bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Two Surveys Using the Sexuality Assessment Tool (SexAT) in Flanders
Authors: Messelis Els , Bauer Michael , Stichele Elisabeth Vander , Elaut els 
Published: December 2021

Abstract
From 2015 it is mandatory in Flanders, Belgium, to develop a policy to deal with sexual abuse in elderly care. Residential Aged Care Facilities (RACF'S) try to focus on this mandatory, but should also pay attention to implement an overall Sex and Intimacy Policy. This study contains a Comparison of two surveys (Messelis & Bauer, 2020 and Vander Stichele, e.a. 2020) in Flanders, Belgium, both using the Sexual Assessment Tool (SeAT, Messelis & Bauer, 2017). Both studies aimed to assess how supportive residential aged care facilities are of residents' sexual expression. In the survey of Messelis & Bauer 750 aged care facilities were contacted in 2017-2018 and 69 (9,2%) completed the SexAT survey after three reminders. Vander Stichele e.a. contacted 100 aged care facilities managers in 2019. Twenty of them (20% response rate) completed the SexAT after three reminders. Findings of the Messelis & Bauer survey indicate that 70% of the facilities rated 'very good' to 'good' (score between 21-59/69), while Vander Stichele e.a. found a prevalence of 76% of this score. Both found no facilities were rated 'excellent' (score greater than 60/69). In the category 'improvement needed' (score less than 20/69), percentages were 30% and 23%; a difference of 7% (CI95% of difference in percentage includes zero, not significant). There is room for improvement in residential aged care facilities for the support of sexual expression of residents. The more recent study confirms results of the previous one, and no significant evolution was observed in two consecutive cross-sectional surveys.
Efforts by the National Academy for State Health Policy
Authors: Fox-Grage Wendy 
Published: December 2021

Abstract
The National Academy for State Health Policy hosts both the RAISE Act Family Caregiving Resource and Dissemination Center and the Hub for State Strategies to Build and Support Palliative Care, with generous funding from The John A. Hartford Foundation. The value of supporting individuals with serious illness and complex conditions as well as their family caregivers through telehealth, care management, advance care planning, and other added family caregiver supports has been especially evident during the COVID-19 pandemic. Policymakers are now grappling with how to restructure hard-hit health care and long-term services and supports systems to better support these individuals and their family caregivers. The State Hub provides concrete resources for states working to implement and expand high-quality palliative care, and the RAISE Center is assisting the Family Caregiving Advisory Council with creating the country’s first national Family Caregiver Strategy.
Caregiver Stress and Empathy: Neural and Hormonal Correlates
Authors: Mirajkar Shalmali , Warren David , Beadle Janelle 
Published: December 2021

Abstract
Providing care to older adults with chronic conditions can be emotionally meaningful and stressful. The tend-and-befriend theory highlights the role of affiliation/empathy in stress reduction, but it has not been established whether this theory extends to caregivers for older adults. Addressing this gap, we assessed caregiver empathy and stress through behavioral, hormone, and neuroimaging measures. In Experiment 1, we compared 19 caregivers (Mage=67.1) to 24 non-caregivers (Mage=72.6), and found that caregivers with a greater reduction in cortisol to an empathic context showed greater prosocial behavior (r2=0.3). In experiment 2 (N=32), we examined differences between caregivers and non-caregivers in whole brain resting-state functional connectivity (RSFC) with seed regions of interest (posterior cingulate cortex (PCC); amygdala), and covariation of RSFC with empathy (α=0.05). For emotional empathy, caregivers had stronger connectivity between the PCC seed, medial prefrontal cortex, and right supramarginal gyrus, and between the amygdala seed and the right middle frontal gyrus.
Safety Considerations of Adaptive Horseback Riding Program for Adults With Dementia and Their Families
Authors: Oestreich Alicia , Fields Beth 
Published: December 2021

Abstract
Human-animal interactions, including equine-assisted services, are becoming increasingly popular to enhance the quality of life of adults with dementia and their families. However, there is a lack of knowledge on safety considerations when serving this population. The purpose of this qualitative descriptive study was to explore the safety perspectives of key stakeholders involved in an adaptive horseback riding program for adults with dementia and their families. Ten, 30-minute semi-structured interviews and two, 60-minute focus groups were conducted with horseback riding program instructors and staff, dementia specialists, and adults with dementia and their families. Thematic analysis of data were guided by the Professional Association of Therapeutic Horsemanship International’s Core Safety Standards and completed using NVivo 12. Stakeholders described two central themes to consider when offering equine-assisted services at therapeutic horseback riding centers to adults with dementia and their families 1) dementia and horse training parameters, and 2) enrollment procedures. Stakeholders recommended that training should encompass “how to interact and communicate in a positive way with the adult with dementia…redirect if a behavior comes up”, and horses should be specially selected to “tolerate standing in a ramp during a difficult mount”. Stakeholders also shared that enrollment in the program should include learning the adult’s health and prior horse experience, precautions and contraindications, horseback riding readiness, and availability of and support from family. Information gleaned from this study may help researchers, instructors, and staff develop policies that demonstrate optimal safety practices when delivering equine-assisted services to adults with dementia and their families.
Multiple Chronic Condition Combinations, Affect, and Memory Among Black and White Older Adults
Authors: Ogletree Aaron , Cooke Steph , Katz Benjamin 
Published: December 2021

Abstract
Research demonstrates the adverse effects of coexisting multiple chronic conditions (MCCs) on older adults’ health and wellbeing. While most research relies on total counts of chronic conditions, little work explores how specific MCC combinations may have compounding effects on depression and memory. Furthermore, no published research explores differences in the prevalence and correlates of MCC combinations between Black and White older adults. The current study assesses within- and between-group heterogeneity in the prevalence and correlates of MCC combinations to advance health equity research. We utilize a sample of 16,757 Black and White older adults drawn from the 2014 wave of the Health and Retirement Study. Respondents were categorized into one of 32 MCC combination groups. Depressive symptoms and self-rated memory were calculated separately for Black and White respondents across each of the 32 groups. Chi-square tests, t-tests, and ANCOVAs were used to compare differences. Black and White respondents differed significantly in the prevalence of 14 out of 32 MCC combinations. Within-group differences were found such that 45% of Black respondents experiencing only Lung Disease met criteria for clinical depression; this rate is similar to Black respondents experiencing Diabetes + Heart Condition + Hypertension + Lung Disease (44.5%). Between-group differences revealed that Black respondents experiencing Arthritis + Diabetes + Hypertension had worse self-rated memory than White counterparts (MB = 3.24, MW = 3.13; two sample t[1139]= -2.04, p &lt; .05; Cohen’s d = 0.13). Additional findings are presented, and theoretical and practical implications for this work are discussed.
Early-Life Racial Discrimination, Racial Centrality, and Adult Allostatic Load Among African American Older Adults
Authors: Tobin Courtney Thomas , Gutierrez Angela , Thorpe Roland 
Published: December 2021

Abstract
This study evaluated the life course processes through which early life racial discrimination (ELRD) and racial centrality (i.e., the importance of Black identity to one’s sense of self) interact to shape allostatic load (AL) among African American (AA) adults aged 50+ in the Nashville Stress and Health Study (N=260). Adolescent ELRD was associated with greater racial centrality in adulthood and conferred 35% greater risk of high adult AL; greater centrality was also linked to high adult AL. Centrality accounts for 24% of the association between ELRD and AL. ELRD and centrality interact to shape adult AL, such that racial centrality is protective against high AL for adults who experienced racial discrimination as children or adolescents. Findings highlight the multiple pathways through which race-related stressors and psychosocial resources interact to shape physiological dysregulation in later life and underscore the health significance of racial identity for older AAs.
Retrospective Perceptions of Changes in Well-Being: The Impact of Age, Culture, and Aging Attitudes on Accuracy
Authors: Park Jeongsoo , Lothary Allura , Hess Thomas 
Published: December 2021

Abstract
Aging attitudes have important consequences on functioning in later-life. A critical question concerns whether such attitudes may bias perceptions of one’s own aging, with potentially negative effects on important outcomes. Using data from adults aged 30 – 85 in the US (n=315), Hong Kong (n=317), and Germany (n=623), we examined the impact of age and aging attitudes on accuracy of perceptions of change in well-being over five years in different domains of functioning. Across contexts, comparisons revealed good correspondence between retrospective reports and actual change. However, older adults and those with negative attitudes retrospectively reported less positive change over this period. Accuracy of perceived change was affected by aging attitudes, with positive attitudes being associated with greater accuracy across most domains, although culture moderated these effects. The results highlight the complex relationship between culture and perceptions of well-being, as well as the potentially insidious effects of attitudes on their accuracy.
STRUMM: An Intelligent, Adaptive Software Package for Older Adults With a Cognitive Impairment
Authors: Czaja Sara , Ceruso Marco , Boot Walter , Charness Neil , Rogers Wendy 
Published: December 2021

Abstract
Many older adults have a cognitive impairment (CI), which negatively impacts on their quality of life and threatens their independence. In this presentation, we provide an overview of the conceptual framework, structure, and processes of our multi-site Center, ENHANCE, which is focused on developing technology support for aging adults with a CI. ENHANCE has two cross-site research projects, two cross-site development projects, training, and dissemination components. A core battery of measures is collected across all projects. We also discuss the Supportive Technology Resources through Usability & Machine-learning Methods (STRUMM) research project, which focuses on an innovative intelligent adaptive software package aimed at providing cognitive and social support, and support for resource access to aging adults with a CI. STRUMM is designed to meet the user’s varying cognitive needs. Finally, we present preliminary data regarding the perceived usability and value of STRUMM from our clinical partners and potential user groups.
The Devastating Economic Impact of COVID-19 on Older Black and Latinx Adults: Implications for Health and Well-Being
Authors: Garcia Marc , Thierry Amy 
Published: December 2021

Abstract
The ongoing COVID-19 pandemic and subsequent economic recession have wreaked havoc on the United States’ economy and brought to the forefront stark racial and ethnic inequalities in our society. Older Black and Latinx adults are particularly hard hit by the pandemic as they have relatively lower levels of income and wealth to protect against crises. This study used data from the 2020 COVID-19 module of the Health and Retirement Study, to highlight how the COVID-19 pandemic has economically impacted older Black, U.S.-born Latinx and foreign-born Latinx adults. Results show the pandemic has economically devastated older Black and Latinx adults across a host of economic factors, with foreign-born Latinx experiencing greater economic hardships relative to other groups. Our findings document stark inequalities that are being exacerbated by the pandemic. We discuss the implications of the economic shocks of the pandemic for the health and well-being of older Black and Latinx adults.
Systemic Mechanisms of Brain Rejuvenation
Authors: Villeda Saul 
Published: December 2021

Abstract
Aging drives cellular and cognitive impairments in the adult brain. It is imperative to gain mechanistic insight into what drives aging phenotypes in the brain in order to maintain, and even restore, functional integrity in the elderly. We, and others, have shown that systemic manipulations - such as heterochronic parabiosis (in which a young and old circulatory system are joined) and administration of young blood or exercise induced blood factors - can reverse age-related impairments in regenerative, synaptic and inflammatory processes, as well as rescue cognitive faculties in the aged brain. These studies have revealed an age-dependent bi-directionality in the influence of the systemic environment indicating pro-youthful factors in young blood elicit rejuvenation while pro-aging factors in old blood drive aging. It has been proposed that introducing pro-youthful factors or mitigating the effect of pro-aging factors may provide effective strategies to rejuvenate aging phenotypes in the brain. Despite this potential, much is unknown as to the systemic and molecular mechanisms regulating pro-youthful and pro-aging effects of blood-borne factors. I will discuss work from my research group that begins to provide mechanistic insight into the systemic and molecular drivers promoting rejuvenation in the aging brain.
Targeting Anticipatory Neurogenesis to Maintain Cognitive Reserve
Authors: Sahay Amar 
Published: December 2021

Abstract
Memory imprecision is a hallmark of age-related cognitive decline and mild-cognitive impairment (MCI) and is characterized by increased memory interference and decreased stability of memory representations. Evidence from humans, non-human primates and rodents demonstrate reduced hippocampal neurogenesis, excitation-inhibition imbalance and inflexible hippocampal remapping during age-related cognitive decline and MCI. Developing strategies to reverse cognitive decline during aging and Mild Cognitive Impairment necessitates an understanding of molecular, cellular, circuit and network mechanisms that support memory functions of the hippocampus. Over the last decade we have built a multifaceted program grounded in basic neuroscience that is aimed at improving memory in aging and MCI. We have demonstrated how we can Rejuvenate the aged hippocampus by selectively increasing neurogenesis and how we can Re-engineer connectivity of aged inhibitory microcircuits to improve memory precision in aging. Ongoing efforts include strategies to Repairing neurogenic niche fitness by targeting intercellular communication in the aging hippocampus. In today’s talk I will present a fourth approach catalyzed by our discovery of the first transcriptional regulator of neural stem cell expansion in the adult hippocampus. We will present data in support of this claim and convey how this discovery may guide strategies to maintain cognitive reserve embodied in the pool of neural stem cells in the adult hippocampus.
The Impact of Diabetes and Edentulism on All-Cause Mortality: Racial and Ethnic Disparities
Authors: Tan Chenxin , Luo Huabin , Sloan Frank , Plassman Brenda , Adhikari Samrachana , Schwartz Mark , Qi Xiang , Wu Bei 
Published: December 2021

Abstract
This study examined the relationships between the concomitance of diabetes mellitus (DM) and edentulism and mortality among Black, Hispanic, and White older adults in the US. We used data from the 2006-2016 Health and Retirement Study with 2,108 Black, 1,331 Hispanic, and 11,544 White respondents aged 50+. Results of weighted Cox proportional hazards models showed that the concomitance of DM and edentulism was associated with a higher mortality risk for Blacks (Hazard Ratio [HR] = 1.58, p &lt; 0.01), Hispanics (HR = 2.16, p &lt; 0.001) and Whites (HR = 1.61, p &lt; 0.001). Findings also indicated that DM was a risk factor for mortality across all racial/ethnic groups, but edentulism was a risk factor only for Whites (HR = 1.30, p &lt; 0.001). This study revealed that the risk of DM and edentulism on mortality varied among racial/ethnic groups. Our study gives alternative explanations for the observed findings.
Disparities in Dental Service Use Among Adult Populations in the United States
Authors: Wu Yan Yan , Zhang Wei , Wu Bei 
Published: December 2021

Abstract
This paper aimed to examine disparities of dental service utilization for younger (20-49), middle-aged (50-64), and older adults (65+), among Whites, Hispanics, Blacks, Asians, American Indians or Alaska Natives (AIAN), and Native Hawaiian or other Pacific Islanders (NHOPI). Weighted logistic regression models were conducted to analyze nine waves of data (2002-2018) from the Behavioral Risk Factor Surveillance System. Results show that the all-wave average prevalence was 71% and racial/ethnic disparities increased with age. Black older adults had the lowest level of dental service utilization (65%), comparing to the two highest groups: White older adults (79%) and Asian older adults (76%). The younger adult populations had low prevalences with the lowest among Asians (65%). The AIAN and NHOPI all age groups tended to have average or below average prevalences. Health policy, federal funding, and community-based programs should address needs of dental service utilization for racial/ethnic minorities including Blacks, AIANs, and NHOPIs.
Fatigability: An Early Marker of Diminished Renal Function?
Authors: Simonsick Eleanor , Moore Ann , Shardell Michelle , Kuo Pei-Lun , Karikkineth Ajoy , Ferrucci Luigi 
Published: December 2021

Abstract
Renal function declines markedly with age due to normal aging and/or disease processes and impacts multiple systems. Diminished renal function may manifest as low exercise tolerance and fatigue threshold. Using data on 951 well-functioning (usual gait speed &gt;.67m/s and no difficulty walking ¼ mile) men and women (51%) aged 60-89 years in the Baltimore Longitudinal Study of Aging, we evaluated the cross-sectional association between perceived fatigability (Rating Perceived Exertion after 5-minute treadmill walk at 1.5mph) categorized as 6-7, 8-9, 10-11 and 12+ and GFR using Cockcroft-Gault. For each fatigability increment, likelihood of suboptimal (GFR=75-89, 21%), diminished (GFR=60-74, 26%) and poor renal function (GFR=15-59, 30%) relative to GFR≥90 was respectively OR(95%CI)p-value 1.51(1.16-1.96).002, 1.38(1.04-1.83).027 and 1.68(1.22-2.31).002 adjusted for demographics, weight, height, smoking, exercise and anemia. Findings were similar for men and women. Perceived fatigability may facilitate identification of apparently well-functioning older adults on the precipice of suboptimal to poor renal function.
Trends of ARNI and Other Heart Failure Medication Use in Older Adults
Authors: Lee Yu-Chien , Patorno Elisabetta , Gopalakrishnan Chandrasekar , Kim Dae 
Published: December 2021

Abstract
In 2015-2017, we identified 276,679 to 315,788 Medicare beneficiaries with HFrEF (mean age 76.6-76.7 years, 75.0-76.2% male, 82.0-83.4% Whites, and 44.8-50.9% frail). Since its approval in July 2015, ARNI use increased from 0.3% to 5.7%. ARNI uptake was lower in patients with older age (6.6% for 65-74 years vs 3.4% for ≥85 years), non-Hispanic race (7.3% for Hispanic vs 5.6-6.6% for other race), no dual eligibility (6.4% for dual eligibility vs 5.5% for no dual eligibility), frailty (5.1% for frailty vs 6.1% for non-frailty) and dementia (3.8% for dementia vs 6.1% for no dementia). Frail patients were less likely than non-frail patients to receive disease-modifying treatments, such as angiotensin-converting enzyme inhibitors (32.4% vs 38.9%), angiotensin receptor blockers (14.5% vs 17.5%), aldosterone antagonists (20.8% vs 23.4%), and beta-blockers (65.1% vs 68.3%), but more likely to receive symptomatic treatment with loop diuretics (56.4% vs 48.0%).
Recruitment, Enrollment, and Retention: Creative Techniques to Overcome Obstacles
Authors: Sefcik Justine , Petrovsky Darina 
Published: December 2021

Abstract
The process of recruiting, enrolling, and retaining older adults in research studies has been challenging, even prior to the COVID-19 pandemic. This symposium presents research conducted and lessons learned on recruiting, enrolling, and retaining older adults, including those with cognitive impairment. Insights are provided on what techniques are most beneficial for improving rates of research participation, spanning time prior to and during the pandemic. The first presentation reports on qualitative perspectives of persons living with dementia and their caregivers as to what helped them decide to enroll into a clinical trial together. The second presentation speaks to how variations in incentive payment allocations played a role in consent decisions of patients with amnestic mild cognitive impairment and their study partners. The third presentation discusses the effectiveness of an adapted framework and strategies to increase the recruitment and retention of older Latinos with Alzheimer’s Disease and Related Dementias (ADRD) into a clinical trial. The fourth presentation shares techniques for recruiting older adults for a survey study during the pandemic. The fifth presentation defines challenges during a longitudinal study when the pandemic and other natural disasters occurred and strategies for success. Taken together, these presentations will inform researchers on techniques that could be used to improve recruitment, enrollment, and retention of older adults in clinical research.
Variations in Payment Allocation to Persons Living With Cognitive Impairment and Study Partners
Authors: McPhillips Miranda , Li Junxin , Sefcik Justine , Petrovsky Darina , Brewster Glenna , Hodgson Nancy , Gooneratne Nalaka 
Published: December 2021

Abstract
There is a paucity of research focused on monetary incentives for recruiting dyads (participants with cognitive impairment and study partners) into research. Our objective was to evaluate if two different variations in allocating compensation among dyads changed consent rates in one clinical trial, Memories2. This trial is evaluating cognitive and functional outcomes of obstructive sleep apnea treatment in patients with amnestic mild cognitive impairment (aMCI). Prior to phone screening, participants were randomly assigned to one of two groups (1) $200 to participant with aMCI or (2) $100 to participant with aMCI and $100 to study partner at consent visit. Allocating all the payment to the participant with aMCI yielded a 2.6% consent rate, while splitting the payment yielded at 1.7% consent rate. We will also discuss how demographic factors affected consent decision by group. This study provides insight into novel strategies that may enhance enrollment of dyads into clinical trials.