bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of In-home Saliva Collection of Cortisol and DHEA-S as a Biomarker of Stress in Dementia Care Dyads
Authors: Emami Azita , Engström Gabriella , Kim Hyejin 
Published: December 2021

Abstract
Dementia afflicts affected individuals and their family caregivers worldwide. Although a non-pharmacological intervention has been recommended as a first-line approach to minimize adverse outcomes (e.g., stress) in dementia care dyads (persons with dementia [PWD] and their family caregivers), most evaluations of such interventions have relied on subjective (e.g., self- or proxy-report) rather than objective (e.g., biomarkers) measures. We aimed to explore the feasibility of saliva collection of cortisol and dehydroepiandrosterone sulfate (DHEA-S) as a non-intrusive method in dementia care dyads. Dementia care dyads living at home were recruited from the memory center in Sweden. Prior to the saliva collection, participants received a one-hour education session with a hands-on demonstration led by a trained study coordinator. Participants were instructed to collect saliva three times (two for morning, one for evening)/day, five days/week for eight consecutive weeks. Out of 32 care dyads (32 PWD and 32 family caregivers), 24 (75.0%) completed the saliva collection. On average, 105.5 (87.92%) and 105.9 (88.25%) samples were collected from PWD and family caregivers during eight weeks. There were no statistically significant differences (p&gt;0.05) in the average number of saliva samples (i.e., total samples, morning or evening samples) between PWD and family caregivers. The findings of this pilot study showed that saliva collection of cortisol and DHEA-S as a stress measurement was feasible in dementia care dyads living at home. Robust and person-centered procedures, tailored educational materials, and effective communication with dementia care dyads should be considered in future biomarker research on stress in dementia care dyads.
Financial Impacts of the COVID-19 Pandemic on U.S. Older Adults: Assessing Pandemic-induced Job and Income Loss
Authors: Dawson Walter , Mattek Nora , Gothard Sarah , Kaye Jeffrey 
Published: December 2021

Abstract
The COVID-19 pandemic has greatly impacted the economic security of millions of older adults. Job loss and reductions in personal income were significant in 2020 stemming from pandemic-induced shutdowns that temporarily closed large swaths of the U.S. economy. Yet, the specific financial impacts of the pandemic on older adults, including family care partners, are not well understood. To understand the COVID-19 pandemic’s effects on the health and financial well-being of older adults, we gathered data from the Research via Internet of Technology and Experience (RITE) Study, a longitudinal survey panel providing data from thousands of participants of various ages and backgrounds in the U.S. on their use of healthcare and technology (N=1,365). We measured by population strata including age, sex, and education and other characteristics including caregiver status. Adults between 20-40 years of age experienced the highest rate of job loss and reduction in wages (33%) as a result of the pandemic, while adults aged &gt;70 years experienced the lowest rate (12.5%). However, adults aged 50-60 and 60-70 also experienced relatively high levels of job loss at (28.4% and 25.7%, respectively). Behavior changes and disruptions to typical routines to avoid COVID-19 infections may have contributed to job and personal income loss amongst Individuals aged 50-60 and 60-70. However, these findings suggest potentially high levels of economic insecurity amongst individuals who continue to work into late-life. These results may help policymakers understand how to better tailor interventions and policies to mitigate economic insecurity, particularly for populations disproportionately impacted by the pandemic.
Inflammatory Biomarkers and Sex Hormones Interact to Predict Ecologically-Assessed Cognitive Performance
Authors: Knight Erik , Harrington Erin , Sliwinski Martin , Graham-Engeland Jennifer , Pavlovic Jelena , Engeland Christopher 
Published: December 2021

Abstract
Inflammatory biomarkers and sex hormones have been investigated as independent risk and resilience factors for cognitive decline in older adults. Many sex hormones are anti-inflammatory and there is emerging evidence that sex hormones may buffer the risk for cognitive decline associated with higher inflammation. However, few studies have included concurrent examination of inflammation and sex hormones in studies of cognitive performance and cognitive aging. A diverse sample of older adults (N = 245; 65% female, 42% Black, 13% Hispanic; mean age = 76.8 years) had blood drawn before and after a two-week measurement burst that included three cognitive tests (6x per day) assessing working spatial memory, perceptual speed, and feature binding. Testosterone, estradiol, estrone, and six basal cytokine concentrations were quantified. Composite scores of basal inflammation were calculated. Multilevel modeling indicated that heightened inflammation related to poorer spatial working memory performance (B = 0.213, 95%CI[0.11, 0.414], p = .040). In addition, sex hormones moderated the association of cytokine concentration with perceptual speed (e.g., basal cytokines x testosterone: B = 0.13, [-0.24, -0.03], p = 0.013; similar effects evident for estrogens). Decomposition these interactions revealed that heightened inflammation predicted poorer performance, but only among individuals with lower sex-hormone concentrations. This study provides evidence of immune and hormonal-by-immune associations with performance in two cognitive domains in older adults. Examining the functional crosstalk between immune and sex hormone functioning will improve understanding of risk and resilience factors related to cognitive performance and help predict cognitive decline in older adults.
Like A Dew Drop On A Lotus Leaf: Perceptions Of Aging Well In South Asian American Older Adults
Authors: Khan Mushira , Shah Sheetal , Basic Ajla 
Published: December 2021

Abstract
Past research has underscored four key themes prevalent in popular and scientific discourse on successful aging in North America – the emphasis on individual agency and control; continuing productive activity into old age; the value of independence in late life; and an ideal construction of permanent personhood, wherein the realities of mortality and decline are inadequately addressed (Lamb, 2014). Yet, the meanings attached to successful aging differ across cultures and are not very well-understood. The Perceptions of Aging Well in Diverse Populations study aims to acquire a holistic understanding of the attitudes and beliefs around aging well across cultures and to identify the similarities and differences in these perceptions within diverse racial and ethnic groups. This presentation highlights preliminary findings from in-depth, semi-structured qualitative interviews with South Asian Americans 50 years and older (n=19; 9 men, 10 women). Participants shared that a sense of inevitability and aging with “grace”, “dignity”, and “wisdom” were key components of successful aging. Maintaining good health, keeping a positive attitude, and remaining independent in later life appeared motivated primarily by a desire to remain connected to, but not necessarily “burden” adult children with caregiving responsibilities. Religious faith and spiritual well-being, availability of support systems, and a sense of community were key facilitators. Limited English proficiency and loneliness posed challenges to aging well, particularly in late-life immigrants. These findings provide unique insights into subjective perceptions of successful aging and may help inform programs and policies that support the health and well-being of older South Asian Americans.
Long-Term Care and Wide Effects on Children Caregivers -- New Evidence From Taiwanese Administrative Data
Authors: Chen Kuan-Ming , Hsiang Chen-Wei , Chou Yu-Hsuan , Chao Shiau-Fang , Tseng Kuan-Ju , Lin Ming-Jen , Chen Ya-Mei , Wu Shih-Cyuan 
Published: December 2021

Abstract
Long-term care (LTC) needs have profound impacts on the care-receivers and their children. Past research has focused on primary caregivers' short-term responses to LTC needs on limited aspects. This study brings new Taiwanese administrative data on health insurance, LTC program usages, and tax records. Rich information allows this study to explore long-term impacts on care-receivers' extended families. Event study combined with various regression analyses is the main framework of this study. Using the longitudinal record of more than 23 million individuals older than 65 over 18 years, the present study examines extended family members' various outcomes along the LTC needs trajectory. Among others, these outcomes include labor market participation and health expenditures. There are several findings in this study. Parents' LTC needs decrease all children's average full-time labor force participation by 2.5 percentage points even 10 years after the needs incurred. These needs do not directly increase children's health expenditure. A precise zero effect is found on children's health expenditure before, during, and after parents' LTC needs. Nevertheless, parents' health status or LTC risks, in general, may still pass on to children through other channels. The inter-generational health association is found to be approximately 0.25, indicating some degree of transmission. The results suggest that the impacts of LTC needs on family members are profound and widespread. Policy needs to address multiple aspects to cater to potential difficulties for care-receivers' family members.
Paving the Way for Ageist Attitudes through Children’s Books
Authors: Schenker Lena-Emilia , Bellingtier Jennifer 
Published: December 2021

Abstract
Older adults are underrepresented and rarely appear in major roles in children’s literature. According to developmental intergroup theory, numerically smaller groups are likely to become targets of stereotypes and prejudice. Because parental ageist attitudes are related to those of their children, and parents typically choose their children’s literature, we investigated parental preferences for books featuring older and younger adults and what factors might predict this preference. In an online survey, 176 parents of children aged 12 or younger rated children’s book covers featuring a child and a prominent younger or older adult. There were two identical versions of each book cover on which only the age of the adult varied. Each respondent viewed covers featuring older and younger adults, but only saw one version of each cover (i.e., counterbalanced design). Parents indicated their preference for the books by stating how much they and their children would like the book and how likely they would be to buy it. Stereotypical expectations regarding the books’ storylines were rated on a semantic differential scale (e.g., modern vs. old-fashioned). Results revealed that there were no significant differences in preferences for books featuring younger, compared to older adults. However, a stronger difference in preference for books featuring younger, over older adults was predicted by the extent of stereotypical expectations regarding the storylines. In particular, this preference was stronger in parents who expected stories with older adults to conform to prevailing ageist stereotypes, suggesting that ageist expectations may deter some parents from books featuring older adults.
Predicting Caregiver Reactions to Challenging Behaviors in the Context of Dementia
Authors: Simon Darby , Mast Benjamin 
Published: December 2021

Abstract
Challenging behaviors exhibited by people living with dementia have been associated with a variety of negative outcomes including greater caregiver burden, nursing home placement, and lower quality of life. Although there has been considerable research on psychological and behavioral changes in dementia, little research has explored family caregiver reactions to these changes and what caregiver characteristics are associated with stronger emotional reactions. This research examined the relationship between established indicators of caregiver mental health (depression, burden, grief, well-being) and caregiver reaction scores on the Revised Memory and Behavior Problems Checklist (RMBPC). The sample consisted of 76 family caregivers for people living with dementia, aged 25 to 93, who participated in a study on caregiver burden and grief. Multiple regression was used to predict RMBPC caregiver reaction scores from the Zarit Burden Inventory, Geriatric Depression Scale, Ryff Psychological Well-Being Scale, and Anticipatory Grief Scale while controlling for RMBPC total behavior frequency scores. RMBPC total behavior frequency scores and Zarit Burden Inventory were significant predictors of caregiver reaction scores (F(2,74) = 87.559, p &lt; .001, R2 = .703). More frequent, challenging behaviors were associated with more distressing reactions and higher caregiver burden also predicted more distress on the RMBPC reaction scores. Psychological well-being was associated with lower reactions at the bivariate level but was not significant in the full regression model. Future research is needed to better understand these relationships and implement this knowledge to benefit family caregivers.
Predictors of Nursing Home Covid-19 Cases: a Community Vulnerability Approach
Authors: Peterson Matthew , Lawhorne Larry 
Published: December 2021

Abstract
It is well known that the Covid-19 pandemic has placed considerable burden on nursing homes, including from resident, facility, and community perspectives, among others. This study examined facility and community factors that were related to incident Covid-19 cases in nursing home facilities. N=12,473 US nursing homes were included in this study. Data from June 2020 - January 2021 from several publicly available sources were combined to create a dataset that included facility name, size, ownership, mortality rate, Covid case rate, personal protective equipment (PPE) and staff shortages, % white residents, and % Medicaid residents. Community factors included core-based statistical area (CBSA) Covid case rates, urban/rural, CBSA death rates, and the CDC’s Social Vulnerability Index (SVI). Zero-inflated Poisson regression models were used to determine predictors of 8-month Covid case counts, normalized by facility size. Results indicated that higher staff shortages, poorer facility rating, for-profit ownership, proportionally more Medicaid and non-white residents were all significantly associated with higher Covid case rates over 8 months (all P &lt; 0.0001). Significant community level predictors of higher cases included urban setting and higher SVI. PPE shortages was not associated with higher case counts. Of all the factors included, SVI was the strongest predictor of Covid case counts. This large US study assists in determining critical facility and community factors that predict increasing Covid burden in nursing homes. Particularly, SVI is an important factor in determining facility and public health policy, and targeting resources in large scale health crises such as the Covid-19 pandemic.
Creating Virtual Community For Older Adults: During the COVID-19 Pandemic And Beyond
Authors: Kosick Lawrence , Hunt Jennifer , Solway Erica 
Published: December 2021

Abstract
Combining data on health and well-being from the University of Michigan National Poll on Healthy Aging (NPHA) with case studies and data from GetSetUp, a virtual online learning community, and the Michigan Department of Health and Human Services (MDHHS), this symposium will highlight how virtual community can be created and supported during the COVID-19 pandemic and beyond. Polling data on loneliness and physical environments demonstrate the need for opportunities for connection before and during the pandemic. Other polling data from the NPHA shows telehealth visits increased significantly as did the use of video chat technology. These findings suggest that comfort with technology may help support aging in place. GetSetUp helps to make this possible with customized learning to help older adults overcome hurdles to tech adoption and use. GetSetUp classes focus on supporting social connection and providing information on resources and services. Beyond the pandemic, these services will remain critical for many older adults, including those facing mobility limitations, those with limited community, and those looking to diversify their networks. The Senior Deputy Director of Aging and Adult Services Agency will highlight how Michigan combines data and technology to support Michigan’s aging network. The GetSetUp and MDHHS virtual community allowed for a statewide connection to health and aging services, including programs such as vaccine information sessions. The data and case studies described will highlight the need for connection during the COVID-19 pandemic and how a startup and State worked together to address this need.
Age-Related Ethnic Differences in Self-Reported Hand Function
Authors: Mulayh Ejlal Bin , Logue Rachel , Brown Susan 
Published: December 2021

Abstract
Racial/ethnic differences in the prevalence of disability based on self-reported activities of daily living (ADLs) exist in older Americans, particularly in Hispanic adults. Such studies have relied on large data sets in which disability is measured across a broad range of functional tasks. While useful in generating a global measure of disability, it precludes an ability to differentiate, for example, deficits in upper versus lower extremity function which can provide useful information in targeting therapeutic interventions. Despite known age-related declines in hand function and concomitant ADLs, racial/ethnic differences in hand-related ADL limitations have not been addressed. Using 2011-2018 data from the National Health and Nutrition Examination Survey (NHANES), we identified 3,189 non-Hispanic White and Hispanic adults aged 65 and older, and classified responses based on perceived difficulty to five self-reported tasks requiring hand dexterity. Compared to non-Hispanic Whites, Hispanic males reported 2.2 times higher rates of difficulty for dressing tasks (p&lt;0.01) and 3.3 times higher rates for difficulties preparing meals (p&lt;0.01). Similar rates of difficulty were also observed in females. Additionally, Hispanic females reported 4.6 times higher rates of difficulty in tasks requiring grasping small objects (p&lt;0.01). Deficits in hand function are often under-reported in older adults despite the role of dexterity in maintaining functional independence. The results presented here indicate that difficulties in hand-related ADLs are more prevalent in the Hispanic population and warrant greater attention in health care settings. Future work will include identifying factors contributing to these observed differences in self-reported difficulties in hand-related ADLs.
Allostatic Load Following Short-Term Intervention: Cognition in Older Hypertensive Adults
Authors: Cirilo Anthony , Kohn Jordan , Ang Gavrila , Pung Meredith , Troyer Emily , Pruitt Christopher , Redwine Laura , Hong Suzi 
Published: December 2021

Abstract
Allostatic load (AL), a measure of cumulative effect of prolonged stressors across physiological systems, is consistently associated with adverse health outcomes. Greater AL is correlated with functional decline in aging, but effects of behavioral interventions, such as Tai Chi (TC), on AL in older adults in a short-term is unknown. To investigate the effects of TC practice on AL and cognitive function and an AL-cognition relationship, older adults (60-95 years) with hypertension were recruited and randomly assigned to 12-week TC or Healthy Aging Practice-centered Education (HAP-E) classes. The AL index (ALI) included: SBP and DBP; urinary epinephrine and norepinephrine; plasma inflammatory biomarkers (CRP, IL-6); metabolic biomarkers (HDL, total cholesterol, triglycerides, HbA1c); and BMI. The Montreal Cognitive Assessment (MoCA) was administered to assess cognitive function. Generalized linear mixed-effects models, adjusted for age, race, education, and intervention attendance, was used. Pre- and post-intervention ALI did not change significantly in TC (2.61 (1.48) to 2.76 (1.62)) or HAP-E (2.84 (1.61) to 2.66 (1.86)). High ALI was associated with lower MoCA scores, indicating poorer cognitive performance (IRR=0.96; 95% CI: 0.93-0.98; p=0.002) across the time points. Of note, the MoCA scores did not significantly change across time (25.4 (3.2) to 26.0 (3.0)). 12-week TC or HAP-E interventions did not lead to a significant change in ALI or cognitive performance in our population. However, our findings show greater AL theoretically attributed to chronic stress is associated with cognitive functioning in older adults consistently over about 4 months.
Attachment Style Differences in the Affective Experience of Chronic Pain in Osteoarthritis
Authors: Cheesman Katherine , Parmelee Patricia , Smith Dylan 
Published: December 2021

Abstract
Objective. To examine the role of adult attachment style in the daily affective experiences of older adults with physician-confirmed knee osteoarthritis (OA). Methods. As part of a larger study of racial/ethnic differences in everyday quality of life with OA, 292 persons over the age of 50 completed a baseline interview including the Revised Adult Attachment Scale (RAAS; Collins, 1996). Dimensional RAAS attachment scores were coded into the secure, preoccupied, fearful, and dismissing groups (Bartholomew & Horowitz, 1991). Positive affect (PA), negative affect (NA), and pain were assessed using an experience sampling methodology consisting of 4 daily phone calls over 7 days. These analyses used ANCOVAs to examine 28-call means and SDs for PA, NA, and pain. Results. After controlling for demographics, results indicated significant group differences in average PA, NA, and pain. Pairwise comparisons indicated that participants endorsing a stable attachment style reported significantly more PA and less NA than those with a fearful attachment style. Group differences for pain were marginal and less clear cut. Significant differences also emerged for variability of NA and pain. Individuals with a secure attachment style were significantly less variable in NA than those in the fearful and preoccupied groups. For pain variability, the preoccupied group showed more variability than those with secure or dismissive styles. Implications. Results contribute to a growing understanding of how individual attachment style may underlie the day-to-day affective experience of chronic pain. (Supported by R01-AG041655, D. Smith and P. Parmelee, PIs.)