bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association Between Parents’ Physical Function and Adult Children’s Caregiving Burden
Authors: Bergren Stephanie , Le Qun , Kong Dexia , Dong XinQi 
Published: December 2021

Abstract
Using data from 544 older parents-adult children Chinese American dyads, this study aims to understand the association between older parents’ physical function and their adult children’s perceived caregiving burden. Parents’ physical function was assessed by the Katz Index of Activities of Daily Living (ADL) and the Lawton Instrumental ADL (IADL), with higher scores indicating more functional limitations. Adult children’s caregiving burden was assessed in five dimensions, including time dependence, developmental, physical, social, and emotion burden. Logistic regression was used to examine the association. More ADL limitations were associated with a higher likelihood of developmental burden (OR:1.14 (1.06-1.23)) and physical burden (OR:1.14 (1.06-1.23)) burden. More IADL limitations was associated with a higher likelihood of time dependence burden (OR:1.08 (1.03-1.12)), developmental burden (OR:1.06 (1.03-1.09)), and physical burden (OR:1.08 (1.04-1.12)). Parents’ physical function was not related to children’s social and emotional burdens. Practice and research implications will be discussed.
Just Another Storm: Conceptualizing Older Adults’ Perceptions of the COVID-19 Pandemic
Authors: Hanks Roma , Freed Christopher , Lio Shoon , Arrieta Martha 
Published: December 2021

Abstract
Older adults of color who experience health disparities are especially vulnerable to health and economic adversity related to COVID-19. This study focuses on nine zip codes wherein 70.2% of residents are of African-American descent and an estimated 31.5% of residents live in poverty. To understand the lived experience of the COVID-19 pandemic, perceived challenges of COVID-19, and the dissemination of information related to COVID-19, we collected interview and focus group data in Spring 2020 from fifteen community members, leaders, or advocates. Analyses reveal that older individuals approach the COVID-19 pandemic with familiar disaster mitigation strategies. Other persons perceive the pandemic as another community challenge that African-Americans must confront. Older adults report generational differences in perceptions of the risk of COVID-19 and compliance with health guidelines. Overall, analyses reveal a deeply cultural context for intergenerational responses associated with COVID-19 and a sense of agency among older community leaders as health advocates.
Emotional Well-Being Human Studies
Authors: Lin Feng 
Published: December 2021

Abstract
Early evidence indicates an association between EWB and underlying brain processes, and that those processes change with both normal and pathological brain aging. However, the nature of these associations, the mechanisms by which EWB and its component domains change with brain aging, and how those changes may be associated with common neuropathologies in ADRD, are largely unexplored. We propose an appraisal-adaptation model in understanding relationships between EWB and ADRD. For human models, we encourage the use of well-established measures that directly assess eudaimonic and hedonic EWB, including abnormal scenarios (e.g., neuropsychiatric symptoms, anhedonia, loneliness, etc.), as well as older adults with exceptional cognition (i.e., superagers or supernormals). Dr. Lin will review premises associated with the appraisal-adaptation model in conducting human research on EWB, aging, and ADRD.
Emotional Well-Being Animal Models
Authors: Wang Kuan 
Published: December 2021

Abstract
Clinical studies suggest an association between EWB and the risk or progression of AD. However, the mechanistic link and causal relationship between EWB and AD remain unknown, due to limited experimental access and control of the underlying human brain processes. Animal models offer genetic control of AD mutations and neural circuit analysis tools, but subjective feelings of EWB cannot be assessed through self-report. To study EWB across species, we adopt a theoretical framework that views emotions as central brain states that respond to exteroceptive or interoceptive stimuli and cause multiple cognitive, somatic and behavioral changes. Recent neuroanatomical and functional imaging studies have identified evolutionarily related brain circuits in the encoding and regulation of central emotional states in animals. Dr. Wang will review progress in elucidating the functional activities of these circuits and discuss the challenges and opportunities to link these neural representations to EWB and AD related pathological progression.
NIA Priorities on Emotional Well-Being
Authors: Simmons Janine 
Published: December 2021

Abstract
In 2021, NIH funded six high-priority research networks designed to develop resources to support and advance the study of emotional well-being (EWB) and its core components. These research networks aim to advance the field by facilitating transdisciplinary research in the social, behavioral, psychological, biological, and neurobiological sciences. The National Institute on Aging (NIA) co-sponsored the RFA, and provided funding for NEW Brain Aging, because of the central importance of EWB to health trajectories across the adult lifespan. In this presentation, Dr. Simmons, Chief of the Individual Behavioral Processes Branch within the NIA Division of Behavioral and Social Research (BSR), will discuss how EWB research fits within NIA priorities. She will then facilitate open discussion about NIA and BSR’s vision for the EWB ‘network of networks,’ the synergy of NEW Brain Aging with other members of the larger network, and the opportunities these networks will provide for investigators interested in EWB.
Association of Leukocyte Telomere Length With Perceived Physical Fatigability
Authors: Katz Rain , Zmuda Joseph , Lee Joseph , Honig Lawrence , Christensen Kaare , Feitosa Mary , Wojczynski Mary , Glynn Nancy W 
Published: December 2021

Abstract
Leukocyte telomere length (LTL) is a potential marker of biological aging, but its relationship to fatigability, a prognostic indicator of phenotypic aging (e.g., functional decline) is unknown. We hypothesized shorter LTL would predict greater perceived physical fatigability. Two generations of participants (N=1,997; 309 probands, 1,688 offspring) were from the Long Life Family Study (age=73.7±10.4, range 60-108, 54.4% women). LTL was assayed at baseline and 8.0±1.1 years later perceived physical fatigability was measured using the validated, self-administered 10-item Pittsburgh Fatigability Scale (PFS, 0-50, higher scores=greater fatigability). Prevalence of greater physical fatigability (PFS scores≥15) was 41.9%. Using multivariate linear regression, one kilobase pair shorter LTL predicted higher PFS Physical scores (β=0.9, p=0.025), adjusted for family relatedness, generation (indicator for age), field center, follow-up time, sex, and follow-up body mass index, physical activity, health conditions. LTL, a promising marker of future fatigability, may allow for early identification of those at-risk for deleterious aging.
Associations Between Perceived Fatigability and Amyloid Status in the Baltimore Longitudinal Study of Aging
Authors: Liu Fangyu , Dougherty Ryan , Wanigatunga Amal , Bilgel Murat , An Yang , Simonsick Eleanor , Resnick Susan , Schrack Jennifer 
Published: December 2021

Abstract
Higher level of and greater longitudinal increase in perceived fatigability are linked to cognitive decline and lower brain volumes in older adults. However, it remains unclear whether perceived fatigability is associated with Alzheimer’s disease-related brain pathology. In the BLSA, 163 participants without neurological disease or cognitive impairment (aged 74.7+/-8.4 years, 45% men) were assessed for perceived fatigability using rating of perceived exertion after a 5-minute (0.67 m/s) treadmill walk and Aß burden using 11C-Pittsburgh compound B (PiB) positron emission tomography. Forty-four participants were PiB+ based on a mean cortical distribution volume ratio (DVR) cut point of 1.066. After adjusting for demographics, body composition, comorbidities and ApoE-e4, higher perceived fatigability was not associated with PiB+ status (OR=0.84; 95% CI: 0.69, 1.05). Results suggest perceived fatigability may contribute to cognitive decline through pathways other than Aß pathology. Future studies should target other mechanisms linking perceived fatigability and cognitive decline.
Dyads' Perceptions: Recruiting Persons Living With Dementia and Caregivers in a Clinical Trial
Authors: Sefcik Justine , Petrovsky Darina , Brewster Glenna , Li Junxin , Gooneratne Nalaka , Hodgson Nancy , McPhillips Miranda 
Published: December 2021

Abstract
Recruiting persons living with dementia (PLWD) and their caregivers (dyads) into research is challenging and costly. The purpose of this study was to better understand factors that influence dyads decisions to enroll in a clinical trial. We used Ajzen’s Theory of Planned Behavior (TPB) to develop a qualitative interview guide and analyze the data with a directed content analysis. We conducted semi-structured telephone interviews with 12 PLWD and 9 caregivers who all enrolled in one clinical trial. Aligning with the TPB we found the following positively influenced enrollment: 1) wanting to learn, in-person meetings with knowledgeable staff, and the money always helps (attitudes toward joining); 2) to support another person (perceived norm); and 3) easy to participate (perceived behavioral control). Flexible scheduling and the study taking place in the home was comfortable and convenient for participants. Findings can inform future recruitment efforts and research studies.
Implementing Physical Activity Studies During COVID-19 and Winter Storms: Lessons Learned
Authors: Na Annalisa , Murphy Calliope , Chao Tony , Morrison Charles , Chapman Karen , Lindsey Ronald , Hastings Mary 
Published: December 2021

Abstract
Patient recruitment and retention are challenging for longitudinal studies. Stay-at-home restrictions for the Galveston and Houston regions in 2020 for COVID-19 and in 2021 for the Winter Storms shut down elective healthcare activities and created additional recruitment barriers during the implementation of a 12-month study examining the physical function of older adults receiving a total knee arthroplasty. This presentation describes recruitment and retention strategies during natural disasters. Ten participants started the study during the pandemic and 6 remained through the winter storms (3 withdrew, 1 no showed). Physical activity monitors were distributed and collected through mail, patient reported outcomes were completed online or over the phone, clinician-initiated measures were only collected when clinics were open, and efforts were made to minimize staff burden and follow evolving hospital guidelines. Most importantly, regular communication and follow-up with participants, research team, and department personnel created a sense of community.
Linkages Between Indigenous Cultural Generativity and Sobriety to Promote Successful Aging Among Alaska Natives
Authors: Lewis Jordan 
Published: December 2021

Abstract
This article builds on the People Awakening Project, which explored an AlaskaNative understanding of the recovery process from alcohol use disorder and sobriety. The presentation will explore motivating and maintenance factors for sobriety among older AN adult participants (age 50+) from across Alaska. Ten life history narratives of Alaska Native older adults, representing Alutiiq, Athabascan, Tlingit, Yup’ik/Cup’ik Eskimos, from the PA sample were explored using thematic analysis. AN older adults are motivated to abstain from, or to quit drinking alcohol through spirituality, family influence, role socialization and others’ role modeling, and a desire to engage in indigenous cultural generative activities with their family and community. A desire to pass on their accumulated wisdom to a younger generation through engagement and sharing of culturally grounded activities and values, or indigenous cultural generativity, is a central unifying motivational and maintenance factor for sobriety. The implications of this research indicates that family, role expectations and socialization, desire for community and culture engagement, and spirituality are central features to both Alaska Native Elders’ understanding of sobriety, and more broadly, to their successful aging. Sobriety can put older Alaska Native adults on a pathway to successful aging, in positions to serve as role models for their family and community, where they are provided opportunities to engage in meaningful indigenous cultural generative acts.
Pet Ownership and Longitudinal Change in Physical Function: Evidence From the BLSA
Authors: Friedmann Erika , Gee Nancy , Simonsick Eleanor , Barr Erik , Resnick Barbara , Werthman Emily , Adesanya Ikmat 
Published: December 2021

Abstract
Successful aging depends on avoiding disease and disability, maintaining high physical and cognitive function, and psychological adaptation. Research examining the relationship of pet ownership (PO) or human-animal interaction (HAI) to human health supports contributions to these successful ag-ing-related outcomes at some point in the life-cycle, mostly in populations with diseases or disabili-ties. We examine the contributions of PO to maintaining physical capacity among generally healthy community-dwelling older participants in the Baltimore Longitudinal Study of Aging (BLSA). Partici-pants’ [N=637, mean age=68.3 years (SD=9.6), pet owners N=149] completed a standardized physi-cal function test battery (among other measures) every 1-4 years and a ten-year PO history. Linear mixed, or generalized linear mixed, models with time varying PO were used to examine change in successful aging-related outcomes over up to 13 years [mean=7.5, (SD=3.6)] according to PO. Physi-cal function declined across all domains examined, but was observed to be less severe with PO in overall physical performance (p&lt;0.001), rapid gait speed (p=0.041), 400-meter walk time (p&lt;0.001), and reported physical wellbeing (p=0.032). No differences were observed for grip strength (p=0.56), usual gait speed (p=0.07), and leisure time physical activity (p=0.26) after con-trolling for age. This study provides the first longitudinal evidence that PO may promote successful aging among community-dwelling healthy older adults by moderating age-related declines in physical functional status in late-life.
Support From a Distance: How Home Care Agencies Influence Paid Caregiving in the Home
Authors: Franzosa Emily , Stone Robyn 
Published: December 2021

Abstract
Paid caregivers (e.g., home health aides, personal care attendants, and other direct care workers) who care for functionally impaired older adults in the home frequently report that while rewarding, their work is logistically, physically, and emotionally demanding. Unlike direct care workers in institutional settings, paid caregivers work with care recipients one-on-one in private settings and often have limited contact with or support from their employers. These factors contribute to high workforce turnover and may impact the quality of patient care. In this symposium, we explore ways that home care agency policies and practices influence the experience of giving and receiving care in the home. First, Bryant et al. describe the range of agency-based models and the impact of workplace design in creating supportive working environments. Next, Fabius et al. explore characteristics of direct care agencies across Maryland, with implications for worker training and support. Reckrey et al. describe the differing perceptions of aides, caregivers and providers around the role agencies play in defining paid caregivers’ roles, and how this may lead to conflict within the caregiving team. Finally, in the context of COVID-19, Franzosa et al. examine communication and coordination between Veterans Affairs-paid agencies and home health aides during the pandemic, while Tsui et al. present a case study of an agency’s efforts to support paid caregivers through group support calls. Together, these studies highlight challenges in the structure, organization and perceptions of home care agencies, and identify potential avenues for agencies to support paid caregivers and their clients.
Job Design for Home Care Work: Perspectives From Employers and Home Care Aides
Authors: Bryant Natasha , Stone Robyn , Hennessa Alex 
Published: December 2021

Abstract
Home-based care is a rapidly growing sector becoming more important to individuals, families, providers, and payers. The ways in which agencies create the work environment for home care aides who are essentially in their clients’ homes is not adequately documented and may be changing rapidly with labor market innovations. This qualitative study describes how different home care business models (e.g., non-profit VNAs, for-profit franchises, uber-style matching, worker-owned coops) address job design and the overall work environment for home care aides. Interviews with employers and focus groups with home care aides examine workplace practices, how work is organized and supported when the workforce is virtual and the workplace is a client’s home, and the perceived attributes of a positive workplace environment across business models. This study fills significant knowledge gaps about home care workplace design and the role of agencies in creating a supportive environment.
Characteristics, Challenges, and Support of Maryland's Direct Care Workers: Findings From a Statewide Agency Survey
Authors: Fabius Chanee , Johnston Deirdre , Wolff Jennifer 
Published: December 2021

Abstract
Direct care workers (e.g., personal care aides) are paid health care professionals who provide hands on assistance with daily activities to persons with disabilities in home, community, and institutional settings. Many workers are employed by direct care agencies, but little is known or understood about the organizational attributes of these agencies. We describe results from a mixed mode (postal mail, electronic, and telephone) survey of n=1112 residential care agency administrators in Maryland to assess organizational (e.g., size, supplemental services) and direct care worker (e.g., training) characteristics. Preliminary findings indicate that half of direct care agencies’ revenue comes from Medicaid and roughly 40% of clients are living with dementia. Administrators report challenges managing dementia-related behaviors (70%), communicating with persons living with dementia (63%) and interacting with family caregivers (63%). Findings from this work will inform the development of an organizational level intervention that targets training and support of direct care workers.
Navigating COVID-19: Communication and Coordination Between Home Care Agencies and Aides Caring for Older Veterans
Authors: Franzosa Emily , Judon Kimberly , Gottesman Eve , Runels Tessa , Koufacos Nicholas 
Published: December 2021

Abstract
Home health aides are essential members of the home care team, but often report limited communication with agency supervisors. To explore the impact of COVID-19 on these dynamics, we conducted semi-structured interviews with providers (n=9), contracted home health agencies (n=6), and aides caring for veterans (n=8) at an urban Veterans Affairs medical center. Data were analyzed through thematic analysis. Agencies relied on aides to observe and report on patients’ conditions, including COVID-19 symptoms, but aides were not always aware of follow-up and wanted more information about their patients’ health and COVID-19 status. Agencies also reported providing personal protective equipment (PPE) and infection prevention guidance to aides; however, some aides reported purchasing their own PPE and seeking out private COVID-19 testing. Supporting aides by providing needed training and protective resources, and engaging them more collaboratively in medical care, may help improve job satisfaction and quality of care.
I Would be More at a Loss Without It: Technology as a Tool for Resilience for Older Adults During the COVID-19 Pandemic
Authors: Newmark Rebecca , Allison Theresa , Smith Alexander , Perissinotto Carla , Kotwal Ashwin 
Published: December 2021

Abstract
COVID-19 associated shelter-in-place orders led to concerns about worsening social isolation and inadequate access to technology among older adults, yet little is known about technology use in this population during the pandemic. We examined older adults’ experiences with technology during shelter-in-place in order to identify lessons learned for a post-pandemic world. We conducted semi-structured in-depth interviews with a purposive sample of 20 community-dwelling older adults in San Francisco. Two independent coders conducted concurrent data analysis using inductive and deductive approaches to identify salient themes. Participants were 78 years on average (range 64-99), 55% female, 25% Black, 75% lived alone, and 60% reported at least one ADL impairment. Technology emerged as core aspect of resilience, indicating whether older adults could navigate pandemic restrictions, with two primary themes identified. First, many participants reported discovery of new technologies to maintain or develop new connections, including Zoom-based community groups and telehealth services (“there’s all kinds of virtual programs where you can exercise”). Second, older adults were resourceful in identifying community resources and enlisting family members to learn (“I had to ask one of my granddaughters how to make the chat thing work”). Despite difficulty navigating passwords, software updates and other common obstacles, most participants expressed gratitude for technology and the connectivity made possible. Many indicated an intention to integrate new technology-based social interactions into everyday life even after restrictions ended. The COVID-19 pandemic has highlighted the role technology can play in fostering resilience among older adults in adapting to external stressors.
Failing to Plan Is Planning to Fail: Utilization of Advance Care Directives in Older Adults Living With HIV
Authors: Nash Paul , Nguyen Annie , Egbert Anna , Brennan-Ing Mark , Karpiak Stephen 
Published: December 2021

Abstract
Advance Care Planning (ACP) makes up an integral part of the care continuum, especially for those living with chronic conditions such as HIV. Little research exists to understand how intersections of race, gender, sexuality and gender identity combine to influence the choices made by older adults living with HIV regarding ACP. The Research on Older Adults with HIV (ROAH) 2 study collected data from across the US and investigated the incidence and range of ACP amongst those 50+ living with HIV. Correlational analysis indicated that being White was significantly related to having at least one directive (R=0.070, p=0.035) where being African American correlated negatively with several forms of ACP. Additionally, there were also significant relationships between being Transgender, being gay, and being a woman as to the engagement with ACP options. Further analysis explored the impact of finance, self-rated health and social support networks.