bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Delirium Rate Across 14 Hospitals During the COVID-19 Pandemic: A Comparative Study.
Authors: Khan Ariba , Klumph Marianne , Schwank Alexander , Malone Michael , Sabih Asma 
Published: December 2021

Abstract
During the COVID-19 pandemic, strategies to prevent delirium in the hospital were limited due to restrictions in staff and visitor policies. Thus, we suspected the delirium rate may increase during the pandemic. This study aimed to investigate the trends in delirium rate over past 2-years and compare this trend prior-to-and-during the COVID-19 pandemic in hospitalized older adults. Data was retrospectively obtained from the Acute-Care-for-Elders Tracker snapshot, an electronic health record tool to identify the presence of delirium within 48hrs of hospitalization for patients ≥65 years. Periods of interests were 3/2019-6/2019 (pre-COVID) and 3/2020-6/2020 (during-COVID). A weighted rate was calculated for each month by combining data from all hospitals for the total number of inpatients ≥65 years. The overall trend in the delirium rate was assessed with simple linear regression models and an ANCOVA. A χ2 and a Wilcoxon-Signed-Rank-Test were utilized to test for differences in the overall delirium rate between two time periods. Overall median delirium rate was 6.8% in 70,562 encounters of 42,878 patients (mean age= 78 years; mean length-of-stay= 6.5 days). The median delirium rate increased by 2.1% (6.6%to8.6%), for pre-COVID vs. during-COVID, respectively (Z=-3.044,p&lt;0.001). There were no significant differences between actual and projected weighted delirium rates (p=0.18). However, the weighted delirium rate—for both the actual and projected trend lines—demonstrated significant changes over time (p&lt;0.001).The trend in delirium rate increased over the study time period regardless of the pandemic. Further analyses with longer time-frame are crucial to understand the consequences of the pandemic on delirium rate.
Nursing Home Satisfaction Surveys: Differences by Race, Age, and Gender
Authors: Castle Nicholas , Harris John , Wolf David 
Published: December 2021

Abstract
Nursing home satisfaction information has gained substantial traction as a quality indicator representing the consumers perspective. However, very little research has examined differences in satisfaction related to race, age and gender. As a quality metric, satisfaction measures are variously used for quality improvement, benchmarking, public reporting, and for adjustment to payments. As such, valid comparisons among facilities are important. To our knowledge, no adjustment to satisfaction scores are currently used for nursing homes. However, in many other settings this is a common practice. In this research, nursing home resident, family, and discharge satisfaction scores were examined from &gt;4,000 participants. The data were collected in 2020 and come from 420 facilities. Satisfaction information came from the CoreQ surveys, which include 23 individual questions four of which can be combined to produce an overall satisfaction score. These CoreQ nursing home surveys are endorsed by NQF. Generally lower overall satisfaction scores were found for family members compared to current residents or discharged residents. Minorities (Black, Asian, Hispanic) had lower overall satisfaction scores compared to whites; however, the differences were not significant at conventional levels. Participants of the lowest age (&lt;65 years) were significantly (p=&lt;.05) less satisfied than older participants (&gt;75 years) and males were significantly (p=&lt;.05) less satisfied than females. The findings indicate that some case-mix adjustment may be applicable for nursing home satisfaction scores.
COVID-19 and Age-Friendliness in Higher Education
Authors: Beaulieu Celeste , Silverstein Nina , Bowen Lauren , Whitbourne Susan , Montepare Joann 
Published: December 2021

Abstract
During the COVID-19 pandemic, universities have changed to an online or hybrid format. These changes provide the opportunity for universities to be more accessible for all individuals. However, the logistics of university life during a pandemic has exposed significant and potentially enduring challenges and opportunities for designing and maintaining an Age-Friendly University. This study investigates perceptions of students, faculty, and staff in the lens of an age friendly university during the COVID-19 pandemic. This study draws on qualitative and quantitative data from over 10,000 faculty, staff, students, and life-long learners from 26 universities. Five items were asked to constituent groups about their perceptions on their university’s response to COVID-19. Overall, students had the poorest average perception of satisfaction with their university’s overall response to the pandemic, with 62% satisfied compared to 74% and 73% of faculty and staff, respectively. Further, 77% of faculty think the university’s response to continuing education accommodated their needs, compared to 69% of students. Respondents from private universities reported more positive satisfaction than respondents from public universities (M=4.23, SD=0.94; t(df=7405)=6.805, p&lt;.001). Qualitative data suggest that older students and faculty needed more technological assistance during this transition to primarily online learning to keep older members involved in the community. Older staff felt that they were more likely to be furloughed and were the group most likely to not have a choice in working on or off campus.
Telehealth as an Element of Home and Community-Based Services in a Pandemic: An Intrinsic Case Study in Two Rural Areas
Authors: Karlin Nancy , Weil Joyce 
Published: December 2021

Abstract
COVID-19 has changed the face of health care delivery. Using technology as a way to ensure Home and Community-Based Services (HCBS) as an option for older adults in rural areas is of increasing interest as a result of the pandemic. Literature suggests older adults do not adopt telehealth and/or medicine practices due to barriers (e.g., Internet and computer availability) and do not use telemedicine as a form of communication with medical staff. However, the combination of needing health care during the pandemic and having federal coverage via Medicare for telehealth virtual visit. Still studies suggest older adults may lack the necessary information about how to adopt telehealth and telemedicine and that they do not see their benefits. Additionally, the cost of technology, limited Internet access and rural connectivity issues persist. This study evaluates the potential for telehealth/medicine use in rural communities through two case studies of rural older persons in the Eastern Plains of Colorado and rural Western Nebraska. Results indicate, for older persons responding to the telehealth/medicine questions, there is support for its potential use with some using teleconferencing, health portals, along with the expectation that telehealth/medicine would be part of new health care systems. Resistance was met by some older adults in the Colorado sample who preferred face-to-face contact alongside other concerns about potential usage barriers such as the lack of Internet services or consistent connectivity. These participants indicated a lack of awareness in finding out how to access this form of medical support.
The Impact of COVID-19 on Older Adults
Authors: Ungar Rachel , Tkatch Rifky , Huang Jane , Kraemer Sandra , Schaeffer James , Yeh Charlotte 
Published: December 2021

Abstract
Background: The onset of the COVID-19 pandemic has dramatically influenced the health and well-being of older adults. Changes in lifestyle patterns has required reframing communication habits and learning new skills to maintain social connections and access healthcare. Objectives: To assess 1) well-being measured prior to and during the COVID-19 era; and 2) use and comfort level of technology for social interactions and telehealth visits during this time. Methods: A mailed survey to a randomly selected national sample (&gt;65) during the summers of 2018, 2019, and 2020. Measures included mental and physical well-being and various psychosocial measures. For 2020, questions related to COVID-19 and the use of technology were included. Results: A total of 4,696 (2018), 3,976 (2019) and 2,726 (2020) responded to these surveys (response rate ~27%). Overall, most constructs remained stable despite the ongoing pandemic. Most respondents reported average or high resilience (90%), high purpose (48%), stable social networks (76%), and low stress (55%). However, loneliness increased during 2020 (57%). Respondents who used technology were more likely to connect with family and friends. Only 43% reported high comfort with using technology, with older age (&gt;75) less comfortable. At the time of the survey 37% had not seen a healthcare provider through telehealth services, and 15% felt their healthcare needs were not met by a telehealth experience. Conclusion: Results demonstrate that respondents were doing well during COVID-19. Yet increases in loneliness and greater technology needs to stay socially connected and to access healthcare may result in negative long-term health outcomes.
Older Adults’ Worry about COVID-19: Associations with Experiences of COVID-19 Among Social Connections
Authors: Leggett Amanda , Koo Hyun Jung , Kobayashi Lindsay , Finlay Jessica , Lee Hannah , Baker Elaina 
Published: December 2021

Abstract
The COVID-19 pandemic has challenged the physical and mental health of older adults, yet it is unknown how much older adults worry about their own exposure. As older adults are at increased risk for severe complications from COVID-19, understanding patterns of worry may inform public health guidelines and interventions for this age group. We investigated older adults’ worry about COVID-19 in the early months of the pandemic and associations with familial/friend’s diagnosis or disease symptoms. Data comes from the baseline (April/May 2020), one-month, and two-month follow-up surveys from the COVID-19 Coping Study, a national longitudinal cohort study of US adults aged ≥55. We used linear regression models to investigate the association between self-reported familial/friend diagnosis or symptoms with pandemic worry, accounting for demographic factors and individual diagnosis or experience of COVID-19 symptoms. Participants (Baseline=4379, 1 month= 2553, 2 month=2682) were 67 years old on average, 72% were female, 5.7% were non-White, and 80.5% had a college degree. At baseline, 26.6% of participants had friends or family who had been diagnosed or experienced symptoms of COVID-19. Having friends or family diagnosed or with symptoms of COVID-19 (B=0.08, SE=0.04, p&lt;.05), being female (B=0.42, SE=0.03, p&lt;.001), and having higher educational attainment (B=0.06, SE=0.02, p&lt;.001) were significantly associated with greater worry about COVID-19. These associations were consistent over 3 months. Understanding if worry about the pandemic correlates with following public health guidelines is a key next step so intervention strategies can prioritize older adults and their social networks.
Prevalence of social isolation before and during the COVID-19 pandemic: A nationwide web-based survey in Japan
Authors: Murayama Hiroshi , Okubo Ryo , Tabuchi Takahiro 
Published: December 2021

Abstract
The coronavirus disease 2019 (COVID-19) pandemic is assumed to have increased the number of socially isolated older adults. Public health researchers and policymakers are concerned about the deleterious effects of social isolation on individuals’ health. However, there is only limited evidence on the prevalence of social isolation. This study investigated the change in prevalence of social isolation caused by the spread of COVID-19 and examined various associated factors. Accordingly, data from the JACSIS study, a nationwide cross-sectional web-based questionnaire survey (N=28,000, age: 15–79 years) conducted in August–September 2020 (during the pandemic) were analyzed. The respondents who contacted family members, friends, or neighbors less than once a week were considered socially isolated. We examined individuals’ frequencies of contact, including meeting in person, e-mail/text message, voice call, and video call, in January (before the pandemic; recall question) and August 2020. The weighted prevalence values of social isolation were 26.8% (26.0%–27.5%) in men and 15.8% (15.1%–16.4%) in women before the pandemic and increased to 34.4% (33.6%–35.2%) and 21.4% (20.7%–22.1%), respectively, during the pandemic. Further, compared to the younger age group, the increase in prevalence during the pandemic was greater for the older age group for both genders. Multinomial logistic regression analysis revealed that those who came to be socially isolated during the pandemic possessed a greater fear of COVID-19 than those who were not continuously socially isolated. These findings suggest the necessity of developing immediate measures for social isolation and risk communication regarding COVID-19.
Villanova ReachOut Forming Connections with Older Adults
Authors: Whitehouse Christina , Curley Catherine , Gomes Caitlin , McKay Michelle , Brewer Christine , O'Connor Melissa 
Published: December 2021

Abstract
Older adults are at increased risk for loneliness and social isolation. Research on loneliness identifies increased rates of depression, increased cognitive decline, and poor cardiovascular health outcomes. The COVID-19 pandemic forced many older adults into social isolation for protection against this insidious virus. Mandated lockdowns and personal decisions to shelter-in-place produced a tremendous increase in rates of loneliness, especially among older adults. Identifying a need for communication and relationships, we created Villanova ReachOut, a program that partners interprofessional students (N= 66) with older adults (N=53) through weekly telephone or video calls. To assess the impact of our program we developed a five question survey administered via phone to older adults and a 13-item survey for volunteers to assess training, satisfaction, needs and impact of the program. Of the older adults (n=16) who completed the survey, 78.6% believe the program helped them feel less isolated throughout the pandemic and 93.8% indicated they looked forward to weekly calls with their partner . Volunteers who completed the survey (N=25), overwhelmingly stated they enjoy and look forward to their calls (100%) and their communication skills have improved (92%). Volunteers reported being paired up with an older adult for weekly conversation had a positive impact on their personal and professional development. Findings from our program evaluation provide rich data in descriptions of positive impact for both the older adult and volunteer. These findings also support the need for programs that engage in intergenerational dialogue, specifically targeting older adults and the potential older adult workforce.
Development and Psychometric Testing of Coding Scheme for Dementia Family Communication Using Video Observation
Authors: Kim Sohyun 
Published: December 2021

Abstract
Understanding communication behaviors between persons living with dementia and family caregivers is essential for meaningful social interaction and decrease problematic behaviors and caregiving burden. The purpose of this study was to develop and test the psychometric properties of a coding scheme for dementia care interactions. The coding scheme items were developed from literature and expert review, and the pilot testing on 16 video-recorded interactions. A secondary analysis was conducted using 77 videos from 21 dyads of dementia family interactions naturally occurred in the participant’s home. The final coding scheme consists of 11 codes for persons living with dementia (6 nonverbal and 5 verbal) and 12 codes for family caregivers (7 nonverbal and 5 verbal). Content validity was excellent (I-CVI = .93, S-CVI/UA = .71, S-CVI/Ave = .93 with 6 experts). Inter-item correlation was acceptable for both caregiver codes (positive nonverbal = .21, positive verbal = .15, negative nonverbal = .36, negative verbal = .29), and patient codes (positive nonverbal = .13, positive verbal = .27, negative nonverbal = .15, negative verbal = .18). Intra-rater reliability (Cohen’s Kappa = .83, percentage of agreement = 83.88%) and inter-rater reliability (Cohen’s Kappa = .81, percentage of agreement = 81.75%) were excellent. Findings suggest the preliminary psychometric properties of the newly developed coding scheme to assess dyadic interactions of persons living with dementia and their informal caregiver in-home care situations. Future testing of the coding scheme for application in communication interventions to improve quality social interaction in dementia care is discussed.
Findings from Community Workshops Designed to Help Expand Arizona's Dementia Capable System
Authors: Coon David , Angulo Aylin , Cortes Marielysse , Carbajal Berta , Stotler Kassey , Weatherall zenya , Goldman jami 
Published: December 2021

Abstract
Among the 5.8 million people living with Alzheimer’s disease (AD), there are three vulnerable groups where community partners can join efforts to serve the community more comprehensively. These include (a) people living alone with Alzheimer’s disease and other related dementias (ADRD) who may or may not have a family caregiver, (b) people with Down Syndrome or another intellectual or developmental disability aging with ADRD and their family caregivers, and (c) people with ADRD and their family caregivers in the Latino community. Dementia capable systems are designed to address the needs and concerns of all individuals, families, and communities impacted by ADRD. The project develops and expands ADRD programs and services across Arizona through educational workshops, case management services, and evidence-based programs. Workshops (N=67) were provided to a variety of professionals and community members ranging from promotores/CHW’s (community health workers) and case managers to family caregivers and people living with dementia (N=2,272). Workshops successfully attracted a substantial proportion of Hispanic or Latino/a participants (63%) and women (84.5%). Perception of benefit ratings were overwhelmingly positive with over 90% of participants agreeing or strongly agreeing that: the workshops met expectations; they were willing to attend other programs by us; and they learned something they could use. Moreover, based on their workshop experience, they felt more confident that they could help these three underserved populations. Overall, workshops were clearly acceptable to participants and feasible to deliver. In addition, they contributed to an increased awareness in ADRD related to the project’s three target groups.
Rising Geographic Variation in Alzheimer's Disease Mortality
Authors: Franco Yujin , Ho Jessica 
Published: December 2021

Abstract
The burden of Alzheimer’s disease (AD) mortality has increased rapidly, growing by nearly 4- (men) and 6-fold (women) between 1990-2017. Limited attention has been paid to geographic inequalities in AD mortality. This study examines age-standardized AD mortality across 10 regions and the urban/rural continuum among adults aged 65+ using National Center for Health Statistics mortality and population data. We also examine mortality for a broader category, Alzheimer’s disease and related dementias (ADRD), to address potential underreporting. The East South Central has the highest AD death rates and experienced larger increases–5-fold (men) and 7-fold (women)–than the nation as a whole. The Middle Atlantic consistently experienced the lowest AD mortality over the past quarter-century. Differences between the best- and worst-performing regions widened over time. AD mortality was 2.5 times higher in the East North Central than the Middle Atlantic region in 2017 (268 vs. 110 [men] and 374 vs. 147 [women] deaths per 100,000). Rural areas facing health care shortages and socioeconomic deprivation may encounter substantial challenges in addressing rising AD mortality. In several regions, rural disadvantages in AD mortality emerged and widened over time. The largest gaps between nonmetros and large central metros are in the East North Central, South Atlantic, and New England, as well as Appalachia (men) and West South Central (women), with nonmetros having 14-56% higher mortality than big cities. These findings identify the heavy burden of AD mortality in the Southern and rural U.S. and have important implications for health care, service, and caregiving provision.
Self-Experienced Cognitive Function in the Digital Era: Are Older Adults at Risk of Subjective Cognitive Decline?
Authors: Smith Samantha , Splonskowski Moriah , Jacova Claudia 
Published: December 2021

Abstract
Older adults often find it difficult to use everyday technology proficiently. We hypothesized that these difficulties would be exacerbated in those with subjective cognitive decline (SCD), that is, self-perceived worsening of cognitive functions that has been associated with increased risk of future dementia. Here we investigated the relationship between SCD symptom burden and technology proficiency. A nation-wide sample of adults (N=483) ages 50-79 (66.5% female; 14.5% age &gt;70) completed an online survey via a crowdsourcing website, Amazon Mechanical Turk. The survey included the Subjective Cognitive Decline Questionnaire (SCD-Q MyCog) (0-25, M=4.71, SD=5.77), questions about respondents’ proficiency with computer, smartphone, and tablet (4-12, M=9.72, SD=1.97), and the PROMIS depression (M=13.18, SD=6.32) and anxiety (M=13.04, SD=5.68) scales. Linear regression was used to examine the ability of technology proficiency to predict SCD score. We also probed the interaction of technology proficiency with age ( &lt;70 vs. &gt;70 years), and adjusted for covariates. We found that the age/technology interaction (B=-0.80), older age (B=7.49), lower education (B=-1.08), higher depression (B=0.20) and anxiety (B=0.16) symptoms predicted higher SCD burden (R-squared=.16). For respondents &gt;70 years low technology proficiency predicted high SCD burden (B=-.79) whereas for those &lt;70 years no relationship was found. Our study draws attention to older adults’ self-experienced cognitive function in the digital era. The association between low technology proficiency and SCD may signal the adverse impact of the digital era on those who experienced technology only later in life. It is equally possible that declining technology proficiency is an indicator of emerging neurodegenerative disease.