bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Matters Most: ACP Evolving in Practice
Authors: Valadares Kevin 
Published: December 2021

Abstract
The University of Southern Indiana (USI) GWEP uniquely embeds Area Agencies on Aging (AAA) care coordinators within primary care settings to invite the participation of aging patients in advance care planning (ACP), among other health interventions. Two subsequently developed features of the USI GWEP’s ACP initiative emerged to address the What Matters metric of the 4Ms: 1) Patients are invited to engage in What Matters Most conversations through multiple touchpoints that frame Medicare Wellness Visits with a Deaconess provider and introduce a free, online ACP platform, Prepare for Your Care. 2) Provider, patients and families are supported in having ACP conversations with the dedication of a new Advance Care Planning facilitator position. Certified in Respecting Choices and jointly funded by the GWEP and Deaconess, the ACP facilitator supports individuals in navigating these essential healthcare conversations about balancing quality care with quality of life.
Elderhood, Agency and Existential Vulnerability
Authors: Laceulle H E 
Published: December 2021

Abstract
Popular conceptualizations of elderhood often use a spiritually inspired language of personal growth and wisdom. These conceptualizations are rightly critical of the language of activity and productivity that abounds in dominant successful aging discourses. Instead, the emphasis is placed on embracing our diminishing strength and increasing dependence with an attitude of resignation and gracious acceptance. Problematically, however, this can reinforce the ageist cultural assumption that old age lacks agency. If the emerging discourse about elderhood is truly to serve as a more inspiring cultural image of late life, it requires a reconceptualization of agency in the face of existential vulnerabilities. This paper aims to present a possible philosophical outlook for such a reconceptualization. It will draw on sources from feminist philosophy to argue how confrontations with vulnerability need not be an obstacle, but rather inspire alternative conceptualizations of agency that are a welcome addition to gerontological thinking.
Elderhood as an Anti-Ageism Intervention
Authors: Gendron Tracey , Arnette Shannon , Inker Jenny , Marrs Sarah , McIntyre Maddie , Bert Waters 
Published: December 2021

Abstract
Ageism is a complex, multi-layered phenomenon impacting feelings, thoughts and behaviors toward self and others. Due to the complexity of ageism, evidence-based anti-ageism interventions have proved challenging and costly. To date, using the concept of elderhood as a mechanism to mitigate the negative impacts of ageism has not been explored. As an anti-ageism strategy, elderhood reframes later life as a stage that encompasses growth and development and expected loss and decline. The current study evaluated a brief video intervention among first-year medical students before participating in a year-long senior mentoring program. First-year medical students (N = 585) from 2018-2021 responded to open-ended questions after viewing the video. Thematic analysis revelated four themes: neutrality, elderhood as development, reframing stigma and elderhood as othering. Findings suggest that elderhood may be a viable and productive anti-ageism strategy.
The Effect of Medicaid Enrollment on Family Caregiving
Authors: Jutkowitz Eric , Shewmaker Peter , Lake Derek , Rahman Momotazur 
Published: December 2021

Abstract
Most people with long-term care needs rely on family caregivers. People with long-term care needs are also more likely to be eligible for Medicaid, which is the largest public payer of home and community based long-term care services. Whether enrolling in Medicaid compliments or substitutes for family caregiving is unknown. We linked Health and Retirement Study (HRS) respondents with their Medicaid enrollment data (2002-2012), to determine the effect of enrolling in Medicaid on family caregiving hours. We identified 130 people that participated in the HRS interview prior to enrolling in Medicaid in the same year (i.e., untreated) and 142 people that participated in the HRS interview after recently enrolling in Medicaid (i.e., treated). Untreated and treated respondents had similar demographic characteristics (age, sex, race). We estimated a series of inverse probability weighted linear regression adjusted models to determine the difference in monthly family caregiving hours between individuals that newly enrolled in Medicaid compared to people that had yet to enroll. We controlled for HRS respondents’ demographics, health care utilization, and nursing home utilization. HRS respondents interviewed after enrolling in Medicaid received 5.98 (95%CI: -27.60, 39.57) fewer monthly hours of family caregiving than respondents that had yet to enroll in Medicaid. HRS respondents interviewed after enrolling in Medicaid were not statistically more likely to receive any family caregiving (risk difference 0.05% 95%CI: -0.16, 0.06) than HRS respondents that had yet to enroll in Medicaid. Initial enrollment in Medicaid does not substitute for family caregiving.
How Long-Term Care Quality Assurance Measures Address Dementia in Australia, England, Japan, and the United States
Authors: Lepore Michael , Edvardsson David , Igarashi Ayumi , Meyer Julienne 
Published: December 2021

Abstract
The prevalence of people with dementia living in long-term care (LTC) is high and rising internationally, and the need to improve LTC for people with dementia is widely recognized. In some countries, LTC quality assurance programs use quantitative measures of LTC quality, and international bodies emphasize the importance of person-centered care and healthy ageing outcomes. To better understand how LTC quality assurance programs address dementia, programs were reviewed in four countries—Australia, England, Japan, and the United States. Quality measures from each program were identified (n = 38) and examined to determine how they address dementia. Most measures did not address dementia, but four risk-adjusted for dementia (antipsychotic use, fractures, falls, mobility), one was dementia-specific (dementia/delirium hospitalizations), and one excluded people with dementia (losing bowel/bladder control). The other 32 measures were calculated equally regardless of the prevalence of dementia among LTC residents. Overall, LTC quality measurement differs internationally, but few measures address dementia. When dementia is addressed in quality measure calculations, it is most often as a risk-adjustor. Risk adjustment can help with attributing performance on these measures to the LTC setting rather than to the types of residents that the setting serves, but risk adjustment factors also are highly amenable to fraud, and thus require ongoing monitoring. Although LTC quality assessment programs and measures can help ensure people with dementia have access to quality LTC, adoption of measures that are meaningful to people with dementia—including measures of person-centered care and healthy ageing outcomes—remains needed.
The Academy of Gerontology in Higher Education Perspective
Authors: Howe Judith 
Published: December 2021

Abstract
Chair: Lori Simon-Rusinowitz;Panelists: Representatives of GSA Sections - Phillip Rozario (SRPP), Stephen Helfand (BS), Tamara Baker (BSS), Cynthia Brown (HS), Judith Howe (AGHE), Darina Petrovsky (ESPO); Discussant: Brian Lindberg. This interactive session is an interdisciplinary look at policy issues in aging with the speakers representing views from their sections. This session, organized by the GSA Public Policy Panel, will provide both GSA section leadership and attendees an opportunity to have an open dialogue on important public policy issues of significance in the field of aging. Presentations will likely address the COVID-19 pandemic, how GSA, each section and its members, and the federal government responded during the past year; how the policy work has been influenced by the increased acknowledgement of institutional and societal racism; and member experiences with the influx of additional economic relief, research funding, and funding for aging supports and services programs.
A Multidimensional Construct of Religiosity Among Baby Boomers and Trajectories of Social Attitudes
Authors: Yoon Joonsik , Hwang Woosang , Brown Maria , Silverstein Merril 
Published: December 2021

Abstract
Although a number of studies have examined relationships between religiosity and social attitudes, less is known about how these relationships change over the life course using a multidimensional construct of religiosity among Baby Boomers. A multidimensional construct of religion allowed us to take a more person-centered approach to religiosity, whereby we examine the association between Baby Boomers with different types of religiosity and the trajectories of their political and gender role attitudes over a period of transition from early to later adulthood. We selected 798 young-adult Baby Boomers from the 1971 wave (mean age: 19 years) of the Longitudinal Study of Generations (LOSG) and tracked their political and gender role attitudes through until the 2016 wave (mean age: 64 years). Using latent class analysis, we identified four latent religious typologies: strongly religious, weakly religious, liberally religious, and privately religious. We found that Baby Boomers in the strongly religious class reported the most conservative political and gender role attitudes among the four classes over this period of transition. Baby Boomers in the privately religious class were conservative in their political and gender role attitudes than those in the weakly religious class. The liberally religious group generally reported the second most conservative political attitudes among the four identified groups, but reported the least conservative gender role attitudes of the four groups. Findings suggest that early religiosity may serve as a significant predictor affecting political and gender role attitudes throughout the adult life course.
The Occupational Narratives of Older Adults Participating in Music-Based Occupations
Authors: Cleveland Penelope Moyers , Beckstein Kassidy , Gartner Allie , Hay Lexy , King Mackenzie , McLeish Sammy , Romatz Courtney 
Published: December 2021

Abstract
The purpose of this study was to implement an occupational therapy intervention that could be used for telehealth services with an emphasis on participants learning ways to independently choose and sustain engagement in meaningful music activities, known as occupations. The researchers’ aim was to examine how music occupation interventions lower risks of occupational deprivation (i.e., prolonged restriction from participation in necessary or meaningful activities) that could occur due to the COVID-19 pandemic. Eight adults participated who were 65 years or older, lived in the community, and enjoyed music. The researchers used narrative qualitative methodology to analyze pre- and post-intervention focus group data. The participants completed seven intervention sessions designed to increase and sustain music engagement outside of the sessions. The pre-intervention focus group data resulted in an occupational pattern analysis and a single occupational narrative. Triangulation of data post-intervention included the two focus groups and their pattern analyses and narratives, field notes from each intervention session, and documents produced through group completion. The final analysis produced an occupational change pattern analysis and narrative. The focus of the change narrative was on the participant’s management or prevention of occupational deprivation. The researchers identified several common themes involving change in routines and habits to include regular engagement in meaningful music activities, skills for using occupational participation as an important method of coping with COVID-19, and developing new technological skills to access music to replace in-person participation of attending live concerts and shows when deemed unsafe because of potential for virus transmission.
Long-Term Cognitive Effects From a Real-World Multi-Skill Learning Intervention in Older Adults
Authors: Ferguson Leah , Sain Debaleena , Kürüm Esra , Strickland-Hughes Carla , Rebok George , Wu Rachel 
Published: December 2021

Abstract
Previous cognitive learning interventions have focused primarily on learning one or two novel real-world skills at a time, or utilizing computer-based programs to enhance specific cognitive skills (Ball et. al 2002; Park et. al, 2014). While these studies yielded immediate cognitive improvements in participants, the long-term benefits of continuing to learn several real-world skills in older adulthood is unclear. In the present two studies, the long-term (1-year post-intervention) benefits of a multi-skill learning intervention were investigated with older adult participants. Study 1 (a pilot sample) included 6 participants (67% female, M = 66.33 years, SD = 6.41, range = 58–74 years old) and Study 2 included 27 participants (67% female, M = 69.44 years, SD= 7.12, range = 58–86 years old). Following a three month intervention which entailed simultaneously learning at least three real-world skills, such as photography, drawing, and Spanish, participants’ cognitive abilities were assessed using four tasks (Flanker, Set-Shifting, Dot Counting, and N-Back), as well as RAVLT and Digit Span. Follow-up assessments were completed at three-, six-, and 12-month follow-ups after the interventions. Linear mixed-effects regression models revealed significant cognitive improvements across time points up to one year following the intervention compared to baseline assessments. These promising results support the idea that intense learning experiences may lead to considerable cognitive growth in older adulthood, as they do earlier in the lifespan.
Exploring the Experiences of Persons Living With Dementia and Their Care Partners During the COVID-19 Pandemic
Authors: Yonashiro-Cho Jeanine , Avent Elizabeth , Mosqueda Laura , Gassoumis Zachary 
Published: December 2021

Abstract
Public health measures implemented to mitigate the spread of COVID-19 have transformed the physical and social environments in which we live. The effects of these policies on persons living with dementia (PLWD) and their care partners (CPs) are not fully understood. This study explores the experiences, attitudes, and perceptions of caregiving dyads during the COVID-19 pandemic. Cross-sectional survey data were drawn from a larger longitudinal study examining the relationship between PLWD aged 65+ and their CPs being conducted in a metropolitan city significantly affected by COVID-19. Interviews with were conducted remotely via videoconferencing and telephone. Data on sources and types of care provided for the PLWD, relationship quality and conflict, and caregiver stress were collected and analyzed using descriptive statistics and tests of independence. Preliminary results from PLWD (n=8) and CPs (n=13) confirmed a reduction in social interaction with family members and friends. CPs reported they (n=5) or other family members (n=2) changed their schedules to provide care for the PLWD. CPs reported increased conflict with the PLWD regarding care provision, going out or welcoming visitors, and home management. In contrast, PLWD reported a lack of conflict among household members (n=6) and the perception of good changes (n=2) and increased quality time with CPs. Preliminary findings provide empirical evidence of the effects of pandemic public health policies on dyads enrolled in this study and reveal differences in perceived relational conflict between PLWD and their CPs. Further research is needed to better understand the experiences of dyads and develop supportive interventions.
Testing Online Men’s Groups to Promote Psychological Well-Being and Reduce Despair During the COVID-19 Pandemic
Authors: Heisel Marnin , Links Paul , Sarma Sisira , Flett Gordon , Wilson Kimberly , Hatcher Simon , Lapierre Sylvie , Conn David 
Published: December 2021

Abstract
Suicide prevention is a healthcare and social justice priority. Older adults have the highest rates of suicide and the highest COVID-19 fatality rates in North America. The combined impacts of social isolation, fear of infection, apathy, and hopelessness could amplify suicide risk among older adults, as appears to have been the case during the 2003 SARS epidemic in Hong Kong. Innovative interventions are thus needed to promote social interaction and reduce risk for suicide in these challenging times. We are currently testing an online version of our Meaning-Centered Men’s Group (MCMG; Heisel et al., 2020), an upstream psychological intervention designed to promote psychological well-being and reduce suicide risk among men struggling with the transition to retirement, in the context of pandemic-related public health restrictions. This presentation will focus on adaptations to MCMG for online delivery, and share participant experiences and findings on positive and negative psychological outcomes.
Disruption to Substance and Opioid Use Disorder: The Deep South Substance and Opioid Use Rural Training Grant
Authors: Allen Rebecca , Jacobs Lindsey , Rybarczyk Bruce 
Published: December 2021

Abstract
The primary objective of this symposium is to describe our integrated, interprofessional behavioral health training program in substance use and opioid use disorders (SUD/OUD) across the adult lifespan (19 to 80) within our clinical psychology graduate program in the Deep South. Due to the COVID-19 pandemic, our assessment, treatment, and prevention delivery has occurred via telehealth. The first paper describes our Clinical Training Model in two federally qualified health centers (one peri-urban and one rural) and one residential drug and alcohol rehabilitation program. Graduate and undergraduate students provide prevention, assessment, and treatment with an emphasis on 1) mindfulness-based relapse prevention, 2) literacy-adapted treatment for chronic pain, and 3) trauma and recovery. The second paper describes the participant population. Specifically, participants (N = 105) receiving prevention, assessment and treatment services report high levels of substance and opioid use and are underserved, impoverished, and have low levels of education and health/mental health literacy. The third paper explores the relation of age, adverse childhood experiences, and PTSD symptoms within the context of substantial or severe SUD/OUD. The final paper describes issues surrounding telehealth delivery in the rural south with underserved populations. The discussant, an expert in integrated, interprofessional telehealth delivery across the adult lifespan, will provide insight on program sustainability and dissemination. Given the pronounced need for SUD/OUD treatment in underserved populations with attention to the intersection of age and urban/rural residence, this project is poised to make a substantive impact across the adult lifespan.
A Typology of Health Services Regulated in U.S. Assisted Living Communities
Authors: Carder Paula , Smith Lindsey , Zhang Wenhan , Zimmerman Sheryl , Sloane Philip , Thomas Kali 
Published: December 2021

Abstract
State agencies regulate assisted living (AL) with varying approaches across and within states. The implications of this variation for resident case mix, health service use, and policy, are not well described. We collected health services-relevant AL regulatory requirements for all 50 states and DC and used a mixed-methods approach (thematic analysis; k-means cluster analysis) to identify six types: Housing, Affordable, Hybrid, Hospitality, Healthcare, and Hybrid-Healthcare. We stratified Medicare claims data by regulatory type, identifying variation in resident case mix and health service use. Housing and Affordable clusters have larger proportions of dual-eligible beneficiaries, Black residents, and residents of Affordable had more long-term nursing home use compared to other clusters. Dual-eligible beneficiaries account for 26.6% of Housing cluster residents compared to 8.1% of Hybrid Healthcare cluster residents. We provide other examples and explain the implications in terms of sampling AL for single and multi-state studies, racial disparities, and health-related policies.
Environmental Assessment of Housing for Older Adults Facing Housing Insecurity
Authors: Gurung Shreemouna , Elkes Shelby , Mahmood Atiya , Qureshi Muhammad , Chaudhury Habib , Canham Sarah , Weldrick Rachel 
Published: December 2021

Abstract
The Aging in the Right Place Environmental Audit (AIRP-ENV) and Secondary Observation (AIRP-ENV-SO) tools were developed to conduct observation-based audit of the built environment in shelters, transitional housing, independent housing with offsite/onsite supports, and permanent supportive housing with onsite medical and/or specialized services for older adults experiencing (or at risk of) homelessness. The 241 item AIRP-ENV tool is used to audit the presence/absence of exterior and interior built environmental features that support housing stability. The seven open-ended questions in the AIRP-ENV-SO tool is used to collect contextual data on function, safety and land-use of surrounding neighborhood. Data were collected at four sites of a transitional housing program in Vancouver, Canada as part of a multi-year, multi-city partnership project on aging and homelessness. Preliminary results demonstrate that built environment and urban design features (e.g., access, privacy, flexible and supportive spaces) contribute towards tenants’ residential resiliency and aging in place.
Effects of Age and Social Adversity on Immune Cell Populations in a Non-Human Primate Model of Human Aging
Authors: Sanchez-Rosado Mitchell , Snyder-Mackler Noah , Higham James , Brent Lauren , Marzan-Rivera Nicole , Pavez-Fox Melissa , Watowich Marina , Sariol Carlos A 
Published: December 2021

Abstract
Significant hallmarks of aging are immune function decline and rising cumulative inflammation. These immunosenescent signatures are also found in individuals who experience chronic social adversity, independently of age. However, no studies to date have examined how social adversity alters immune function across the lifespan –data that are essential to identify the molecular routes through which social adversity might lead to increased aging-related disease. Over a two-year period, we investigated how age and social adversity (quantified by low social status) affected immunity. We measured immune cell proportions at baseline and their gene regulation after in vitro stimulation with pathogen molecules that stimulated both Th1 and Th2 immune responses in a population of free-ranging rhesus macaques. We first performed flow cytometry on peripheral whole blood to quantify changes on immune cell proportions across the lifespan (n=235) and in animals of different social statuses (n=141). We found significant decreases in CD20+ B cells and CD3+/CD4+ T cell proportions with age, suggesting diminished antibody production and adaptive immune responses in older individuals. Age-associated increases in CD3+/CD8+, CD3+/CD4+/CD25+ T regulatory cells and CD14-/CD16+/HLA-DR+ non-classical monocytes indicated heightened baseline inflammation in older animals. Social adversity recapitulated the effects of aging in CD14+/CD16-/HLA-DR+ classical monocytes, indicating immune deficits in phagocytosis and pathogen clearance in older and lower status individuals. Using RNA-seq, our stimulations (n=1,320) will allow us to identify molecular immune pathways that are disrupted by age and social adversity, similarities in response between age and adversity, and how the effect of adversity varies across the lifespan.