bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Analysis of Dementia Care Programs and Delivery Models
Authors: Peckham Allie , Saragosa Marianne , King Madeline , Roerig Monika , Marchildon Gregory 
Published: December 2021

Abstract
Dementia has significant social and economic impacts for those living with dementia and their caregivers. Despite an increase in prevalence of complex chronic conditions and dementia, long-term care services are continuously pushed out of institutional settings and into the home and community. The majority of people living with dementia in Canada and the United States (U.S.) live at home with support provided by family, friends, or other unpaid caregivers. Ten dementia care programs and service delivery models across five different North American jurisdictions in Canada and the U.S. are compared using a deductive analytical approach using a comparative policy framework developed by Richard Rose. The policy efforts included in this research attempt to improve health system flow and access for vulnerable populations. One common theme among all jurisdictions are long-standing institutional barriers that can make change difficult. These barriers can prevent the ability for systems to be flexible and adapt to meet the changing needs of populations. Incrementalism is often considered an appropriate approach to health system reform. Yet, incremental change efforts lead to policy layers and these layers can lead to tension between different policy mixes and unintended consequences. These programs were introduced in a manner that did not fully consider how to patch current structures and risk creating further system redundancies. One approach to reduce this risk is to combine evaluative efforts that assess ‘goodness of fit’. The degree to which these programs have embedded these efforts successfully is low, with the possible exception of DSRIP from NY.
The StrongerMemory Program: A Brain Health Intervention for Mild Cognitive Impairment
Authors: Tompkins Catherine , Ihara Emily , Liebreich Rob , Fredericksen Jessica , Bradley Lauren 
Published: December 2021

Abstract
The StrongerMemory program is a brain health intervention targeting older adults with mild cognitive impairment (MCI). Approximately 20% of individuals over 65 years old have MCI and 38% will potentially develop dementia after 5 years of MCI onset. Participants in the 16-week StrongerMemory program practice exercises involving math, writing, and reading aloud for 20-30 minutes a day, stimulating the prefrontal cortex of the brain, which governs the brain’s ability to retrieve memories. The current research exploring participants’ experiences with the StrongerMemory program was approved by the University’s Institutional Review Board. A semi-structured interview was implemented with each participant and the interviews took about 15 to 30 minutes to complete. There was a total of 24 respondents associated with a local continuing care retirement community, each providing their verbal consent to be interviewed and recorded over Zoom. The respondents were mostly female ranging in age from 65 to 90. Most respondents reported having advanced degrees and were participating in the program on their own, with a spouse or friend. Each interview transcript was coded by at least two members of the Mason research team. Participants reported being motivated to participate in the program due to fearing memory loss because of experiences of family members and friends and others wanted to remain “cognitively fit.” Codes and themes representing participants’ perceptions and reactions to exercises and their challenges and lessons learned from their participation will be discussed, including participants feelings of being “less foggy” and better able to remember information.
Adult Learning and Employment Opportunities for Older Workers in Australia and the United States: Lessons for Adult Education
Authors: Cummins Phyllis , Taylor Philip , Yamashita Takashi , Janssen Leah 
Published: December 2021

Abstract
This study examined the role community colleges (U.S.) and Technical and Further Education (TAFE; Australia) institutes play in providing educational opportunities to older workers in the U.S. and Australia. Employment for adults of all ages has been impacted by job automation in recent decades. We analyzed national level data to estimate the impacts of job automation by age group. In both the U.S. and Australia, about 65% of older workers in sales occupations are at risk for job loss due to automation. Additionally, we reviewed occupational projection data and employment opportunities for workers who may be displaced by automation. Needs for health care support occupations, such as nursing assistants and occupational and physical therapy assistants are expected to grow rapidly. We will provide several recommendations based on the integration of our findings related to education/training programs and the aging workforce in the context of community colleges and TAFEs.
Health Risks, Perceptions, and Self-Care Patterns: A Comparative Study Between Older and Younger Filipinos
Authors: Soberano Julienne Ivan , Caciata Marysol , Flores Jo Leah , Leyva Erwin William , Hernandez Mary Abigail , Tuazon Josefina , Evangelista Lorraine 
Published: December 2021

Abstract
Worldwide trends in health risks, lifestyle behaviors, health perceptions, and health-seeking patterns suggest alarming disparities among individuals from low- and middle-income countries; particularly for older individuals (≥ 60 years). This study aims to compare health risks, perceptions, lifestyle behaviors, and health-seeking patterns between younger (&lt; 60 years) and older (≥ 60 years) Filipinos from rural communities in the Philippines; and assess relationships between demographic, health risks and perceptions, and lifestyle behaviors to bolster health promotion efforts. A comparative cross-sectional study was employed with 863 younger and 427 older Filipinos. Results show that older participants were more likely to be single/widowed and had ≤ high school education. Older participants had higher rates of hypertension, dyslipidemia, diabetes, and depression but were more likely to report higher quality of life, ≥ 150 minutes of physical activity per week, ≥ 5 servings of fruits and vegetable per day, more difficulty falling asleep, report seeing a physician regularly, going to the community health center when sick, and attend stress management classes compared to their younger counterparts (all p’s &lt; .001). There were no differences in rates of obesity, self-medication, and use of integrative health. Older age was associated with higher risks, improved health perceptions, healthier lifestyle behaviors, and better health-seeking patterns. Our data suggest that health risks are higher in older individuals but risky lifestyle behaviors were higher in younger individuals and suggest the need to design separate health promotion interventions that target the unique needs of older and younger Filipinos from rural communities.
Patient-Centered Digital Screener for Elder Abuse in the Emergency Department
Authors: Abujarad Fuad , Choo Esther , Dziura James , Edwards Chelsea , Pantalon Michael , Jubanyik Karen , D'Onofrio Gail , Gill Thomas 
Published: December 2021

Abstract
Elder abuse is a growing problem where many cases are left unidentified by professionals. For some older adults, the emergency department may be the sole point of care where they have an opportunity to be identified as victims of abuse. However, current methods of screening tend to miss less obvious forms of abuse and may deter older adults from self-reporting due to either a lack of understanding of abuse or fear of potential consequences. VOICES is an innovative, self-administrated, and automated tablet-based tool that combines screening, educational content, and brief motivational interviewing to enhance and improve identification of elder abuse cases. Combining an elder abuse screener and digital coach designed to guide the older adult through a customized pathway to encourage self-identification and self-reporting of abuse, VOICES is a robust tool engineered to place the screening process in the hands of the older adults, rather than the providers. We will discuss preliminary results of the ongoing feasibility study currently being conducted in the ED, which has successfully enrolled over 500 older adults. Current data indicate that 93% of patients find the tool to be satisfying, engaging, and easy to use. Preliminary findings also suggest that older adults who come in with “Little to none” knowledge of elder abuse increase knowledge of abuse after using the tool. In summary, VOICES appears to be a feasible tablet-based screening tool in the emergency department.
Feasibility of the ACTPlan Program for African American Dementia Caregivers: A Self-Directed Multimedia Delivery
Authors: Watkins Yashika , Collinge William , Hart Alysha , Tharpe Rita , Aggarwal Neelum , Bonner Gloria 
Published: December 2021

Abstract
African Americans (AA) are less likely than White Americans to complete advance care plans or end-of-life treatment documents. They face significantly greater risk of Alzheimer’s Disease, a silent epidemic for this population, and other dementias. The healthcare system’s lack of dementia support for AAs contributes to disparate care. A four-session caregiver group education program was conducted on advance care planning for AA dementia family providers. The program was based on Kolb’s Experiential Learning Model and initially found effective in an R01 study using in-person delivery by a professional. The present pilot assessed feasibility of delivering the program in a self-directed multimedia format without professional facilitation, using Session 1 on tube feeding decisions as the test session. Twenty-six AA dementia caregivers completed the session in groups of 5 to 8 at a church equipped with a large TV screen. On-screen prompts guided navigation through the program which included recorded lecture, slides, short videos on decision-making, and group discussions. Using quantitative and qualitative methods, pre-and post-survey instruments were administered and interviews conducted. Usability ratings averaged 84%. Knowledge and self-efficacy gains exceeded those of the R01, with a 35% increase in correct responses on knowledge items, versus 18% for the R01 subjects; and increase in perceived decisional self-efficacy of 31% versus 30% for the R01 subjects. Qualitative feedback was universally positive. These findings confirm the feasibility of the self-guided multimedia approach to delivery of the program. A large RCT is planned which, if successful, will support wide dissemination to AA caregivers in need.
State Adoption of Nursing Home Immunity From Legal Liability During the COVID-19 Pandemic
Authors: Nadash Pamela , Miller Edward , Simpson Elizabeth , Gusmano Michael , Beauregard Lisa 
Published: December 2021

Abstract
Twenty-eight states have provided nursing homes (NHs) with immunity from legal liability related to COVID-19. This study places these provisions in the context of prior actions protecting NHs from legal action and explores factors influencing the adoption of such immunity provisions across states. It uses cross-sectional data to examine patterns of policy adoption and to assess states’ likelihood of adopting immunity provisions using multivariate methods. Variables of interest include information on state political, socioeconomic, programmatic, and COVID-19-related characteristics as well as data on campaign contributions and lobbying activity at the state level. Factors significantly related to NH immunity provision adoption included measures of state fiscal health (unemployment), ideology (percent legislators Democrat), governing capacity (unified government), and NH characteristics (percent not-for-profit, hospital-based, and chain). Population density and Medicaid as a percentage of state general fund expenditures proved significant as well. Against these complex influences, organizations lobbying on behalf of NH residents and their families have found themselves ineffectual in creating avenues for accountability. Results indicate that enforcing accountability for NH deaths during the COVID-19 pandemic is a complex process, constrained by available policy tools and made more complicated by factors external to the NH environment that contributed to high death rates. Historically, the NH industry has been successful in avoiding consequences for poor quality care, a pattern that has persisted in that NHs have generally been successful in avoiding liability for negligence during the COVID-19 pandemic.
Predictors of Multimorbidity Among Korean Older Adults: Longitudinal Secondary Data Analysis
Authors: Kim Eunkyung , Lee TaeWha , Ji Yoonjung 
Published: December 2021

Abstract
Multimorbidity has become a global concern for an aging society. It has been reported to be associated with increased health service utilization, leading to poor health outcomes including quality of life. However, the incidence of multimorbidity and its related factors are poorly understood. The aim of this study was to determine the socioeconomic and health-related factors predicting the incidence of multimorbidity in Korean older adults using longitudinal secondary data from the Korean Longitudinal Study of Aging (KLoSA) dataset from 2008 to 2018. The KLoSA aimed to collect basic data to be used for developing socioeconomic policy for the aging society in Korea. The sample included 3,019 older adults aged 65 years and over who had 0-2 chronic diseases at baseline in 2008. Multimorbidity was measured with the incidence of co-existence of three or more chronic diseases using Cox’s proportional-hazards model. Among 3,019 respondents (female 57.6%, mean age 73.07±6.30 years), 586 (19.4%) incidents of multimorbidity were reported after 10 years of follow-up. Low participation in social activities, being overweight or obesity, more depressive symptoms, current or past drinkers, and lower life satisfaction were identified as significant predictors of multimorbidity among Korean older adults. This study identified high risk groups with overlapping senility and multimorbidity, who require more attention from health care providers in the course of chronic disease monitoring and management. This longitudinal approach will contribute to the development of preventive strategies to reduce the incidence of multimorbidity among older adults.
It’s Yet Another Thing: Barriers to and Recommendations for Physician Referrals to Home-Based Palliative Care
Authors: Kogan Alexis Coulourides , Cardenas Valeria , Zhu YuJun , Giulioni Jenna , Rahman Anna , Enguidanos Susan 
Published: December 2021

Abstract
To understand primary care providers’ (PCPs) experiences with referring patients to home-based palliative care (HBPC), we conducted individual, key-informant interviews with 31 PCPs. About half participants were male (54.8%), White (42.5%), US-born (58.1%), and were 57 years old (SD=9.17), on average. About one-third of participants (32.3%) indicated they refer 10+ patients annually to HBPC, while most (80.7%) reported “strong” comfort discussing palliative care with patients. Qualitative analysis revealed three prominent thematic categories, each related to barriers PCP experienced when referring patients to palliative care: (1) PCP-level (lack of knowledge and comfort); (2) perceived patient-level (culture, family disagreement, need, home-based aspect); and (3) HBPC program-level (need to close the loop with PCP, insurance coverage, program availability, and eligibility). PCP recommendations for overcoming identified barriers will be discussed. Findings hold important implications for timely patient-referrals to palliative care by PCPs and for sustaining palliative programs that rely on these referrals.
Effects of Age on Dual Task Walking Performance as Measured Using a Smartphone Application in Middle-Aged Adults
Authors: Zhou Junhong , Cattaneo Gabriele , Yu Wanting , Tormos Jose , Lipsitz Lewis , Bartres-Faz David , Pascual-Leone Alvaro , Manor Brad 
Published: December 2021

Abstract
After the age of 65, one’s ability to walk while performing an additional cognitive task (i.e., dual-tasking) is predictive of both future falls and cognitive decline. However, while it is well-known that older adults exhibit diminished dual-task performance, the time course of age-related dual-task decline has not been established. We thus conducted an analysis of data collected within the ongoing Barcelona Brain Health Initiative, a prospective population-based study characterizing the determinants of brain health maintenance in middle-aged adults. Cognitively-unimpaired participants (n=655) aged 40-65 years without neuro-psychiatric disease completed laboratory-based trials of walking normally (single-task) and walking while performing a verbalized serial subtraction task (dual-task). A smartphone-based gait assessment application was used to capture data and derive both the mean stride time (ST) and stride time variability (STV, defined as the coefficient of variation about the mean stride time) of each trial. The dual-task costs (DTC) to each gait metric were obtained by calculating the percent change from single- to dual-task conditions. We categorized participants into five groups according to age (e.g. Group 1: 40-45 years; Group 5: 60-65 years). Age group did not have an effect on single-task gait outcomes (p&gt;0.51). However, the oldest age group, as compared to each of the other groups, exhibited greater DTC to both ST and STV (p&lt;0.03). These results indicate that dual-task walking performance in particular may begin to diminish in late middle age even in the absence of detectable cognitive issues, DTC may offer a sensitive metric to age-related change in cognitive function.
Isolation and Loneliness: Implications for Health and Well-Being of Older Populations
Authors: Holt-Lunstad julianne 
Published: December 2021

Abstract
Evidence suggests social isolation and loneliness are prevalent within the population and may potentially be exacerbated due to the pandemic. Social connections have powerful influences on health and longevity, and lacking social connection qualifies as a risk factor for premature mortality. Evidence from the recent National Academy of Science consensus report on social isolation and loneliness among older adults will be summarized, providing the scope of the health effects, potential mechanisms and risk factors, as well as current gaps in the evidence. Importantly, this evidence points to several implications for solutions across sectors, including medical and healthcare practice and policy.
Research Applying Adaptive Leadership Framework for Chronic Illness Across Settings of Care
Authors: Bryant Ashley Leak , Beeber Anna , Wu Bei 
Published: December 2021

Abstract
The carepartner is an essential member of the team to facilitate and assist in maximizing the independence of the older adult. The four papers in this symposium applies The Adaptive Leadership Framework for Chronic Illness (ALFCI) at the point of design, as well as an analytic framework for literature synthesis, intervention design, and analysis of existing data. In the first paper, a qualitative metasummary of a scoping review synthesizes qualitative findings about fatigue adaptation and challenges for stroke survivors, care partners, and healthcare professionals. The second paper describes the use of the ALFCI in an intervention study to manage symptom challenges in older adults with acute myeloid leukemia. The third paper shares staff’s experiences of providing direct care for older residents with advanced dementia in long-term care facilities. The fourth paper describes use of the carepartner–assisted intervention to improve oral hygiene of older adults with cognitive impairment. The ALFCI is a useful framework for intervention design 1) this framework provides a comprehensive way to examine the context of symptoms/behaviors (not just the symptom/behavior in isolation), 2) the framework guides “collaborative work”, 3) analytically it can help guide development of shared meaning of communication and “collaborative work” of dyads (family caregivers, long-term care staff and older adults), and 4) helps understand process of staff utilizing their strengths and doing adaptive work to facilitate interactions and communication, managing older residents’ behavioral and psychological symptoms of dementia, and improving their care provision and work life.
Efforts by the Coalition to End Social Isolation and Loneliness
Authors: MacPherson Andrew 
Published: December 2021

Abstract
Established in the Fall 2018 and based in Washington, D.C., the Coalition to End Social Isolation & Loneliness brings together dozens of national organizations including consumer groups, community-based organizations, health plans, mental and behavioral health organizations, health care innovators, and many others to lead a multi-stakeholder dialogue to address the crisis of social isolation and loneliness in America. The Coalition focuses on three major areas to achieve this goal: Disseminating research findings, developing and advocating for federal and state legislative and regulatory policy interventions, and leading public awareness events in Washington, D.C. and across the nation. The COVID-19 pandemic has greatly accelerated efforts to engage Congress and the Executive Branch on a range of federal policy priorities, including leveraging and advancing social services and supports, supporting health care delivery to support those who are socially isolated and/or lonely, and advancing federally-funded research initiatives.
Caregiver Stress: Biomarkers Linked to Disease Risk and the Psychobiology of Stress Reduction
Authors: Beadle Janelle , Jain Felipe 
Published: December 2021

Abstract
Caregivers to older adults with chronic diseases frequently experience chronic stress which can negatively affect caregivers’ physical and mental health, and increase disease risk. This interdisciplinary symposium will highlight critical factors influencing caregiver stress, and the role of biomarkers in detecting caregiver disease risk. First, we will discuss the effects of stress and emotional experiences on risk for cardiovascular disease in caregivers of persons with dementia (PWD). In the first talk, Dr. Mausbach will examine relationships among perceived stress, blood glucose and risk of diabetes and cardiovascular disease in caregivers of PWD. Next, Dr. Losada-Baltar will discuss the degree to which caregivers’ ambivalent feelings towards providing care are associated with inflammatory markers of cardiovascular risk. Following this, two talks will investigate critical links between stress and caregiver emotional well-being. Dr. Liu will report relationships among the stress-related hormone cortisol, sleep, and anxiety in the context of adult day services. Dr. Beadle will examine the degree to which caregivers’ affiliative, empathetic interactions with others relate to their experience of stress through cortisol assessments and neuroimaging. The final talk by Dr. Jain will investigate the effects of a Mentalizing Imagery Therapy intervention for family PWD caregivers on stress, evidence for mindfulness as a causal mediator of stress reduction, and the relationship to brain networks associated with emotion regulation. Taken together, this symposium will identify relevant psychosocial and biological factors that contribute to caregiver stress, as well as discuss the psychobiology of amelioration of caregiver stress.