bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social Relations, Stress, and Racial Health Disparities
Authors: Ajrouch Kristine , Webster Noah , Antonucci Toni 
Published: December 2021

Abstract
This symposium brings together four papers that address racial health disparities by investigating stressful aspects of social relations at different points in the life course. Cleary and colleagues focus on racial disparities in psychological health by testing cross-sectional effects of intergenerational stress over time. In particular, they investigate effects of network composition on the relationship between mothers' stressors and their children's depressive symptoms at three time points over 23 years. Camacho and colleagues use longitudinal data from the National Social Life, Health and Aging Project to examine cognitive decline among U.S. African-American, Latino, and White adults aged 60 and above. Results indicate loneliness predicted greater global cognitive decline over time in all groups. However, race differences in this association were found across cognitive function domains. Turner and colleagues consider dementia caregiving challenges among non-Hispanic Blacks. Data from five focus groups were analyzed to reveal distinctive challenges to caregiver health during the COVID-19 pandemic including increased burden and barriers to service access. Finally, Sol and colleagues examined the bidirectional association between loneliness and self-rated health over time among a racially diverse sample. Findings illustrate racial patterns in how loneliness at midlife influences health in later life. Antonucci will discuss the role of stress from social relations as a means to fully understand racial disparities in health across the life course.
Maternal Stress, Familial Ties, and Children’s Well-Being Across 23 Years
Authors: Cleary Jennifer , Manalel Jasmine , Brauer Simon 
Published: December 2021

Abstract
According to the family stress model, parental stress impacts child well-being through several mechanisms, which may be amplified in ethnic/racial minority families given increased experiences of stress. We extend this model to examine associations between maternal stress and child well-being at three points spanning 23 years, beginning when children were aged 8-12 years and mothers were aged 24-59 (n=193 dyads). Preliminary results indicate that maternal stressors are associated with increased depressive symptoms in childhood (B=3.56, p&lt;0.001), and this association was stronger among Black children compared to White (B=4.12, p&lt;0.001). Effects of maternal stress on children’s depressive symptoms strengthened among White children with proportionally larger kin networks (B=0.05, p&lt;0.001). However, this association weakens as children enter adulthood. Future work will focus on identifying social resources that account for changes in the intergenerational effects of stress.
Exploring the Relationship Between Subjective Age and Worry for Older Adults in Times of a Pandemic
Authors: Tingvold Maiken , Kornadt Anna , Albert Isabelle , Murdock Elke , Hoffmann Martine , Nell Josepha 
Published: December 2021

Abstract
Given the role of age as a risk factor in the covid pandemic, we examined the longitudinal cross-lagged relationship between subjective age and Covid-related worry, and possible moderators of this relationship. Data were obtained at two-time points (June and October 2020) by a phone/online survey, from N = 611 older participants (Mage = 69.92 years). Participants felt on average 10 and 8.5 years younger than their chronological ages at the two-time points, respectively. Younger subjective age at T1 increased the level of worry at T2 irrespective of age, perceived control and subjective health. Higher worry increased subjective age at T2, but only for those with worse subjective health. Our results show that subjective age and Covid-related worry interact over time. This relation needs to be explored further in order to understand the relationship between subjective age and well-being especially, but not only in the pandemic context.
A scoping study of low-wage workers’ retirement in the U.S. after the Great Recession
Authors: Yeo Hyesu 
Published: December 2021

Abstract
Background Retirement comes with high risks for low-wage workers because of their cumulative disadvantages, and the Great Recession aggravated this population's working lives. However, there has been a lack of research about this vulnerable population's retirement. The purpose of this scoping study is to offer a comprehensive understanding of low-wage workers' retirement after the Great Recession. Methods Based on the rigorous method of scoping review by Arskey and O'Mally, the researcher systematically searched, selected, and synthesized literature. The articles were collected from eight databases and were published in January 2008 - February 2019. The search terms included terms related to retirement and low-wage. After systemically reviewing titles, abstracts, and full-texts from 5,268 articles, the final chart contains sample characteristics, definitions of low-wage workers, policy/programs, etc., from 23 peer-reviewed empirical studies. Results The results indicated that: 1) Most of the retirement studies covered middle-wage class workers, excluding low-wage workers because of their lack of retirement affordability; 2) There was no common definition of low-wage workers among scholars; 3) 11 studies assumed Social Security is the only retirement income for low-wage workers, and 12 studies investigated how to improve the workers' participation in other retirement programs; 4) Most studies were economic-centered; 5) Low-wage workers had different socioeconomic and labor market characteristics. Conclusion and Implications First, a consensus on the definition of low-wage is required to improve policies and programs associated with this population's retirement. Second, the life-course perspective approach from various disciplines is necessary to improve low-wage workers' retirement, considering diverse backgrounds.
A Study of Social Isolation, Multimorbidity and Multiple Role Demands among Middle-age Adults Based on the CLSA
Authors: Li Lun , Wister Andrew , Mitchell Barbara 
Published: December 2021

Abstract
Our understanding of the influence of concurrent multiple social and family roles on social isolation among the middle-aged generation remains limited. Given the increasing complexity of parenting, caregiving and working patterns over recent decades in many countries, and greater concern of multimorbidity in mid-life, this study examines the longitudinal effects of these contexts on social isolation among middle-aged persons. We apply Linear Mixed Models to analyze a sub-sample of 29,847 middle-aged (aged 45 to 64) participants drawn from the Baseline and Follow-up 1 waves of the Canadian Longitudinal Study on Aging. Separated analyses were conducted for participants with or without multimorbidity in order to identify patterns across these groups. Both middle-aged participants with and without multimorbidity experienced greater social isolation over time. Among participants without multimorbidity, holding multiple roles serves as a protective function to prevent social isolation over time. Among participants with multimorbidity, the parenting role remain as a protective factor; however, the caregiving role increases the risk of social isolation over time. This study confirms several life-course transitions from middle age to older age, including increased risk of social isolation and caregiving demand, and decreased parenting and working involvement. Different associations were uncovered among middle-aged persons occupying multiple roles on social isolation with and without multimorbidity over time. The findings emphasize the necessity to study multimorbidity as a salient contextual factor, and to provide enhanced support to multimorbid middle-aged individuals with increasing family caregiving demands.
College Students Life Course Drawings And Their Descriptions
Authors: Schuster Amy , Terhune Katherina , Newsham Tina K , Guest M Aaron , DuMont Renee , Hackett Lauren , Patton J R , Segosebe Kebafe 
Published: December 2021

Abstract
Drawing as a qualitative method has been employed to elicit views on aging. The subject matter of the drawings, without an explanation from participants, can be misinterpreted. Therefore, in this research, we explored college students’ drawings of the life course and the extent to which the content of these drawings corresponded to their written descriptions. A content analysis was performed on 524 college students’ life course drawings and their descriptions. Participants drew, on average, five life stages. The majority (75%) of the human beings represented were alone in each life stage. Twelve percent of the drawings were non-human representations of the life course (e.g., flower, tree). The majority of the images (85%) included in the drawings were not mentioned in the written descriptions, for example, hair changes (e.g., from long and straight to curly and short for women). Some physical characteristics (e.g., wrinkles [29%], hunched back [22%]) and some contexts (e.g., tombstones [37%], nursing home [100%]) were present in both the drawing and descriptions. Findings highlight which ideas associated with aging participants thought needed an explanation and which they might have seen as intrinsic to aging, warranting no explanation, emphasizing the importance of examining both drawn and written content when using drawing as a method in aging research. A more thorough and precise examination of the beliefs and perceptions of college students, who will serve as future professionals working with older adults, allows for the development of educational and engagement strategies that accurately target commonly held misperceptions regarding aging.
“It isn’t Going to Last Forever!” The Effects of COVID-19 Pandemic on Older Adults
Authors: Liou Chih-ling 
Published: December 2021

Abstract
The media puts a spotlight on older adults’ vulnerability to COVID-19 with limited consideration on how they view and cope with this crisis. This study is to give older adults voices to share their experiences of this pandemic. Data were collected using semi-structured interviews with 46 adults between the ages of 66 and 97 from the midwestern United States. Participants were asked to share how the pandemic affects them, their vision for the future, and how they cope during the pandemic. Although they worried about their health, felt isolated and missed seeing family and friends, most participants shared an optimistic view for the future. Some said that they are looking forward to receiving the vaccine, some believed that the effects of the pandemic are just temporary, and others compared that of the pandemic to the wars and other types of hardships which were much worse. Strategies for coping during the pandemic vary from spiritual practices to positive thinking, from exercises to new hobbies, and from calling family members to cutting down on the news. The results also show that the oldest-old and old-old participants seem to be better at regulating their negative effects compared to the young-old. One female participant in her 90s shared that she does not worry about the pandemic because there is nothing that she can do about it. Older adults’ adaptability during the COVID-19 pandemic should be better understood to reverse the image of their vulnerabilities and promote late-life coping during crises.
Pandemic-Inspired Strategies for Cross-Sector Collaboration on Food Equity Across the Lifespan
Authors: Ilardo Joan , Zell Angela 
Published: December 2021

Abstract
Early during the pandemic, access to food by residents across the lifespan was problematic in many communities. We observed well-intentioned responses by community organizations but a lack of centralized coordination across sectors, even as donations and resources significantly increased. Most of the organizations were in various sectors and not aware of the efforts and capabilities of others causing duplication or gaps in services. To prepare for future emergencies, our team created a project to develop and pilot a user-friendly, evidence-based roadmap to guide communities through the process of developing and sustaining effective collaborative partnerships for food and nutrition-related problems they could address together. We will describe the process through which we developed the roadmap structure and recruited stakeholders and content experts for our advisory board. To determine the effectiveness of our interventions, we designed methods with which we can analyze the organizations willing to use the roadmap and participate in the collaborative partnership; how they implement the roadmap; and ways they cope with challenges they face during implementation using strategies in the roadmap. We will describe elements of an effective, efficient roadmap development process using as many currently available evidence-based resources as possible and creating evidence-informed resources when we identify gaps. Expected outcomes are: 1) format of the final roadmap; 2) types of groups willing to use it; 3) how well the roadmap was implemented; 4) feasibility of continued use of the roadmap by groups over the long term; and 5) potential to expand roadmap use to other communities.
Perceived Stress and Life Stressors in Adults With and Without Fibromyalgia
Authors: Nguyen Ha , Buck Courtney , Cherry Barbara , Zettel-Watson Laura 
Published: December 2021

Abstract
Fibromyalgia (FM) is a widespread chronic pain condition often accompanied by comorbid conditions, such as depression, which may impact perception of stress severity. The current study examined perceived stress and life stressors in adults ages 50 and older with and without FM. It was hypothesized that individuals with FM and/or depression would subjectively rate stressors as more severe than those without. Ninety-four participants (52% with FM, 78% female) aged 50 to 93 (M = 67.72, SD = 9.26) were administered the Perceived Stress Scale (PSS) to measure perception of stress and an updated version of the Social Readjustment Rating Scale (SRRS) to assess stressors (i.e., major life events). The difference between the SRRS pre-determined values and participants' subjective ratings was calculated. Difference scores indicated that self-reported severity exceeded standardized values. Hierarchical regression analyses revealed that older adults and men were less likely to report exaggerated stress severity. Controlling for age and gender, individuals with FM were significantly more likely to report stress severity far above standardized severity scores. Both depression and chronic pain impact stress ratings, but when controlling for the former, FM impact was no longer significant, suggesting that the impact is significantly greater for depression. Results also found a significant interaction between FM status and depression for perceived stress, but not for life event stressors, which may further emphasize the distinctions between the two measures. The findings underline the importance of assessing different types of stress and stressors in individuals with chronic pain and other related comorbidities.
Increased Self-Efficacy among Older Adults Aging-in-Place during COVID-19.
Authors: Lindquist Lee , Miller Amber , Muhammed Ruqayyah , Opsasnick Lauren , Murawski Alaine , Ramirez-Zohfeld Vanessa 
Published: December 2021

Abstract
Self-efficacy is defined as a person's belief in their capacity to execute behaviors necessary to produce specific performance attainments. It also reflects confidence in the ability to exert control over motivation, behavior, and environment. During the COVID-19 pandemic, older adults were stressed with forced isolation, concerns over mortality, and finding alternate means of fulfilling their home-based needs. We sought to assess how COVID-19 pandemic affected the self-efficacy of a cohort of older adults aging-in-place. The LITCOG cohort is a group of community-dwelling older adults (65 years and older) who have had longitudinally assessment of cognition, health literacy, and functional skills over the past 15 years. As part of a larger study of the LITCOG cohort assessing decision making for aging-in-place, we assessed self-efficacy using validated PROMIS (Patient-Reported Outcomes Measurement Information System) measures with older adults prior to COVID-19 and during the COVID-19 pandemic. Survey results were obtained from 214 subjects (n=66 pre-COVID and n=148 during COVID). Nearly half of the sample (48.2%) had either marginal (25.5%) or low health literacy (22.7%). PROMIS General Self Efficacy was higher among those assessed during the COVID-19 pandemic (45.8 (7.7) pre-COVID vs 43.7 (8.0), p=0.07). PROMIS Self Efficacy for managing social interactions was higher during the COVID pandemic (45.0 (6.1) pre-COVID-19 vs. 48.7 (8.3) during COVID-19, p=0.02). During the stress and social isolation of the COVID-19 pandemic, older adults exhibited increased levels of self-efficacy. Ongoing longitudinal follow-up will determine how this self-efficacy evolves after the COVID-19 pandemic and impacts the ability to age-in-place.
Association between Loneliness and Diseases Self-Management in Older Adults: Systematic Review
Authors: Cho Emma , Garcia Alexandra , Huang Ya-Ching , Kuo Hsuan-Ju 
Published: December 2021

Abstract
Purpose: Older adults with chronic diseases are more at risk for loneliness, and loneliness has a negative impact on health behaviors, which are key to managing chronic diseases. However, little is known about the association between loneliness and self-management behaviors in older adults with chronic diseases. As societies worldwide experience the growth of aging populations who are at higher risk of having chronic diseases as they age, clinicians and researchers should assess and address loneliness of older adults with chronic diseases. Methods: This systematic review synthesizes research found in PubMed, MEDLINE, PsychINFO, CINAHL, and SocINDEX. Findings: fourteen studies were conducted in four countries and represented n= 128,610. Loneliness was measured by three different instruments. Reports of loneliness were frequent and ranged from 7.7% (in a report of severe loneliness) to 43.2% (moderate loneliness) of older adults. Older adults who experienced loneliness were less likely to be physically active, eat a healthy diet, or cope in positive ways and more likely to be female and seek healthcare. Conclusions: This systematic review found that loneliness was moderately prevalent, and that loneliness was associated with negative disease self-management behaviors in older adults with chronic diseases. Gaps in the research include a need for studies guided by theoretical pathways, using a consistent, theoretically-based measure of loneliness, and conducted on among people with specific chronic diseases.
Death With Dignity: A Policy Analysis
Authors: Suntai Zainab 
Published: December 2021

Abstract
Death with dignity is one of many titles attributed to the practice of providing a patient with terminal illness a means to die in light of extreme suffering as a result of a terminal illness. The purpose of the Oregon Death with Dignity Act is to provide individuals suffering from a terminal illness with the right to make a written request for life-ending medication to end their life in a “humane and dignified manner.” Deborah Stone’s policy goals of equity, efficiency, welfare, security, and liberty provides a framework to analyze whether a policy is doing what it says it wants to do. As such, the goal of this presentation is to apply the policy goals framework to determine if the Death with Dignity Act is accomplishing its stated goals. Applying a theory of the policy process, the Death with Dignity Act was analyzed using the most recently available data from the Oregon Health Authority. Results showed that since the Death with Dignity Act passed in 1997, 2,518 people have received prescriptions for life-ending medications, and of those, 1657 or 66% have used the medication to end their lives. Based on the data aggregated between 1997 and 2019, the Death with Dignity Act has mostly met its purpose of providing individuals with a terminal illness with the right to die on their own terms and with dignity. However, there are still several issues regarding equity, especially for low-income BIPOC populations. Implications for practice, policy and research are discussed.
User Perceptions & Subjective Memory Concerns are Associated With Brief, Remote Cognitive Assessment Performance
Authors: Lee Samuel , Dorociak Katherine , Mattek Nora , Gothard Sarah , Lee Jonathan , Kaye Jeffrey , Hughes Adriana 
Published: December 2021

Abstract
Online cognitive tests offer a cost-effective, accessible means of cognitive screening and may prove especially important for individuals with memory complaints, a risk factor for cognitive impairment (Kaup et al., 2015). Although older adults’ perceptions of everyday technologies impact their uptake and adoption, there is limited understanding about how perceptions of online cognitive screening tests impact test performance. The purpose of the current study was to examine relationships between performance on a brief, self-administered, web-based cognitive assessment tool (SMART) and user perceptions (e.g., ratings of challenge and length), technology confidence, brain health activities, and memory complaints. Participants were 1336 adults without a diagnosis of cognitive impairment (Mage=60.48 years, SD=15.18; 65.8% female; 81.8% White; 21.2% with subjective memory complaints). Most participants (97%) were willing to complete the SMART again, with over half (53.5%) willing to complete the SMART on at least a weekly basis. After adjusting for age and education, better SMART performance (i.e., faster completion time) was associated with user ratings of greater ease of completion, higher technology confidence, and greater participation in brain health activities (p&lt;.05). In a subsample aged 60+, individuals with memory complaints took longer to complete certain SMART tasks (Trail Making Test B, Total SMART) than those without memory complaints (p&lt;.05). Results suggest that the SMART is a well-accepted tool for frequent remote cognitive screening and highlight the importance of user perceptions, technology confidence, and memory complaints on online cognitive test performance.
Impacts of COVID-19 on the Utilization of the Medicare Hospice Benefit
Authors: Plotzke Michael , Fout Betty , Christian Thomas 
Published: December 2021

Abstract
The Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE) has had a substantial impact on the provision and utilization of healthcare services. Given the high mortality rate associated with COVID-19 amongst older adults, COVID-19 is likely to have a profound impact on all hospice users due to disruptions in providing services. Our work describes how Medicare beneficiaries have utilized the Medicare Hospice Benefit (MHB) during the PHE and how that compares to utilization of the MHB prior to the PHE. We conducted a retrospective analysis of 100% Part A and Part B Fee-for-Service (FFS) Medicare claims from January 1, 2019 – December 31, 2020. We identified approximately 42.3 million unique Medicare FFS beneficiaries from January 2019 through December 2020. Of these, 1.6 million (3.8%) had at least one hospice claim and 1.7 million (4.0%) had at least one Medicare Part A or Part B claim with a COVID-19 diagnosis during the same time period. The rate of COVID-19 amongst FFS Medicare patients who utilized hospice was 8.3%. Average per-beneficiary per-month hospice visits fell by 28.2% for aides and 15.4% for nurses from December 2019 (7.1 aide visits, 6.5 skilled nursing visits) through December 2020 (5.1 aide visits, 5.5 skilled nursing visits). CMS should continue to monitor the prevalence of COVID-19 amongst hospice users and measures of hospice utilization amongst all hospice users in order to better understand how the PHE impacts the provision of the MHB and ensure beneficiaries continue to have access to needed services.