bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care in Context: Dementia Support in Mexico and the United States
Authors: Rote Sunshine , Angel Jacqueline , Vega William 
Published: December 2021

Abstract
Due to rapid demographic transitions, the number of people with dementia is rising in the Americas, and is expected to double in the coming decades, increasing from14.8 million in 2030 to over 27 million by 2050. The burden of dementia is especially pronounced for the Mexican-origin population in Mexico and the U.S. For Mexico, financial support for older low-income citizens and medical care are universal rights, but limited fiscal resources and the needs of a large low-income population create inevitable competition for limited resources among the old and the young. Although the United States has a more developed economy and well-developed Social Security and health care financing systems for older adults, Mexican-origin individuals in the U.S. do not necessarily benefit fully from these programs. The institutional and financial problems are compounded in both countries by longer life spans, smaller families, as well as changing gender roles and cultural norms. Such changes affect the Mexican-origin population in particular because of a higher prevalence rates of cognitive impairment than other racial and ethnic groups, and the lower access to resources to provide care. In this GSA Symposium, the authors of four papers deal with the following topics as they relate to dementia care in Mexico and the United States: (1) living alone in late life; (2) living arrangements and dementia care; (3) the role of non-governmental organizations in care; (4) next steps to address dementia care needs in the U.S. and Mexico.
Living Beyond 80: A Longitudinal Study of Cognitive and IADL Disablement Among the Oldest Mexican Americans
Authors: Kim Jiwon , Angel Jacqueline , Rote Sunshine 
Published: December 2021

Abstract
Mexican Americans live longer on average than other ethnic groups, but often with protracted cognitive and physical disability. Little is known, however, about the role of cognitive decline for transitions in IADL disability and tertiary outcomes of the IADL disablement for the oldest old. We employ the Hispanic Established Populations for the Epidemiologic Study of the Elderly (2010-2011, 2012-2013, 2016, N=1,078) to investigate the longitudinal patterns of IADL decline using Latent Transition Analysis. Three IADL groups were identified: independent (developing mobility limitations), emerging dependence (limited mobility and community activities), and dependent (limited mobility and household and community activities). Declines in cognitive function were a consistent predictor of greater IADL disablement, and loneliness was a particularly salient distal outcome for emerging dependence. These results highlight the social consequences of cognitive decline and dependency as well as underscore important areas of intervention at each stage of the disablement process.
Bilingualism and Healthy Aging: Onset Age of Bilingualism as a Predictor of Older Adult Theory of Mind
Authors: Yow W Quin , Li Xiaoqian , Lee Jia Wen 
Published: December 2021

Abstract
The ability to understand and speak more than one language (i.e., bilingualism) may protect against age-related cognitive deterioration (Abutalebi et al., 2015). While there is mounting evidence suggesting that bilingualism confers advantages in domain-general cognitive abilities in late adulthood (see Bialystok, 2017, for a review), few studies have investigated the influences of bilingualism on socio-cognitive abilities such as theory of mind (ToM) in the normal aging process. Thus, in this study, we examine how bilingualism factors (i.e., onset age of bilingualism, language balance, and diversity in language use) are associated with individual differences in ToM in healthy older adult bilinguals aged 58-79 (N=44). ToM abilities were assessed using the Theory-of-Mind Task Battery (Hutchins et al., 2008), where participants viewed vignettes and answered questions about the protagonists’ cognitive and affective mental states. All participants completed a self-report language background questionnaire and the Montreal Cognitive Assessment (MoCA) test as a measure of general cognitive ability. Results revealed that better ToM was negatively correlated with participants’ chronological age (r=-.43, p=.004) and the onset age of second-language acquisition (r=-.41, p=.006), but not language balance and diversity (ps&gt;.40). Partial regression analyses showed that earlier onset age of bilingualism predicted better ToM performance (β=-.40, p=.009), even after controlling for age, education, and general cognitive ability. These findings suggest that bilingual language experience, particularly earlier exposure to a second language, may provide benefits to older adults in preserving their ability to understand others’ mental states, acting as a cognitive reserve against age-related declines in socio-cognitive functions.
Verbal Communication in Dementia Family Caregiving: Using the VNVIS-CG Scale for In-Home Video Observations.
Authors: Williams Kristine , Coleman Carissa , Aly Iman , Wilson Paige 
Published: December 2021

Abstract
Communication is fundamental for dementia care and identifying communication behaviors is key to identifying strategies that facilitate or impede communication. To measure caregiver verbal communication, we adapted the Verbal and Nonverbal Interaction Scale for Caregivers (VNVIS-CG) for second-by-second behavioral coding of video observations. The VNVIS-CG was adapted for computer-assisted Noldus Observer coding of video interactions captured at home by family caregivers from the FamTechCare clinical trial. Operational definitions for verbal communication behaviors were developed and inter-rater reliability was excellent (Kappa = .86) using two independent coders. Videos (N=232) were coded featuring 51 dyads; caregivers were primarily female (80%) spouses (69%) of men (55%) diagnosed with moderate to severe dementia (64.7%). Mean caregiver age was 65 years. Silence occurred most frequently (44.9% of the time), followed by caregiver direction or instruction (22.6%), and the person with dementia (PWD) verbalizing (22.8%). Caregiver communication also included asking questions (14.2%), verbalizing understanding (7.9%), repeating information (2.1%), affirmations (1.0%), acknowledging emotions (0.3%), and ignoring (0.0%). Questions most commonly requested clarification, showed interest, or repetitive quizzing; few questions sought to engage PWD input (ex. offers choices, encourages emotional expression, or ask permission). Tone was overwhelmingly neutral rather than humorous, aggressive, or patronizing. The adapted behavioral coding scheme provides a reliable measure that characterizes dementia caregiver verbal communication behaviors for analysis of video observations. Ongoing research will identify strategies that facilitate communication as well as determine how strategies vary by dementia stage, diagnosis, and dyad characteristics.
Intensity of Walking Training Impacts Cognition Among Assisted Living Residents With Frailty
Authors: Danilovich Margaret , Norrick Christie 
Published: December 2021

Abstract
Exercise has many proven cognitive benefits but the precise intensity to modify cognition is unclear. This pilot study investigated the role of exercise intensity on cognitive outcomes among assisted living residents. We enrolled n=33 frail or pre-frail residents who completed an 8 week, twice-weekly walking intervention. Participants were 66% female, and on average were 88 years old with a MMSE score=25.6, and low cognitive scores (Category Fluency Animals=10.45, Category Fluency Vegetables=7.67, Trail Making Test A=60.82 seconds, Trail Making Test B=155.18 seconds). Walking sessions used 5-minute intervals focused on maximizing steps, fast speeds, and multi-directions for 45 minutes per session. Participants in the high intensity group walked at &gt;70% heart rate maximum or RPE 15-17 and those randomized to the casual intensity group walked at &lt;60% heart rate maximum or RPE &lt;13. Results showed the casual-intensity group improved more on Category Fluency tests (increase of 0.88 animals and 1.06 vegetables) compared to the high-intensity group (increase of 0.12 animals and increase of 0.35 vegetables). On Trail Making Test A, high-intensity participants had a 7.47 second decrease in time to complete compared to the casual-intensity group (2.00 seconds increase). On Trail Making Test B, high-intensity participants decreased time to complete by 27.13 seconds compared to a 26.19 decrease in the casual-intensity group. Results show promising trends in the role of exercise intensity in impacting different elements of cognition among assisted living residents.
Worsening Mental Health and Self-Rated Health in Older Incarcerated Persons During the COVID-19 Pandemic
Authors: Barry Lisa , Noujaim Deborah , DePalma Alexandra , Coman Emil , Wakefield Dorothy 
Published: December 2021

Abstract
Incarcerated persons age 50 and older comprise one of society’s most vulnerable groups given high rates of chronic illness, estrangement from family/friends, and suicide. Consequently, the mental health impact of COVID-19 on this population may be especially salient. Using data from the ongoing Aging Inmates’ Suicidal Ideation and Depression study (Aging INSIDE), we determined change in older incarcerated persons’ mental health (anxiety and depression symptoms) and change in self-rated health (SRH) from before to during the COVID-19 pandemic, and evaluated how these variables were related. Of the 202 still-incarcerated Aging INSIDE participants, 157 (77%) completed Check-In Surveys between August-September 2020. Participants were 96% male, racially diverse (41% White, 41% Black, 18% Hispanic/Other) and average age was 56.0(±5.8) years. From before to during the COVID-19 pandemic, average anxiety symptom scores, assessed by the GAD-7, increased (worsened) (from 6.4±5.7 to 7.8±6.6; p&lt;0.001), average depressive symptoms scores, measured by the PHQ-8, increased (worsened) (from 5.5±6.0 to 8.1±6.5; p&lt;0.001), and average SRH decreased (worsened) (from 3.0±0.2 to 2.6±0.2; p&lt;0.001). Worsening anxiety led to worsening depressive symptoms (direct effect = 0.339; p&lt;0.05). A mediation model controlling for age, race, chronic conditions, years until release, and change in social support score found a total effect of change in anxiety on SRH change of -0.04 (p&lt;0.001), of which 34.2% flows indirectly through change in depression (p&lt;0.001). Older incarcerated persons experienced worsening mental health and SRH during the COVID-19 pandemic. Future research will determine if mental health and SRH improve following vaccination and return to “normal” procedures.
Co-Calibration of Cognitive Domains Across Different Countries Without Common Linking Items
Authors: Nichols Emma , Jones Richard , Gross Alden 
Published: December 2021

Abstract
Modern psychometric methods allow for cocalibration of cognition across cross-national surveys, given the presence of common tests across studies. For narrow cognitive domains, there may not be common tests due to cultural and linguistic differences in testing. We developed a novel method to facilitate cocalibration that entails (1) identifying a common score across studies highly correlated with the focal domain; (2) deriving scores separately in each study for the domain of interest; and (3) applying stratified equipercentile equating to equate domain scores in (2) to the distribution of the common metric in (1). We tested this method by equating executive functioning in the Harmonized Cognitive Assessment Protocols (HCAP) in the US (N=3496), India (N=4096), and England (N=1273). The method preserves the rank order of executive functioning derived separately (r&gt;0.99 in England; r&gt;0.99 in India), while preserving between-study differences observed in general cognitive functioning. We discuss limitations and future directions.
Online Training That Changes Family Caregiver Behavior and Attitudes
Authors: de Klerk-Rubin Vicki 
Published: December 2021

Abstract
The Family Caregiver Course (FCC) is an 18-week Validation training to sensitize family carers to the psycho-social needs of their relatives, integrate new behaviors that build relationships and specific verbal and non-verbal techniques to increase communication. Validation Training Institute partnered with the Alzheimer’s Association of Colorado in 2019 and 2020 in delivering this course. Due to COVID-19 limitations, the 2020 iteration was completely digital, using principles of online learning. To replace the two-day in-person component of this course, we developed four, 4-hour Zoom sessions that allowed participants to: practice specific Validation techniques, exercise, process and apply what was learned, role play and receive coaching to anchor skills. Important online rules were maintained, such as, offer opportunities for participant engagement every 10 minutes and create a community of inquiry. Pre- and Post-Surveys of the 2019 and 2020 iterations of FCC showed that after taking this course, family carers: reported that they knew what to do when faced with challenging behaviors from their relative; understood that lying or pretending to agree with a disoriented person was not an effective strategy for communication; gained knowledge of the different forms of dementia and that the differences are significant; were clear about the differences between Validation and other methods.
Spillover Benefits and Achieving Sustainability of Age-Friendly Communities
Authors: Gleason Shayna , Coyle Caitlin , Mutchler Jan 
Published: December 2021

Abstract
As the age-friendly movement grows in its second decade, urgent questions of initiative sustainability have taken hold in the academic literature and among advocates implementing age-friendly changes. The creation of authentically age-inclusive environments requires not just the continuation of the initiative itself, but that its principles become embedded in formal and informal organizational processes, across sectors and beyond familiar networks focused on older populations. This paper argues that sustainability of age-friendly initiatives is enhanced by “spillover” effects, in which a behavioral or policy change in one environment spurs change in another environment. Evidence for such spillover and an understanding of how and when it occurs is currently limited in the context of age-friendly environments. This paper draws on the experiences of Age-Friendly Boston, which has been working towards age-friendly goals for more than five years. Based on Boston’s experience, we identify, describe, and exemplify three pathways to positive spillover across environments: 1) branding positively; 2) publicizing successes; and 3) embarking on new relationships, while strengthening existing ones, in pursuit of shared goals. We also draw conclusions about what positive spillover means for the sustainability of age-friendly environments.
The Role of Secondary Care Networks, Gender, and Race on Primary Caregiver Burden
Authors: Liang Jiaming , Aranda Maria 
Published: December 2021

Abstract
In addition to primary caregivers, many older adults receive care from secondary care networks (SCN), which include family members and friends. Literature rarely considers support that SCN provided to primary caregivers. This study examines: (a) the association between SCN support and primary caregiver burden, and (b) the intersectional effects of gender (male/female)-race (White/Black) identities of primary caregivers on the association. A cross-sectional study using data from 2015 National Health and Aging Trend Study (NHATS) and National Study of Caregiving (NSOC) was conducted. A total of 967 older adults, 967 primary caregivers, and 2253 secondary caregivers were selected. SCN support was measured by (a) care domain overlap, and (b) proportion of caregiving by SCN. Negative binomial regressions on overall and split samples estimated main effects of SCN support and the intersectional effects of gender and race. Both SCN-related variables were associated with primary caregiver burden, but significant three-way interaction was only found between gender, race, and proportion of caregiving by SCN. Black female caregivers reported heaviest burden and having SCN support was associated with lower risk of being burdened. Whereas Black male caregivers reported lightest burden and SCN support was not associated with their perceived burden. Our findings support the positive role of SCN in reducing stress of primary caregivers, and demonstrate that positive impacts of SCN support vary across gender-race groups. The results indicate a strong need for support programs aimed at promoting cooperation among family caregivers for burden reduction, especially families with female and Black primary caregivers.
Lessons Learned in Executing the Nursing Home COVID Action Network
Authors: Faul Anna , Cotton Samantha , Yankeelov Pamela , Gordon Barbara 
Published: December 2021

Abstract
The University of Louisville ECHO Hub for the Nursing Home COVID Action Network put together a hub of experts that could effectively address the diverse needs of the 240 nursing homes in the 7 cohorts launched. We included an infectious disease expert, a geriatrician, and a behavioral health specialist who adjusted the curriculum to be more in line with the needs of the nursing homes. Our nursing homes were diverse in terms of geography, size and location. We created space for our cohorts to feel comfortable with each other, despite their differences. To foster this sense of togetherness, our facilitators used anonymous opinion polls and incorporated the use of virtual breakout rooms to encourage small group discussions. These strategies assisted in developing a sense of community within the Project ECHO sessions, that will continue to evolve in the post COVID world.
Material Hardship Among Custodial Grandparents and Grandchildren's Physical and Mental Health in COVID-19
Authors: Xu Yanfeng , Zhao Qianwei , Schuler Brittany , Levkoff Sue 
Published: December 2021

Abstract
COVID-19 has increased economic hardship for many families, including custodial grandparent-headed families. We aim to examine latent classes of material hardship among custodial grandparent-headed families, to assess predictors associated with identified classes, and to investigate associations with grandchildren’s physical and mental health outcomes during COVID-19. Data was collected from a cross-sectional survey in June 2020. The sample comprised of 362 grandparents. Latent class analysis and logistic regression were conducted. Three latent classes of material hardship were identified: Class 1 (n = 232; 64.1%) low overall hardship with high medical hardship, class 2 (n = 52; 14.4%) moderate overall hardship with high utility hardship, and class 3 (n = 78; 21.5%) severe overall hardship. Factors, such as race, household income, labor force status, financial assistance status, and trigger events to raise grandchildren, were associated with class membership. Class 2 (OR = 0.19, p &lt; 0.05) compared to Class 1 was significantly associated with grandchildren’s physical health. Our findings suggest that material hardship is heterogeneous among custodial grandparents during COVID-19, and children in households experiencing utility hardship have a higher risk for poorer physical health outcomes. Results highlight the needs to meet grandparents’ material needs and call for future research to examine the mechanism that explains the link between material hardship and grandchildren’s outcomes.
Resourcefulness Skills Use by Grandmothers Raising Grandchildren: A Longitudinal Case Study Approach
Authors: Jeanblanc Alexandra , Musil Carol , Tracy Elizabeth , Zauszniewski Jaclene 
Published: December 2021

Abstract
In the U.S., over 2.7 million grandparents are primary caregivers to grandchildren. It is critical to understand the experiences of grandparent caregivers to design tailored, supportive programs. Our aim was to analyze 4 weeks of daily online journals of 129 grandmothers with respect to their use of a set of Resourcefulness Skills© following web-based skills training. Using a thematic analysis approach, coding was completed by a three person team using NVIVO 12. Percent agreement among coders was over 90% (Kappa = .956). Twelve cases were randomly selected for case study development. Comparative case study analysis was used to look within and across cases for instances where skills were used and how skill use changed over time. The pattern of skill use showed that grandmother caregivers used resourcefulness skills to deal with the grandchild’s behavior and developmental issues as well as within the entire family system to manage conflicted relationships with the grandchild’s parents, balance relationships with their spouse/partner, and maintain relationships with other relatives. Case studies will be presented to show skill use over the four weeks of journaling in the context of the family system, as well as the strategies used by participants who improved skill use over time and those who faced barriers to skill use. Findings highlight the use of journals as a means to assess enactment fidelity of treatment interventions and the importance of the family network in skills training program implementation and ways to help grandmothers make use of skills training in the family setting.
Supporting One’s Own? Grandparents’ Help to Grandchildren Who Live With Other Unrelated Children
Authors: Cooney Teresa 
Published: December 2021

Abstract
The structures of young families today are becoming increasingly complex, which may impact grandparents’ involvement. I examine whether grandparents’ support to adult children’s households differs for those with biological grandchildren only, versus households with both biological and non-biological (step, unrelated) grandchildren. The resource dilution hypothesis and sociobiology theory suggest that grandparents will be less supportive of grandchildren when other unrelated children co-reside in their households. Grandparents (mean age 62.23) in the Add Health Parent Study (2015-2017) reported on instrumental and financial help given to each of their adult children's families in the past year. These data were merged with information from their adult children (mean age 36.76) who participated in Add Health Wave V (2016-2018). Adult children’s household structures—biological children only (n=400) or biological + other children (n=51)—were determined using their fertility histories and household rosters. No significant differences were found in the likelihood that grandparents offered any instrumental or financial support to these two household types (controlling for grandparent resources and adult child characteristics). Nor was the level of grandparents’ financial support significantly different for the two groups. However, grandparents gave significantly fewer hours of help to adult children heading households including both biological grandchildren and unrelated children. Grandparents appear less willing to devote time to assisting their grandchildren’s families when their investment is diluted by the presence of unrelated children. Perhaps time with grandchildren is less pleasing or comfortable when unrelated children are present. This same issue does not impact financial giving, which need not involve contact.