bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of Low Back Pain and Physical Activity on Mental and Physical Health Outcomes in Older Adults With Arthritis
Authors: Taylor Janiece , Regier Natalie , Liu Minhui , Szanton Sarah , Skolasky Richard 
Published: December 2021

Abstract
Nearly 50% of Americans aged 65 and above have been diagnosed with arthritis at any point in time, and an estimated 80% of adults experience low back pain (LBP) at some point in their lives. However, little is known about the experience of LBP in older adults with arthritis and whether or not it is related to adverse mental and physical health outcomes over and above those linked to arthritis. This study examined the relationship between LBP and four associated physical and mental health conditions (depression, insomnia, mobility limitations, and self-rated health) in older adults with arthritis. We also examined whether physical activity mediated the relationships between LBP and these four conditions. A cross-sectional analysis was conducted using data from the National Health and Aging Trends Study. Descriptive analyses and chi-square tests assessed whether there were demographic differences between persons with and without LBP. Binary logistic regressions found that participants with LBP were 30% more likely to endorse insomnia (95% confidence interval (CI) =1.1 to 1.5, p&lt;.001), had 40% higher odds of depression (95% CI=1.1 to 1.6, p&lt;.001), and 70% higher odds of poor self-rated health (95% CI=1.5 to 1.9, p&lt;.001) than those without LBP. Activity mediated the relationship between LBP and the four health outcomes in unadjusted models. Findings indicate that LBP may be associated with adverse mental and physical health in older adults with arthritis, and treatment for older adults with arthritis and comorbid LBP should include interventions targeting LBP and routine assessment of mental and physical health.
Do Social Connections Buffer Loneliness Associated With Living Alone?
Authors: Schafer Markus , Sun Haosen , Lee Jin 
Published: December 2021

Abstract
The growth of solo living has important implications for the rising “loneliness epidemic” among older adults. This study considers whether two forms of social connectedness—extra-household core discussion networks and formal social participation—buffer the loneliness associated with living alone. Our study uses data from two surveys (National Social Life, Health, and Aging Project; Survey of Health, Ageing and Retirement in Europe) encompassing 20 developed Western countries in 2009/2010 and 2015/2016 (n = 110,817). Harmonizing measures across data sets, we estimate survey-specific and pooled linear regression models with interaction terms. Results indicated that high levels of social connectedness only moderately buffer the loneliness associated with living alone in later life. Findings were largely consistent across regions of Europe and the United States, though the buffering patterns were most robustly identified for widowed solo dwellers. Taken together, the results suggest that extra-household connections are partial compensators, but do not seem to fully replace the ready companionship afforded by residential co-presence in later life. Future research is needed to understand whether the efficacy of compensatory connections differs by gender, race/ethnicity, and across more diverse global regions.
Speaking of Dementia: How to Refer to Dementia in Racial-Ethnic Minority Community-Facing Communications
Authors: Baker Zachary , Shippee Tetyana , Gaugler Joseph 
Published: December 2021

Abstract
What do you call “dementia”? In academic writing, researchers often chose the inclusive, “Alzheimer’s Disease and Alzheimer’s Disease Related Dementias (AD/ADRD)”. When referring to the people experiencing dementia, the person-centered language: “persons living with dementia (PLWD)” is preferred. This is a welcome departure from the antiquated disease-centered language of “dementia patients” or “the demented”. Still, AD/ADRD and PLWD may be less fitting in community-facing education or participant recruitment. For instance, community-facing materials may benefit from choosing terms like “memory loss”, “issues related to memory or aging”, or “changes in ability, behavior, or judgment”. In this symposium we present a range of viewpoints focused on how to refer to “dementia” in community-facing materials/conversations. These viewpoints include those of several racial and ethnic groups (i.e., African Americans, African Immigrants, American Indians, Asians, Hispanics/Latinos/as/x/e, and Whites). We also include viewpoints from people interfacing with many different diseases that cause dementia (i.e., Alzheimer’s disease, dementia with Lewy bodies, Early-onset Alzheimer’s disease, and Parkinson’s disease dementia) because of the different manifestations of dementia that can arise from those diseases. Viewpoints were gathered through 1) a nation-wide community advisory board, 2) community conversations with African Immigrants, 3) a national effort to increase the representation of Hispanics/Latinos/as/x/e PLWD in AD/ADRD research, and 4) eight community projects exploring the African American AD/ADRD experience. These talks will present possible terms to use within groups, considerations to increase inclusiveness, issues with translation into native languages, considerations surrounding symptoms that may be most recognizable to community members, and stigmatized terminology.
Holy and Helping: The Role of Sanctification in the Communal Coping of Older African American Couples
Authors: Skipper Antonius , Rose Andrew , Joiner Jhazzmyn , Jones Ethan , Reeves Alex 
Published: December 2021

Abstract
Disproportionately affected by numerous relational stressors (e.g., financial strain, morbidity), older African American couples frequently find solace in religion and each other. Research notes that both married and cohabiting couples effectively respond to difficult situations by sharing the ownership of a stressor and organizing a collaborative, collective response. However, little is known about the influence of religion on shared coping experiences, particularly among older African American couples. This study examined dyadic data from the Strong African American Couples Project to capture the influence of relational sanctification on the communal coping practices of married and cohabiting older African American couples. The sample included 194 African American couples (146 married and 48 cohabiting) between the ages of 50 and 86 years. With the use of Actor Partner Independence Models, this study found that men’s sanctification predicted both their own communal coping and their partner’s communal coping. However, there were no significant effects when women’s sanctification was used as a predictor of communal coping among older African American couples. These findings are both important and novel, because these relationships had never before been examined within the United States, much less among older African American couples. Similar to existing research among majority White couples, this research finds that men’s religiosity may be a more influential predictor of relational outcomes than women’s religiosity. Such findings offer a valuable foundation for future studies seeking to consider how relational sanctification and communal coping may impact other outcomes associated with the romantic relationships of older African Americans.
Sustainability of the Aging Network's COVID-19 Responses: Isolated Impact or Transformative Change?
Authors: Kunkel Suzanne , Kunkel Suzanne 
Published: December 2021

Abstract
The COVID-19 pandemic mobilized individuals, organizations, and communities. Area Agencies and Aging (AAAs) and Title VI Native American Programs, core organizations of the network of community-based organizations (CBOs) that serve older adults and their families, pivoted their service delivery methods to provide life-sustaining services. Their long-standing expertise in community needs assessment, pre-existing cross-sectoral partnerships, and an infusion of emergency federal funding, enabled this rapid response. Recently concluded studies using key-informant interviews and national surveys of AAAs and Title VI programs highlight these service adaptations, from expansion of home-delivered meal programs to new partnerships in telehealth. These organizations also reported expansion of services offered and people served, and the emergence or strengthening of partnerships with other CBOs, businesses, and governmental organizations such as public health entities. For example, 78% of the respondents to the recent survey of AAAs reported that they have a role in vaccination outreach, scheduling support, or delivery. The papers in this symposium will use these new studies to describe the nature, origins, and potential sustainability of new and expanded services and partnerships. The Collective Impact Model for community change (introduced in the Stanford Social Innovation Review) will provide a framework for the discussion. Built on the importance of cross-sector coordination, the five pillars of success for collective rather than isolated impact are: a common agenda, mutually reinforcing activities, continuous communication, shared measurement, and a backbone organization. Each of these five pillars is relevant to the heightened community response during the pandemic, and to the likelihood of sustainability.
Day-to-Day Mobility, Affect, and Stress Couplings in Swiss Older Adults
Authors: Roecke Christina , Kim Eun-Kyeong , Griffel Pascal , Moulder Robert , Fu Cheng , Luo Minxia , Martin Mike , Weibel Robert 
Published: December 2021

Abstract
The Mobility, Activity, and Social Interactions Study (MOASIS) is part of a global effort to more closely examine indicators of functional ability in relation to person characteristics and life contexts as proposed by the WHO’s healthy aging definition. In MOASIS, sensor-based and self-reported mobility and activity indicators were used to capture functional ability in 153 community-dwelling older adults aged 65-91 over 30 days. The present study examines daily time out-of-home and place diversity and its within-person associations with positive and negative affect and stress. Initial between-person analyses indicate that mobility is only weakly related to indicators of physical and mental health. We propose that the health- and well-being implications of mobility more strongly play out in daily life and at the within-person level, and will examine general health, cognitive ability, and marital status as intrinsic capacity moderators accounting for some of the expected interindividual heterogeneity.
The Many Faces of Elevated TSH: When to Avoid Thyroid Hormone Therapy in Older Adults
Authors: Mammen Jennifer , Abbey Enoch , McGready John , Ferrucci Luigi , Simonsick Eleanor 
Published: December 2021

Abstract
We have previously demonstrated that hypothalamic-pituitary-thyroid axis aging is characterized by several distinct patterns. An elevated thyrotropin (TSH) level (mean 5.6mIU/L) with normal free thyroxine (FT4) was present in 75 BLSA participants with at least 3 visits. Twenty-one percent had an historical pattern consistent with primary gland failure, while 13% had a pattern consistent with an HPT response to stressors (aging-adaptation). The remainder had intermediate patterns of change. FT4 &gt;0.92pg/ml identified those in whom TSH elevations occurred with aging-adaptation with a 90.0% sensitivity and 93.8% specificity, indicating no need for therapy. In addition, among 597 participants with stable TSH levels in the reference range, being on thyroid hormone therapy increased mortality risk (IRR=1.8; 95% CI 0.9-2.1). Thus, including FT4 in the diagnostic criteria for hypothyroidism in older adults could target therapy to avoid the potential harm of reversing the aging adaptations in those who do not have true early hypothyroidism.
Well-Being and All-Cause Mortality in Aging Women in the Women's Health Initiative (WHI)
Authors: Rillamas-Sun Eileen , Pike Kenneth , Cochrane Barbara , Woods Nancy 
Published: December 2021

Abstract
To study the relationship between well-being and all-cause mortality, we estimated mortality among women in four classes of well-being using the well-being profile from the Women’s Health Initiative Study (WHI). Demographic characteristics were self-reported at enrollment (1993-98). All-cause mortality included death from any cause between 2012-2020. We used logistic regression to examine all-cause mortality risk across the classes, using Class 4 (highest hedonic and eudaemonic well-being scores) as the referent, adjusting for age and race. Compared to Class 4, all other classes had higher age- and race-adjusted odds of death. Highest risks were in Class 1 women (OR=2.61; 95% CI: 2.46-2.76) and Class 3 women (OR=1.62; 95% CI: 1.55-1.68). Women in Class 4 had the lowest risk of all-cause mortality over an 18-year follow-up. These results confirm the utility of a profile of well-being for predicting all-cause mortality while preserving ability to identify the differences among well-being indicators across classes.
Bridging Digital Divides: GWEP Pivots to Support Telehealth for Clinical Care and Education
Authors: Lee Jung-Ah , Gibbs Lisa , Rousseau Julie , Sehgal Sonia , Saville Neika 
Published: December 2021

Abstract
Early in the pandemic, the University of California, Irvine (UCI), GWEP pivoted to focus on building telehealth and remote patient monitoring, while supporting team-based interdisciplinary learners. Our Health Assessment Program for Seniors (HAPS) adapted to provide hybrid remote/in-person evaluations with our Geriatric Fellows and Doctor of Nurse Practitioner (DNP) students working alongside our multi-disciplinary team. Learner teams innovatively bridged the digital divide through weekly DNP support phone calls, and the Fellows delivered family conferences through Zoom. In ASSIST, medical students and nursing students gained digital competencies through a phone support system for isolated older adults with friendly weekly check-ins providing referrals to community resources. Another IRB-approved pilot, Healing at Home, diverted patients from the Emergency Room and In-Patient care with a team of ED, Hospitalists, Geriatricians teaching DNP and Fellows telehealth management. GWEP successfully piloted symbiotic learning for both older adults and health profession students through new virtual formats.
Greater Adolescent Cognitive Ability Is Linked to Lower Risk of Cognitive Impairment in Later Life
Authors: Gruenewald Tara , Zavala Catalina , Grossman Molli , Arpawong Thalida , Manly Jennifer , Lapham Susan , Gatz Margaret , Prescott Carol 
Published: December 2021

Abstract
There have been few investigations of the role that adolescent cognitive ability plays in predicting later-life cognitive impairment, and the mechanisms, such greater life course educational exposure, that might underlie these connections. This knowledge gap is due, in part, to a lack of cohorts with early-life cognitive assessment who are followed to later adulthood. We capitalized on data from the 1960 Project Talent (PT) high school cohort (n&gt;360,000) and two recent follow-ups, the Project Talent Twin & Sibling (PTTS; n=2,491 in 2014) Study and the Project Talent Aging Study (PTAS; n=6,421 in 2018), to examine these potential links. In 1960, ability was assessed in multiple cognitive domains (e.g., general aptitude, quantitative, reasoning). Participants/proxies reporting 2 or more symptoms of cognitive impairment in 2018 on the AD8 Dementia Screener were classified as having a positive screen. Binary logistic generalized estimating equations with race, sex, and adolescent family SES covariates, indicated that in multiple cognitive domains, higher ability in adolescence predicted lower odds of a positive AD8 screen in later life (ORs of 0.80 - 0.85). The effects were only slightly attenuated with inclusion of life course educational attainment. Sibling models found a similar pattern of associations and effect sizes, indicating that the association is not attributable to shared family and genetic background. These findings indicate that higher cognitive ability as indicated by better performance in multiple cognitive domains in adolescence may be protective against cognitive impairment five decades later and life course educational attainment only partially mediates this association.
Early Adversity and Later Health: The Pathway of Social Relationships in Adulthood in HRS and ELSA
Authors: Liu Yin , Steptoe Andrew , Chopik William , Leggett Amanda , Kong Jooyoung , Polenick Courtney 
Published: December 2021

Abstract
Early adversity is associated with compromised health and well-being in later life, but whether social functioning mediate the association is unclear. We examined 2 longitudinal samples of older adults (&gt;= 50 years) whose baseline surveys were between 2006 and 2008 with follow-up until 2016 in the Health and Retirement Study (HRS, n = 15,946) and its sister study in England (ELSA, n = 9,692). Health outcomes included depressive symptoms, chronic health conditions, and subjective memory complaints. Social relationships were measured by contacts, relationship strains, and feelings of loneliness. Early adversity was measured by parental physical abuse and alcohol and drug problems in the family before the age of 16. Patterns of association were similar in these 2 samples, where social contacts decreased over time, while relationship strains and loneliness increased especially for older adults with early trauma, which in turn mediated the associations between early adversity and poorer later health.
Socioeconomic Status and Later-Life Health: Longitudinal Evidence From Europe and China
Authors: Cheng Mengling , Sommet Nicolas , Jopp Daniela , Spini Dario 
Published: December 2021

Abstract
Scholars are divided as to how the protective effect of SES on health (the SES-health gradient) varies over the later-life course: The age-as-leveler perspective suggests that the SES-health gradient weakens with age, whereas the cumulative (dis)advantages perspective suggests that it strengthens with age. To clarify this, we used SHARE 2004-2017 (73,407 respondents from 19 European countries) and CHARLS 2011-2018 (8,370 Chinese respondents). Congruent with the age-as-leveler perspective, growth curve models revealed that the overall protective effect of SES on multimorbidity was weaker for older than younger adults (the country-specific effects were significant in two thirds of the case). We interpret this as a selection effect. However, the within-participant protective effect of SES on multimorbidity did not vary over the later-life course (the country-specific effects were nonsignificant in the majority of the case). Findings suggest that extant cross-sectional studies should be interpreted with caution and that longitudinal, cross-national studies are needed.
Adapting Nutrition Programming for Intergenerational Implementation
Authors: Jarrott Shannon , Scrivano Rachel , Naar Jill Juris , Bunger Alicia 
Published: December 2021

Abstract
Practitioners frequently tailor programming to meet participant characteristics and logistic constraints, or to incorporate diverse participants, such as intergenerational programming. Adapted programming may be responsive but reduce impact on outcomes. With growing interest in and limited availability of intergenerational protocol, implementation science guides program tailoring to ensure that youth and older adults mutually benefit from adapted programming. We integrated guidelines for tailoring interventions (Framework for Reporting Adaptations and Modifications-Expanded: FRAME) and evidence-based intergenerational practice. We illustrate how program fidelity can be supported in intergenerational settings using examples from an adapted USDA-approved preschool nutrition curriculum delivered intergenerationally. Program acceptability, appropriateness, and feasibility were rated favorably by program stakeholders, and observational implementation data suggest fidelity can be maintained using evidence-based intergenerational strategies. Our findings support the potential for protocol developed for one age group to benefit youth and older adults when it is adapted using implementation and intergenerational guidelines.
Detroit Needs Assessment Study: A Community Academic Partnership With the Detroit Area Agency on Aging
Authors: Hopp Faith , Keys Fay , Chapleski Elizabeth , La Wicker Cheryl , Rencher Patricia , Thomas Shirley , Davis Anne , Taylor Ronald 
Published: December 2021

Abstract
This presentation discusses a comprehensive needs assessment to inform long-term strategic planning for the Detroit Area Agency on Aging. The goal was to provide in-depth input from the older population (age 60+) and key agency stakeholders, using surveys (413 community participants), listening sessions (132 participants), 23 interviews with homebound older adults, and online surveys (94) targeting medical, church, government, academic, media and HSO stakeholders. Findings indicate that many participants were not aware of available community services. For example, one-third (33.3%) had not heard of Medicaid waivers providing services outside of nursing homes, while nearly one in five (22.0%) had not heard about senior employment services. The most common areas of unmet need were for caregiver workshops (16.3%) and diabetes management classes (15.7%). Community services most often noted as ‘extremely important’ included health and wellness programs (68.8%), services to help access health and supportive services (71%), easy to find service information (67.7%), home care and housekeeping services (66.4%), and caregiver support (63.7%). Stakeholder findings provide insight regarding this lack of awareness. Asked “How familiar do you think the general public is with DAAA?” , 10.8% answered ‘very familiar’ and 33% ‘unfamiliar’. Findings related to an “Age-Friendly City” suggest the importance of access to supportive community services, transportation, safety, housing, and healthcare. Engagement of older adults in needs assessments plays a vital role in Area Agencies on Aging meeting the needs of emerging aging cohorts by developing ‘age friendly’ strategies to address increasing racial, ethnic, socioeconomic, and cultural diversity.
Corporate Policy, Male Breadwinners, and Their Family Care in Aging Japan
Authors: Costantini Hiroko , Roberts Glenda 
Published: December 2021

Abstract
A rapidly emerging set of carers are men who combine care for older relatives with employment. In Japan, a 2015 government initiative aimed at reforming work to make employment and care compatible by 2020 failed to reduce the approximately 100,000 annually quitting employment mainly due to care for older relatives. This paper aims to evaluate the initiative’s limited impact through a multilevel understanding of the roll-out of the family care policy. Stakeholder views, based on 32 interviews including with employers, the Japanese Business Federation, local care providers and NPOs, are juxtaposed with the perspectives of employed male family carers drawn from 37 qualitative in-depth narrative interviews complemented by participant observation in the Tokyo area in 2019. The ethnographic fieldwork evidences informants’ diverse engagement with care for older relatives underpinned by strongly held cultural views of care provision being a ‘private’ issue, which contrasts with government attempts to make family care a ‘social’ issue by broadening stakeholder participation. Further, corporates tend to have tacit reluctance to transform working practices to accommodate care. Thus, employed men’s devotion to work competes with the culturally embedded notion that carers should be committed to care provision. In conclusion, such a disjuncture is a major factor in the government initiative’s failure. Although cultural values and meanings in policy evaluation theories are often neglected, this research points to the significance of ongoing (re)construction of the socio-cultural notions congruent with social policy enablement.