bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aging Strong: Promoting Resilience Through Optimism, Purpose, and Social Connections
Authors: Wicker Ellen , Schaeffer James 
Published: December 2021

Abstract
Resilience is defined as the ability to adapt and cope with circumstances in a way that empowers one to emerge stronger, thrive, and incorporate lessons learned. Resilience as a trait can be learned and modified and have a significant impact on healthy aging. UnitedHealthcare (UHC) and AARP Services, Inc. (ASI) are committed to the health and well-being of participants in UHC’s Medicare Supplement insurance plans, recognizing that health and wellness need to be promoted on a holistic level to ensure successful aging. In this effort, an initiative titled Aging Strong 2020 was developed to promote health, well-being, and increase resilience by focusing on the key individual pillars of enhanced purpose in life, social connectedness, and optimism. To accomplish this goal, a series of eight interventions over three years were created and delivered, with a focus on the key pillars in order to improve clinical and psychological health outcomes and participants’ satisfaction with health care. This symposium will specifically discuss efforts related to the Aging Strong 2020 program. First, we will describe the prevalence and outcomes of the pillars in a large national survey. Next, key challenges and successes in recruitment and retention for the various interventions will be highlighted, followed by overall findings from the eight interventions targeting the pillars. Finally, qualitative findings on participant experience as a result of participation will be discussed. Results from these initiatives demonstrate that interventions designed to improve well-being among older adults contribute to the holistic model of health.
Implementation of a Shared Decision-Making Tool for Osteoarthritis Treatment to Reduce Decisional Conflict
Authors: Watkins Yashika , Gonzalez Rose , Johnson Charla , Kaur Ravneet 
Published: December 2021

Abstract
Shared decision making is a key component of patient centered care where clinical evidence and the patient’s preference and values are considered. Physical activity and weight loss are often recommendations in the treatment plan, especially in mild to moderate stage of osteoarthritis (OA). Movement is Life (MIL) created an innovative SDM tool to provide a framework for patient-centered discussions. The tool leverages an underlying Markov Model and represents the likely pain, activity levels, and lost productivity at three future time points. By comparing the patient’s likely progression depending on treatment choices compared to doing nothing, the patient has an illustration of future state. A pilot of N=108 women, ages 45-64, with chronic knee pain for at least three months and at least one co-morbidity (obesity, hypertension, diabetes) were randomized to a control (n=54) or intervention (n=54) arm of the study at eight centers across the United States. Results showed the demographic profiles were similar between the groups. At one-month, n=47 control and n=50 intervention patients returned for evaluation. Self-reported level of physical activity increased in the intervention group (56% vs 34%, p = 0.0229). Qualitative feedback from the intervention group indicated high satisfaction with use of the tool. Both groups reported a high likeliness to recommend the provider to a friend or family member. Inclusion of the SDM tool added an average of one minute to the patient counseling time over the control group. The quasi script provides a consistent communication pathway and may reduce disparities by addressing unconscious bias.
Predicting Symptom Severities in Middle-Aged and Older Adults With Arthritis and Multimorbidity
Authors: Zhang Wenhui 
Published: December 2021

Abstract
Introduction: Uncertainties increase with disease guideline-driven decision-making for older adults as their numbers of chronic conditions and functional limitations increase. A national study found that people with arthritis plus ≥ one other chronic condition have reported significantly higher social participation restriction, serious psychological distress, and work limitation than those with ≥two non-arthritis chronic conditions. However, how arthritis comorbidities contribute to the symptoms such as pain, fatigue, sleep, depression, anxiety, and cognitive abilities that chronically impair people’s daily functioning remain unexplored. Purpose: To explore how arthritis comorbidities predict the symptom severities of pain interference, fatigue, sleep disturbance, depression, anxiety, and cognitive abilities among community-dwelling middle-aged and older adults. Method: 140 community people aged over 50 with arthritis and multimorbidity were recruited. Stepwise regressions predicted the PROMIS symptoms of pain interference, fatigue, sleep disturbance, depression, anxiety, and cognitive abilities with arthritis type and 18 comorbidities measured by the Functional Comorbidity Index checklist after controlling for demographics. Results: Obesity, chronic obstructive pulmonary disease, diabetes, and income significantly predicted pain interference (adjusted R2=35%). Marital status, obesity, and peripheral vascular disease significantly predicted fatigue (adjusted R2=17%). Depression diagnosis and income adequacy significantly predicted depressive symptoms (adjusted R2=23%). Depression, income adequacy, and anxiety diagnosis significantly predicted anxiety (adjusted R2=23%). Age significantly predicted cognitive abilities (adjusted R2=12%). Discussion: Comorbidities and socio-demographics, especially income, impact symptom experiences of people aging with arthritis and multimorbidity. Future studies should explore the pathogenesis among arthritis, comorbidities, and symptoms for tailored intervention while disclosing health disparities associated with the arthritis multimorbidity.
Risk Factors for Cognitive Decline in Older Adults in Puerto Rico: Assessing Bias From Sample Attrition
Authors: Downer Brian , Pope Caitlin , Bell Tyler , Milani Sadaf , Andel Ross , Crowe Michael 
Published: December 2021

Abstract
Many risk factors for cognitive decline are associated with mortality and are common among older adults who cannot complete a survey interview. Our objective was to compare analyses of risk factors for cognitive decline among older adults in Puerto Rico with and without accounting for sample attrition. Data came from the Puerto Rican Elderly: Health Conditions Study. Our sample included 3,437 participants interviewed in 2002/03. Cognitive function was measured using the Mini-Mental Caban (MMC). The outcome was the change in MMC score between 2002/03 and 2006/07. Logistic regression was used to estimate inverse probability weights for being interviewed in 2006/07 (n=3,028) and completing the MMC at follow-up (n=2,601). Linear regression models were used to assess the association between stroke, hypertension, diabetes, smoking status, and cognitive decline with and without the IPWs. In the unweighted analysis, stroke was associated with a significantly greater decline in cognition (b=-0.62, standard error [SE]=0.30, p=0.04). Hypertension (b=-0.02, SE=0.12, p=0.84), diabetes (b=-0.22, SE=0.13, p=0.10) and being a current (b=0.05, SE=0.22, p=0.84) or former smoker (b=0.05, SE=0.14, 0.74) were not associated with cognitive decline in the unweighted analysis. The results were similar when including the IPW for mortality (stroke b=-0.63; hypertension b=-0.03; diabetes: b=-0.20; current smoker: b=0.08; former smoker: b=0.07) and having completed the MMC at follow-up (stroke b=-0.58; hypertension b=-0.03; diabetes: b=-0.20; current smoker: b=0.03; former smoker: b=0.09). These findings indicate that stroke is a risk factor for cognitive decline among older Puerto Rican adults even after accounting for selective attrition.
The Utility of the WHO Intrinsic Capacity Screening Tool to Identify Physical and Mental Function Declines
Authors: Ma Lina , Zhang Yaxin , Liu Pan , Li Yun 
Published: December 2021

Abstract
Background: The disease concept is increasingly being replaced by a functional approach to address the healthcare needs of the older people. WHO proposed the Integrated Care for Older People (ICOPE) screening tool to identify older people with priority conditions associated with declines in intrinsic capacity (IC). Very few evidence on the clinical utility of the ICOPE tool is available. Objectives: To determine if the tool can identify adults with poor physical and mental function. Method: 376 participants aged 50–97 years were included. IC was assessed with the WHO ICOPE screening tool, covering the following five domains: cognitive decline, limited mobility, malnutrition, sensory loss, and depressive symptoms. We assessed the activities of daily living, the Fried frailty phenotype, FRAIL scale, SARC-F scale, MMSE, GDS, social frailty, and quality of life. Peak expiratory flow, bones mineral density, body composition were obtained. Results: 69.1% of the participants showed declines in IC. Participants with declines in IC were older, had more chronic diseases, worse general health, worse physical function as indicated by lower Barthel index, walk speed, grip strength, and physical fatigue, worse mental function indicated by lower MMSE scores, higher GDS scores, more mental fatigue, and worse social function. After adjusting for age, IC was positively correlated with walking speed, resilience score, and MMSE score and negatively correlated with frailty, SARC-F score, IADL score, GDS score, and physical and mental fatigue. Conclusion: The WHO ICOPE screening tool is useful to identify adults with poor physical and mental function in Chinese older adults.
COVID Vaccine Rollout for Older Adults in Israel
Authors: Mahroum Naim 
Published: December 2021

Abstract
The COVID vaccine rollout in Israel has prioritized older adults. It led to a substantial decline in the incidence of COVID-19 in older adults. The new variants are threats to the current achievements. We will provide detailed information later. The symposium has experts from 8 countries. We will use an interview and dialog format, instead of presentations.
ENHANCE: The Center for Enhancing Neurocognitive Health, Abilities, Networks, & Community Engagement
Authors: Czaja Sara , Boot Walter , Bourgeois Michelle 
Published: December 2021

Abstract
Approximately 9 % of those aged 65 and over have a cognitive impairment due to a variety of causes including Alzheimer’s disease and other forms of dementia, Mild Cognitive Impairment (MCI), Parkinson’s disease, traumatic brain injury (TBI), and stroke. Few technology solutions have been directed towards supporting older adults with cognitive impairments and the literature regarding the efficacy of these solutions is sparse. In this symposium, we describe our new Center called ENHANCE (Enhancing Neurocognitive Health, Abilities, Networks, and Community Engagement), which is focused on developing technology support for aging adults with a cognitive impairment due to MCI, TBI, and Stroke. Sara Czaja will provide an overview of the conceptual framework, goals, and structure of ENHANCE, and describe the STRUMM project, that focuses on the design and evaluation of an innovative intelligent adaptive software package aimed at providing cognitive and social support to aging adults with cognitive impairments. Wendy Rogers will discuss the ENACT project, a longitudinal needs assessment focusing on understanding the needs, challenges, and support preferences of our target population and informal caregivers. Neil Charness will describe the AUGMENT development project, which is concerned with developing an instructional support tool for mobility activities, such as wayfinding, locating, and using transportation services. Finally, Walter Boot will discuss the DREAM development project, which is focused on developing a technology-based cognitive aid to support prospective memory activities. Michelle Bourgeois will serve as the discussant for the symposium and highlight the unique opportunities and challenges associated with ENHANCE.
Interdisciplinary Education Model in the Study of Aging: Example and Course Design
Authors: Su Yan-Jhu 
Published: December 2021

Abstract
Collaboration among various disciplines is essential to the gerontology curriculum because it is a a new and comprehensive subject. This presentation will discuss the design of interdisciplinary courses to include practical applications in the study of aging. The presenter will share examples based on personal experience to illustrate how music and psychology may be applied to the study of aging. In addition, the presentation will include analysis of actual course designs to show how different fields can be integrated in the classroom setting. This symposium presentation intends to improve cross-discipline applications as well as help students contribute to and benefit from the study of aging.
Assessing Knowledge, Attitudes, and Beliefs of Nurses About LGBTQ Older Adults Using a Documentary Video
Authors: Dutton Suzanne 
Published: December 2021

Abstract
Statistics reveal that lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults experience health disparities and barriers to accessing healthcare because of discrimination and fear of disclosing sexual orientation. Nurses receive limited education regarding care for LGBTQ older adults. This study exposed nurses to the documentary, Gen Silent, which details LGBTQ older adult experiences. The objective of the study was to increase participants’ understanding of LGBTQ health disparities. A one-group pre-/post-test design was conducted to test the effect of the documentary on knowledge and attitudes about LGBTQ health. A total of 379 nurses participated in the study. A questionnaire including a 16-item standardized scale and an open-ended question asking how participants would change their practice was administered before and after the intervention. Findings revealed statistically significant increases in LGBTQ knowledge and inclusive attitudes. This research supports the use of a documentary as an educational method related to LGBTQ older adults.
Factors and Functions Associated With Health and Well-Being Among Older Adults: Evidence From NHATS
Authors: Anderson Loretta , Wennberg Alexandra , Gibson Allison 
Published: December 2021

Abstract
The National Health and Aging Trends Study (NHATS) is a nationally representative sample of Medicare beneficiaries aged 65 and older. From 2011 through 2020, annual in-person interviews have collected data in many areas, including health, environment, wellbeing, cognition, and function. With a decade of follow-up, including replenishment samples, NHATS is an ideal setting to investigate trends and trajectories of aging. Aging is heterogeneous and understanding the myriad of factors and functions that impact health and wellbeing is critical to developing interventions and care to promote health and wellbeing. Considering a multifactorial, wholistic approach to aging will provide a deeper understanding to create an impact. This symposium features pivotal research conducted using NHATS data, while highlighting overall strengths of the dataset for future research. The first presentation of this symposium investigates the factors that define cognitive profiles associated with dementia diagnosis over a period of five years. The second presentation investigates the role engagement in personally meaningful activities play in cognitive, emotional, functional, and health-related outcomes in older adults. The third presentation investigates the association between sleep medication use and fall risk among older adults with and without dementia. The session concludes with an investigation of end-of-life communication in persons with dementia and hearing impairment.
Cognitive Decline Over a 5-Year Period: The National Health and Aging Trends Study
Authors: Gibson Allison , Holmes Sarah , Richardson Virgina 
Published: December 2021

Abstract
The classification of Alzheimer’s disease and related dementia (ADRD) is important for understanding the progression of cognitive decline. This longitudinal study used data from the National Health and Aging Trends Study (NHATS). A sample of 3,287 eligible Medicare beneficiaries were included in the study. Nine cognitive profiles were examined from Waves 1 to 5 (2011-2015). Discriminant factor analysis was used to identify factors that differentiated across the cognitive profiles. Results showed that 1,076 had some measure of “possible” or “probable” dementia over the 5 years. In Wave 1, there were 104 self-reported ADRD diagnoses, and in Wave 5, there were 327 self-reported ADRD diagnoses. Social participation was an important factor in those that impairment reversed from probable to possible ADRD. Findings support previous evidence that certain activities may slow or reverse cognitive decline and can inform future studies exploring the causality of dementia onset.
Falls Among High- and Low- Frequency Sleep Medication Users With and Without Dementia
Authors: Anderson Loretta , Wennberg Alexandra 
Published: December 2021

Abstract
Difficulty with sleep and falls are prevalent among older adults. Sleep medication use is associated with falls in older adults, but little is known about its impact in older adults with dementia. We used data from the 2011 National Health and Aging Trends Study to assess the association of low- versus high- frequency sleep medication use with falls in older adults with self-reported dementia. In our fully adjusted model, among those with dementia, high-frequency sleep medication users were more likely to fall than low-frequency sleep medication users (OR=3.86, 95% CI: 1.31, 11.37). Among those without dementia, high-frequency sleep medication users were more likely to fall than low-frequency sleep medication users (OR=1.40, 95% CI: 1.11, 1.77). Reducing sleep medication use in older adults with and without dementia may help reduce the risk of falls and fall-related outcomes in older adults.
Hearing Loss and Neuropsychiatric Symptoms in Persons With Dementia at the End of Life
Authors: Nieman Carrie , Regier Natalie 
Published: December 2021

Abstract
Access to effective communication is critical to the conversations that occur at end-of-life and represents an unaddressed need within palliative care. These challenges may disproportionately affect persons with dementia (PWD). Hearing loss is one of the most common comorbidities among PWD and is independently associated with neuropsychiatric symptoms. However, relatively little is known about the potential impact of hearing loss on PWD at end-of-life. We examined last month of life (LML) data from 971 proxies of deceased PWD from the National Health and Aging Trends Study (2011-2020). Hearing difficulty was associated with increased anxiety/sadness in PWD, χ2(1)=4.596, p=.032, such that 65.6% of persons with hearing difficulty reported anxiety/sadness in the LML. Binary logistic regression found that hearing difficulty was significantly associated with increased anxiety/sadness (OR=1.40, 95% C.I. 1.00 – 1.80, p &lt; 0.05). Interventions that optimize communication for PWD may be a meaningful approach to improving the end-of-life experience.
Health Disparities in COVID-19: Implications for Research, Policy, and Practice
Authors: Mingo Chivon , Rooks Ronica 
Published: December 2021

Abstract
The rapid transmission of COVID-19 has resulted in more than 100 million confirmed cases in over 200 countries and continues to have wide-community spread. Consistently, it has been reported that older adults are at a greater risk for requiring hospitalization or dying from the virus compared to younger adults and children. In fact, compared to those age 18-29, age 65-74 are five times more likely to be hospitalized and 90 times more likely to experience death. The risk increases exponentially with age. Individuals 85 and older are 13 times more likely to require hospitalization and 630 times more likely to die from the disease. The physical health-age correlation has permeated the media and many discussions concerning the pandemic. However, fewer discussions have centered on the interaction of age and social variables that further exacerbate COVID-19 related burden or mortality such as race/ethnicity, socioeconomic status, and limited access to healthcare. Therefore, this symposium will bring direct attention to COVID-19 related health disparities that compromise public health, discuss implications on future research, policy, and practice, and discuss opportunities to reduce the burden and mitigate health inequities. The symposium presenters will specifically address the impact of social support during COVID-19, disparities in the effects of social distancing on health status, the economic impact on health, cognitive decline among low-income older adults navigating a global pandemic, and factors associated with higher rates of hospitalizations among racial/ethnic diverse older adults.
Children’s Filial Piety and Parents’ Depressive Symptoms: Findings From a Dyadic Study
Authors: Bergren Stephanie , Le Qun , Dong XinQi 
Published: December 2021

Abstract
Filial piety is an important Chinese cultural value that prescribes child behavior towards their parents, but little is known about its relationship to the parents’ psychological wellbeing. This study utilizes dyad data from the PINE and PIETY Studies. Filial piety was measured by asking how much the participant thought children should 1) care; 2) respect; 3) greet; 4) please and make happy; 5) obey; and 6) provide financial support to their parents. Depressive symptoms were measured by Patient Health Questionaire-9 with a cutoff of 5 indicating the presence of depressive symptoms. Logistic regressions were used to examine the associations controlling for both children’s and parents’ sociodemographic characteristics. Higher filial piety in happy (OR:0.80, (0.65-0.99)) or obey (OR:0.83, (0.68-1.00)) was associated with a lower likelihood of depressive symptoms among parents. Future research should explore the potential causal relationships between children’s filial piety and parents’ mental health.
Parents’ Self-Reported Versus Child Evaluation of Parents’ Mental Health Outcomes: Is There a Difference
Authors: Dong XinQi , Hua Yingxiao , Kong Dexia , Le Qun 
Published: December 2021

Abstract
Older Chinese-Americans are more likely to experience depressive symptoms compared to the general U.S. aging population. This paper aims to examine the level of congruence between parents’ self-reported mental health and children’s evaluation of their parents’ mental health. Dyad-level understanding is particularly relevant considering the family-based medical decision-making preference in the Chinese-community. Older parents’ depressive symptoms were measured by PHQ-9 with a cutoff of 5 indicating the presence of depressive symptoms. Adult children were asked whether their parents informed them of their depressive symptoms or if they suspected that their parents were depressed. Logistic regressions were conducted. Parents’ self-reported depressive symptoms were associated with both adult children’s awareness (OR:3.28 (2.00-5.39)) and suspicion (OR:3.10 (2.02-4.77)) of their parents’ depressive symptoms. Results remained consistent among mother-child and father-child dyads. Study findings underscore the importance of incorporating adult children’s’ perspective in mental health research in the Chinese community.