led to lower levels of perceived work ability. These results suggest that greater efforts are required to reduce age discrimination and its negative consequence on perceived work ability and self-efficacy among older workers. Furthermore, age discrimination laws should be more explicitly enforced in the policy direction for older workers.
Caregiving, Loneliness, and Stress: The Role of COVID-19
Authors: Syed Sumaiyah , Yang Iris , Wilson Stephanie 
Published: December 2021

Abstract
According to many prior studies, informal caregivers are at risk for heightened loneliness and distress. Moreover, the COVID-19 pandemic has introduced new challenges that may be accentuated among caregivers. This study examined caregiving frequency and its relation to loneliness, perceived stress, and negative affect during the COVID-19 pandemic. We then investigated the moderating roles of COVID-19 concerns and impacts, anticipating magnified effects among caregivers. Participants included respondents from the Health and Retirement Study (HRS) COVID-19 project sample (n=2108, mean age=69) who reported their caregiving frequency, general concern about COVID-19, related concerns about family members’ health, and social disruptions caused by the pandemic. Controlling for age, gender, and health status, daily caregivers reported significantly greater distress during COVID-19 compared to non-caregivers (p=.036). Higher levels of concern about family members’ health during COVID-19 was significantly associated with greater loneliness among daily caregivers (p = .009), but not among non-caregivers, such that daily caregivers with greater concerns had the highest levels of loneliness. On the other hand, unexpectedly, daily caregivers who experienced fewer social disruptions due to the pandemic reported higher levels of loneliness (p = .002); however, the association was null for non-caregivers. Findings suggest that daily caregivers may be particularly vulnerable to greater loneliness and stress during the COVID-19 pandemic. These experiences may exacerbate existing mental health disparities for those providing daily care.
Coping with the Subjective Impact of COVID-19 among Older Adults in Puerto Rico
Authors: Camacho David , Marti Yamile , Cho Sunghwan , Buckley Thomas , Vazquez Julia , Burnette Denise , Fabelo Humberto 
Published: December 2021

Abstract
The COVID-19 pandemic poses serious physical and mental health risks for older adults worldwide. To develop culturally and contextually congruent services to mitigate these risks requires understanding their stress and coping processes, which remain understudied in Latin America. This study examines qualitative data from 51 adults aged 60 and over who participated in an ongoing study of older Puerto Ricans’ knowledge, attitudes, and practices about COVID-19. Trained interviewers collected the data by telephone from January to August, 2021. Two-thirds of participants were female, 60% had less than high school education and 90% had poverty-level incomes. Drawing on Lazarus and Folkman’s Stress and Coping Theory, we conducted a thematic analysis of responses to open-ended questions about the nature and extent of COVID-related stressors, stress management, and meanings and guidance they had gleaned from their experience. Participants perceived the pandemic as an added threat to ongoing chronic stressors (e.g., Hurricane Maria, poverty, political instability); disruptions in daily routines, family cohesion, and grief and loss processes; and increased isolation and loneliness. They reported using cognitive, behavioral, socioemotional and spiritual coping, including positive thinking, keeping occupied, relaxation, religious practices and, in a few cases, social media. Participants highlighted a revitalized appreciation for emotional qualities of relationships, freedom and life in general. Consistent with our guiding theory, cultural, contextual, religious, and socio-political factors shaped their appraisals of stress and their coping strategies. Future research should examine how these practices relate to health outcomes and quality of life and how they can inform effective, appropriate interventions.