bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Determines Vulnerability to Neighborhood Walkability in Older Adults?
Authors: Rosso Andrea , Rosano Caterina , Harding Alyson , Studenski Stephanie , Clarke Philippa 
Published: December 2021

Abstract
Environmental influences are recognized as important predictors of walking behaviors in older adults. However, individuals may differ in vulnerability to low environmental walkability. We determined associations of a walkability index (factor analysis of 16 variables; range -1.65 to 2.23) from audits of online images with self-reported walking behaviors in 406 adults mean age=82 (44% male, 39% Black). Effect modification by 12 variables representing sociodemographics, physical and mental health, and neighborhood characteristics was tested in general linear models. Effect modification was evident for knee pain, marital status, and neighborhood socioeconomic status (nSES) (all p-interaction&lt;0.05); associations were present only in those with knee pain, those who were unmarried, and those in the highest race-specific tertile of nSES. For example, a 1 point higher walkability score was associated with 1.06 (CI: 0.78, 1.44) higher odds of walking in those without knee pain compared to 1.91 (CI: 1.25, 2.90) in those with knee pain.
Adjunctive Telehealth Mindfulness Therapy for Persons With Dementia and Their Caregivers in the Rural Deep South
Authors: Jacobs Lindsey , Durkin Daniel , Hilgeman Michelle 
Published: December 2021

Abstract
The emotional care needs of persons with dementia (PwD) and their caregivers are multitudinous. Multicomponent interventions may be necessary to meet their multiple needs. Mindfulness interventions have a positive impact on well-being but are often only offered as a stand-alone treatment and typically are available only to the caregiver. This presentation will describe a telephone-delivered adjunctive mindfulness intervention that was offered to caregivers and dyads in conjunction with care consultation. Participants were 26 caregivers and 22 PwD living in the Deep South. The adjunctive mindfulness therapy included four core sessions and an additional five sessions that were optional. Mindfulness was deemed to be a “good fit” for almost 75% of the sample. Duration of mindfulness sessions ranged from 30 to 65 minutes. Participants attended more sessions as a dyad (M=10.10) compared to caregivers alone (M=6.5). Information regarding attendance and treatment engagement will be presented.
State Regulatory Response to COVID-19 Limited Assisted Living Resident Caregiver Networks
Authors: Smith Lindsey , Lowe Bethany Linscott , Dys Sarah , Thomas Kali , Zimmerman Sheryl , Carder Paula 
Published: December 2021

Abstract
This paper describes a qualitative content analysis of assisted living emergency rules, revised regulations, and executive orders responding to the COVID-19 pandemic. Using key search terms, we identified 36 states that enacted policies between February and October 2020. The following themes occurred most frequently: testing, infection control, access restrictions, suspension of requirements, and reporting. The convoys of care model recognizes internal, external, formal, and informal caregivers as essential members of an AL resident’s care network. We found that non-staff care providers, including external formal caregivers (e.g. home health and hospice) and informal caregivers (e.g. family), were most often addressed in policies limiting access. Informal caregivers were the least often specifically addressed in these policies. Given the importance of these network members in the AL context, these policies have implications for the wellbeing of the resident and care network.
Dissemination of a COVID-19 Rapid Response Telehealth Group Addressing Worry and Social Isolation Among Older Adults
Authors: Weiskittle Rachel 
Published: December 2021

Abstract
In response to the urgent need for virtual mental health treatments during the COVID-19 pandemic, an 8-week group intervention deliverable over video or telephone was developed and disseminated in March 2020. Manual content addressed social isolation and information related to COVID-19. In August 2020, a national web-based provider feedback survey was disseminated to evaluate feasibility of the manual. Respondents (n = 21) across a variety of geriatric mental health clinics reported this intervention to be effective and clinically useful with their patients in providing social support and in mitigating COVID-19 anxieties. The majority of respondents delivered the group in multiple cohorts and found the manual adaptable beyond the early pandemic period.
Advance Directive Completion and Hospital Out-of-Pocket Expenditures
Authors: Zhu Yujun , Enguidanos Susan 
Published: December 2021

Abstract
Healthcare costs remain high at end of life. Although advance directives (AD) have been shown to improve care congruence with patients’ preferences and lower cost of healthcare services, little is known about the relationship between AD completion and hospital out-of-pocket costs. This study examined whether AD completion was associated with lower hospital out-of-pocket spending at end of life. We used the Health and Retirement Study participants who died between 2000 and 2014 (N=9,228) to examine the association through the use of a two-part analytic model that has been widely used in health economics. We controlled for socioeconomic status, death-related characteristics, and health insurance coverage and imputed missing data using multiple imputation by chained equations. Of the 43.9% of decedents who completed an AD, 90.7% chose to limit care or to be kept comfortable; 78.8% indicated that they wanted to withhold treatment, and 5.6% wanted to prolong life. Having an AD was significantly associated with $632 (95% CI: [-$1,116.47, -$146.71]) lower hospital out-of-pocket costs, with greater savings among younger decedents, dropping from $1,560 (95% CI: [-$2,652, -$268]) at age 50 to $230 (95% CI: [-$445, -$14]) at age 110. Decedents who completed an AD 12 months or less before death had higher out-of-pocket spending ($1,591 on average) than those who completed more than a year before death ($1,001 on average). Our findings have policy implications for physician-patient communication about costs of care and may provide an opportunity for physicians to involve cost-sharing discussions when completing ADs with patients.
Big and Mini: A Promising Program to Link Generations to Cope With Social Isolation
Authors: Chen Zhirui , Xu Ling , Fields Noelle , Zhou Allen , Zhou Anthony , Merchant Aditi 
Published: December 2021

Abstract
Introduction: Social isolation disproportionately affected older adults prior to and especially during the COVID-19 pandemic. To help older adults cope with social isolation, a new program “Big and Mini” was created in April 2020 to link young and older adults together (matched through a custom website developed for this program) and to help increase social connectivity through weekly phone calls. Using a survey with both closed and open questions, this study evaluated participant feedback three months after the program was launched. Methods: 63 Bigs (age 50+) and 53 Minis (age 18+) completed the survey. Stress compared to before COVID-19, social isolation, life satisfaction, intergenerational solidarity, and satisfaction with the program were measured for both the Big and Mini participants. Descriptive, bivariate correlation, group comparison and conventional content analyses were conducted. Results: Results showed that 38.1% of Bigs and 37.7% of Minis felt higher levels of stress than before COVID-19. Both Bigs and Minis had medium levels of social isolation. They also reported high levels of satisfaction with life, satisfaction with the program, and intergenerational solidarity. Content analysis suggested that the reasons to join or expectations of the program were curiosity, friendship, mutually beneficial intergenerational connections, and coping with loneliness. Both Bigs and Minis reported benefits from the learning and sharing opportunities that the program offered. Conclusions: The Big and Mini program offers a promising approach with mutual benefits for both Bigs and Minis. Strategies to improve the program and implications for other phone-based intergenerational programs are presented.
Age Differences in Emotion Globalizing Across the Adult Lifespan
Authors: Barlow Meaghan 
Published: December 2021

Abstract
Emotion globalizing, the extent to which current emotions impact satisfaction with life, is associated with poorer psychological well-being. Given extant aging theories and research highlighting age-related changes in emotional experiences and emotion regulation, the present study examined age differences in positive and negative emotion globalizing across the adult lifespan. Participants (N = 145 females; aged 23-79) completed assessments of positive emotion (i.e., amused, energetic, calm, happy, interested, excited, and content), negative emotion (i.e., anxious, lonely, sad, annoyed, angry, and distressed), and life satisfaction for 16 days. Multilevel model analyses revealed age differences in negative, but not positive, emotion globalizing. More specifically, older individuals reported lower levels of negative emotion globalizing, as compared to younger individuals. These findings highlight the need to explore downstream consequences of emotion globalizing across the lifespan, as this could unveil novel pathways towards successful aging.
Transforming Education Using Virtual Reality: Geriatrics Clerkship Before and During Pandemic
Authors: Saunders Pamela 
Published: December 2021

Abstract
Since 2006, the Georgetown University School of Medicine has offered a two-week elective in Geriatrics for third-year medical students. Students rotate through diverse clinical experiences, including general geriatrics, geriatric neurology, physical medicine & rehabilitation, memory disorders, Parkinson’s and dementia, and palliative care. In addition, students learn about arts, humanities & ethics, communication skills, and taking the patient’s perspective. In Fall 2019, pre-pandemic, we added virtual reality (VR) experiences focused on hearing & vision loss, Alzheimer’s disease, and end-of-life conversations created by Embodied Labs. Curricular goals included increasing students’ empathy and sensitivity, decreasing ageism & stereotyping, and increasing clinical knowledge. Findings suggest regardless of pandemic (pre vs. during) or modality (in-person vs. Zoom) that after participating in the VR labs, students are slightly more comfortable taking care of older adult patients with dementia as well as hearing & vision loss, and participating in end-of-life conversations.
Genes Involved in Physiological Dysregulation and Decline in Resilience: Role in Alzheimer’s Disease
Authors: Arbeev Konstantin , Ukraintseva Svetlana , Bagley Olivia , Duan Hongzhe , Wu Deqing , Akushevich Igor , Kulminski Alexander , Yashin Anatoliy 
Published: December 2021

Abstract
Our recent GWAS of a composite measure of physiological dysregulation (PD) in the Long Life Family Study (LLFS) found that the top genes associated with age-related changes in PD are involved in biological pathways relevant to maintaining neural networks and brain resilience. In our prior work, PD itself was linked to resilience-related traits. Alzheimer’s disease (AD) is a heterogeneous trait and it may involve an accelerated decline in resilience with age as a contributing factor. We proposed that genes associated with aging-changes in PD and brain resilience may contribute to AD risk. We investigated interactions between SNPs in such candidate genes with AD in LLFS and Health and Retirement Study (HRS). Our analysis revealed significant interactions between SNPs in UNC5C and other genes with AD, in both LLFS and HRS. These findings support roles of genetic interactions with UNC5C gene (implemented in axon growth and neuronal apoptosis) in AD.
Collaboration With the State Department of Health
Authors: Unroe Kathleen 
Published: December 2021

Abstract
COVID-19 disproportionately affected older adults, creating opportunities for experts in geriatrics and gerontology to support public policy. In Indiana, the Probari team, composed of a geriatrician and a team of nurses with geriatrics and palliative care expertise, supported the state government response to long-term care facilities during the pandemic. The team was involved in helping coordinate all staff testing (534 nursing homes) by the State Department of Health in June and in August, prior to the Federal mandated testing and the distribution of antigen machines. The Probari team also fielded surveys on behalf of the State regarding staff attitudes towards testing and willingness to be vaccinated, to inform state policy and resource efforts. In addition, Probari collaborated with the State Department of Health and the Indiana National Guard by training over 1600 service members to provide non-clinical support in nursing facilities, and monitoring and evaluating that 3 month deployment.
COVID-19 in Long-Term Care Facilities With Advanced Practice Registered Nurses
Authors: Harrison Tracie 
Published: December 2021

Abstract
The purpose of our report is to give our analytical description of COVID-19 response. The study placed two APRNs in each of five participating nursing facilities (NF), 5-7 days/week for up to two years with the purpose of quantifying if employment of a full-time, salaried APRN, as part of the NF care team, improved the quality of care for the NF residents. Secondarily, we studied policies that influenced ability to provide APRN care in the NF. Resident data collected and evaluated to determine if this model of care reduced the rates of adverse events among NF residents. Data included re-hospitalizations, inappropriate prescribing (antipsychotics, antibiotics, opioids and polypharmacy), observational data, and clinical outcomes negatively affecting the quality of life for NF residents (such as falls and pressure injuries). Factors influencing APRN employment in the NF setting were NF mission, environmental aesthetics, resources, NF administrator interactions, state law, and medical director support.
Longitudinal Associations Between Loneliness and Self-Rated Health
Authors: Sol Ketlyne , Brauer Simon , Antonucci Toni 
Published: December 2021

Abstract
Cross-lagged structural equation models examined the bidirectional association between loneliness and self rated health over three time points. We adjusted for age, gender, network size, and depressive symptoms at baseline. At baseline, the sample was 28% Black and 40% male. Average age at time 1 was 46 years, 56 years at time 2, and 63 years at time 3. Results indicated that loneliness at time 1 was associated with loneliness at time 2; loneliness at time 2 was associated with loneliness at time 3. We had similar findings for associations among self rated health. However, only one of the cross-lagged paths was significant. Specifically, more loneliness at time 2 was associated with worse self rated health at time 3. These associations did not vary across black and white race. Findings indicate that loneliness at later midlife may be detrimental to later life health, regardless of race.
Loneliness and Changes in Cognitive Functioning Among Racially Diverse Older Adults in the United States
Authors: Camacho David , Pacheco Kelly , Henderson Charles , Reid M Cary , Wethington Elaine 
Published: December 2021

Abstract
Longitudinal studies examining the association of loneliness with cognitive decline rarely include older members of racial minorities. Guided by a Minority Stress Framework, we used Waves 2 and 3 from the National Social Life, Health, and Aging Project to assess whether loneliness (UCLA-3-items) at W2 predicts cognitive decline (Chicago Cognitive Functioning Measure) among US African-American, Latino, and white older adults (ages≥60). We included interactions of W2 loneliness with race in examining changes in cognitive functioning. Estimates were (N=1,950) adjusted for demographics, chronic disease, depression, and social connectedness. In all groups, loneliness was positively associated with greater global cognitive decline over the 5-year interval. However, analyses of different domains of cognitive functioning (e.g., executive functioning, memory) suggested that this association differs by cognitive domain and race. Future research on interventions to prevent cognitive decline should consider targeting loneliness, include diverse older adults, and examine global and specific domains of cognitive functioning.
Technological Interventions and Social Participation in Community-Dwelling Older Adults With or Without Dementia
Authors: Heins Pascale , Boots Lizzy , Koh Wei Qi , Neven An , Verhey Frans , de Vugt Marjolein 
Published: December 2021

Abstract
Social isolation is a growing health issue in community-dwelling older adults with and without dementia as it can negatively affect their health and well-being. Consequently, psychosocial interventions targeting their social participation are increasingly gaining importance. So far, however, little is known about the potential of technological interventions in this population. Therefore, this systematic review explored the effectiveness of technological interventions in improving social participation of community-dwelling older adults with and without dementia. Records identified through five scientific databases were independently screened by two reviewers. A total of 36 studies published between 2005 and 2020 were included in a narrative synthesis. Studies differed widely in study design, type of technology, used outcome measures, and methodological quality. However, the findings highlight the potential role of technological interventions in improving different dimensions of social participation. At the same time, barriers and facilitators of these interventions to social participation were identified.
Case Study of an Outbreak: Resident, Staff, and Community Indicators
Authors: Miles Toni 
Published: December 2021

Abstract
Outbreak investigation is not infection control. We present a self-study of factors influencing outcomes inside a single nursing home during the early stage of the outbreak - February to May 2020. We examine 3 sources of influence: Practice / Operations; Local, State & Federal Policies; Uncontrollable operational factors. Outcomes of interest include: mortality and resident / staff health. Data consists of clinical records, review of communications, and interviews with staff present during the critical period. Infection control is different from outbreak investigation. There must be a balance between staff empowerment and adherence to guidelines. In an outbreak, staff need the confidence to make decisions based on incomplete knowledge. The presentation concludes with lessons learned – what worked and what actions need improvement. There are areas requiring further analyses of policy and ethics.
Views of Aging During the Corona Pandemic
Authors: Bellingtier Jennifer , Kornadt Anna 
Published: December 2021

Abstract
In the Covid-19 pandemic, media stories and government reports have emphasized the heightened risk of being “old” and placed a spotlight on the way we think and talk about older adults and aging. In this symposium we investigate how the pandemic and the public discourse about older adults has shaped views of aging in different countries. Bellingtier et al. report on German children’s views of older adults before and during the pandemic. Children placed greater distance between themselves and older adults both before and after the pandemic, suggesting early ageism in children that predates the pandemic. Levy et al. provide experimental evidence that media stereotypes about aging and Covid-19 influence the mental health of older American adults, both in positive and negative. Schwartz and Ayalon found that greater perceptions of age-based discrimination in the healthcare system by Israeli adults 50+ were significantly related to greater Covid-19 worries. Greater worry can motivate older adults to take precautions, but be detrimental if it becomes too high. In line with this finding, Tingvold et al. found in a study with older adults from Luxembourg that more Covid-19 worry predicted feeling older four months later, but only for those in worse health. Finally, Terracciano examined longitudinal change in subjective age and found that American adults reported feeling younger after the emergence of Covid-19 than before, suggesting that perceptions of aging partly reflect a coping process to counter the negativity in the media.
Self- and Other-Directed Ageism and Worries Concerning COVID-19 Health Consequences
Authors: Ayalon Liat , Cohn-Schwartz Ella 
Published: December 2021

Abstract
Worries associated with COVID-19 health consequences are well-justified. They may motivate people to take safety precautions, but may hinder if they become too intense. Current research examined mainly age and gender as potentially associated with worries. This study instead, focuses on self-perceptions of ageing (SPA) and perceived age discrimination as potential predictors of worry, in light of the ageism pandemic which co-occurred with the COVID-19 outbreak. The study is based on a national representative sample of 1,092 adults aged 50+ in Israel. Phone interviews were conducted between March – May 2020, when Israel gradually moved from strict to partial lockdown. Our findings show that SPA and age-based discrimination in the healthcare system were significant predictors of worries. The findings point to the potentially negative impact of the ageism pandemic in relation to worries. Interventions that address ageism directed by self or others might alleviate people's worries in the COVID-19 pandemic.
Impact of Media-Based Age Stereotypes on Older Individuals’ Mental Health During the COVID-19 Pandemic
Authors: Levy Becca , Chang E-Shien , Lowe Sarah , Provolo Natalia , Slade Martin 
Published: December 2021

Abstract
During the COVID-19 pandemic, stigmatization of older persons has increased in traditional and social media. It was unknown whether this negative messaging could be detrimental to the mental health of older individuals, and whether the relatively uncommon positive messaging about older individuals could benefit their mental health. To address these gaps, we designed age-stereotype interventions based on actual news stories that appeared during the pandemic. As expected, the exposure of older individuals to the negative-age-stereotype-messaging interventions led to significantly worse mental health (more anxiety and less peacefulness), compared to a neutral condition; in contrast, the positive-age-stereotype-messaging interventions led to significantly better mental health (less anxiety and more peacefulness), compared to a neutral condition. The results demonstrate the need for media messaging aimed at empowering older individuals during the pandemic and beyond.