bluuebunny/crossref_metadata_2025_split huggingface dataset:
Engagement in Assisted Living During the COVID-19 Pandemic: Challenges and Promising Practices.
Authors: Bartoldus Victoria , Cho Youngmin , Perez Janelle , Wang Jing , Palmertree Stephanie , Beeber Anna 
Published: December 2021

Abstract
The “lockdown” in assisted living (AL) from the COVID-19 pandemic has physically isolated residents from the outside world and affected resident and family engagement in care. This presentation outlines a content analysis of qualitative semi-structured telephone interviews conducted from April 2020 with 105 AL staff, residents, and family members exploring COVID-19 experience/restrictions and engagement during the pandemic. Analysis revealed AL families and residents expressed difficulties with COVID-19 visiting and distancing restrictions, reduced family visitations, discontinuity of care, and worries about COVID-19 infection. Staff/administrators expressed uncertainty about lack of knowledge about COVID-19, worries about transmission, and if staff will get exposed outside of work. Promising factors include enhanced communication between staff and families regarding care, improved virtual communication, creative strategies to socially engage residents, and improved infection control practices and staff training. The presentation discusses the implications of the findings for future research, policy, and practice.
Approaching Multimorbidity From a Translational Geroscience Perspective
Authors: Newman Anne 
Published: December 2021

Abstract
Multimorbidity describes the accumulated burden of chronic disease. Multimorbidity erodes physiologic reserve, increasing the risk of frailty, disability and death. Most older adults have at least one chronic health condition by age 65. Once established, many age-related conditions progress and accumulate with age. Geroscience holds that there are key biologic pathways that explain the increase with age in multimorbidity, frailty and disability Translation of geroscience principles to human studies requires careful assessment of biomarkers of these pathways and multisystem outcomes. In this symposium, translational researchers in geriatric medicine and gerontology will present current work to elucidate biologic underpinnings of aging and potential intervention targets. We will address whether blood biomarkers of aging processes are prognostic using combinatorial techniques and explore the potential for proteomics to identify novel pathways for health aging. New insights into the role of inflammation will be discussed with an emphasis on its relationship to multimorbidity. Brain aging will be considered with respect to the interactions between external stressors and resilience evaluating the role of ketone bodies which have immunomodulatory effects particularly on innate immune cells. Finally, the role of multimorbidity as an intervention target and potential intermediate outcomes including biomarkers will be presented with discussion of next steps needed to realize the potential for translational geroscience clinical trials to improve health span.
Operationalizing Healthspan as an Outcome for Clinical Trials in Geroscience
Authors: Justice Jamie 
Published: December 2021

Abstract
Efforts targeting biological aging pathways are advancing interventions which could extend healthy lifespan. Design of clinical trials to test such interventions necessitates an operational definition of healthspan, such as slowed accumulation or progression of multiple chronic diseases, functional decline, and disability. In this talk we explore these composite measures of healthspan proposed as outcomes for clinical trials in aging. This will be examined in example cases including multimorbidity and deficit accumulation frailty indices in an 8-Year intensive lifestyle intervention trial, and an update on multimordbity, functional, and biomarker endpoints in the trial Targeting Aging with MEtformin (TAME). Through these examples we will explore issues related to effect sizes and statistical challenges related to composite endpoints. Finally, we will discuss the role existing and emerging biomarkers of aging in clinical trials in geroscience and summarize evidence linking biomarkers to clinically meaningful outcomes.
Behavioral Health, Social Engagement, and Long-Term Care Services Use Among Community Older Adults: USA vs. Taiwan
Authors: Hou Su-I , Li Chien-Ching , Liu Darren 
Published: December 2021

Abstract
As healthcare advances, older adults are living longer. While 90% of older adults prefer aging in their own homes and communities, it is important to examine key factors influencing healthy aging-in-community and community-based long-term care (LTC) services available in different countries. This symposium examines behavioral health, social engagement, and LTC services utilization among community-dwelling older adults in the USA and Taiwan. Lessons learned from older adults across countries will provide insights for tailored community-based LTC services and program development. Dr. Hou from The University of Central Florida (UCF) will highlight similarities and differences in behavioral health profiles and the topics that most interest community-dwelling older Americans participating in three aging-in-community programs in Central Florida. Dr. Wang from Case Western Reserve University will examine the impact of neighborhood social cohesion on mobility among community-dwelling older Americans aged 65 and older from the national Health and Retirement Study. Dr. Liu from National Cheng-Kung University in Taiwan will share results of healthy lifestyle on quality of life among community-dwelling older adults in southern Taiwan. Dr. Young from State University of New York at Albany will compare long-term care use among community-dwelling older adults with and without dementia in Central Taiwan. Finally, Drs. Cao and Hou from UCF will analyze home and community-based services in the USA versus Taiwan. This symposium will further discuss similarities and differences of key factors related to healthy aging-in-community, along with practical recommendations and lessons learned across countries and cultural environments to improve community-based long-term care services and programs.
Home and Community-Based Services Between the USA and Taiwan
Authors: Cao Xian , Hou Su-I 
Published: December 2021

Abstract
Home and community-based services (HCBS) are critical to support our rapidly growing and aging population around the world. This paper takes initial steps to compare HCBS between the USA and Taiwan from four perspectives: funding sources, service types, challenges, and recommendations. Peer-reviewed articles and governmental reports (both English and Chinese) in the U.S.A. and Taiwan were reviewed. Analyses showed both countries mainly use tax dollars to fund HCBS. Although both countries have similar service categories, USA lack a clear organization scheme whereas Taiwan has detailed and clear services provisions. Workforce quality and shortage were common challenges for both countries, especially from culture perceptive. Recommendations for USA include expanded funding pool, better coordination between agencies, and rebalancing HCBS and institutional care with limited budget. Recommendations for Taiwan include expanded service coverage and quality to reduce disparity in rural areas, and providing more support for informal caregivers.
Social Connection Planning for Lonely or Socially Isolated Older Adults
Authors: Bower Emily , Newman Aurora , Reohr Paige , Vandorden Kimberly 
Published: December 2021

Abstract
Social connections are important for maintaining health and well-being with age. Behavioral interventions to promote connectedness hold promise, but there is limited evidence to guide effective modifications in the context of physical distancing or quarantine restrictions, such as those required during the COVID-19 pandemic. We present evidence for a brief (1-2 session) social connection intervention, “Connections Planning,” to enhance social connectedness for older adults. We first describe a cognitive-behavioral model of loneliness, which served as the framework for developing the intervention. We then present two case examples to demonstrate the application of the intervention with older adults in a community mental health clinic during physical distancing restrictions. Finally, we present initial findings from a pilot study to examine the feasibility and acceptability of the intervention delivered remotely with up to 10 community-dwelling older adults who endorse clinically significant loneliness. Recommendations for adapting the intervention during physical distancing restrictions are provided.
Differences in Geriatric-Focused Education Preparation and Beliefs About Providing Care to Older Patients in Ghana
Authors: Karikari Grace , Asante Samuel 
Published: December 2021

Abstract
With the increasing growth rate of older persons and a rise in related illnesses in Ghana, it is vital that health practitioners are equipped with geriatric-oriented knowledge and expertise to provide the needed services to geriatric patients. The purpose of this study was to examine (i) the differences in the level of geriatric-focused educational preparation between graduating medical and nursing students in a Ghanaian public institution, and (ii) the association between educational preparation and students’ beliefs about providing care to geriatric patients. The study hypothesized that students with more positive beliefs will be linked to higher educational preparation. Descriptive and inferential statistics were conducted (n=136 students). Findings show significant differences in the educational preparation of medical and nursing students (t [134] = -3.790, p &lt; .001). Graduating nursing students, comparatively, had higher educational preparation (M=23.14, SDe3.30) than medical students (M=21.14, SD=2.76). However, there was no significant association between students’ educational preparation and their beliefs about geriatric care. The findings underscore the need for extensive or more focused training. Further, the association between beliefs and educational preparation warrants further exploration. The need to examine the social cultural environment within which the research participants reside are discussed.
Online Gerontology Courses: Issues of Equity
Authors: Sharma Anita 
Published: December 2021

Abstract
The COVID-19 Pandemic changed higher education in several significant ways. The most significant impact was on methods of course delivery. In March 2020, all educational institutions changed their methods of instruction to fully online instruction. It happened almost overnight and left the students as well as the instructors unprepared for the unanticipated metamorphosis . The sudden and unanticipated change in the method of instruction and delivery of course contents also highlighted issues of equity. There appeared to be high levels of inequity in the use of technology across school and college campuses. A survey of students conducted by the author at the University of Louisiana at Monroe revealed different types of inequity such as, lack of finances to buy equipment, lack of training in the use of technology, and lack of personal space to study from home. A significant percentage of student population at ULM consists of first-generation college students. These students were impacted the most by the new methods of course delivery. Additionally, the author looked up similar surveys at other educational institutions and conducted a meta-analysis of published studies. This paper presents these findings.
The State of Gerontological Training in Ghana: Implications for a Specialized Workforce and the Aging Population
Authors: Asante Samuel , Karikari Grace 
Published: December 2021

Abstract
The rise in older population in Ghana is accompanied by several challenges that may require trained professionals with specialized knowledge in geriatrics and gerontology to help address. Extensive review of existing literature, however, indicates a lack of comprehensive geriatric focused training in Ghana’s education system. Unfortunately, the scope of this training deficiency, potential impact on the geriatric workforce, as well as the health and wellbeing of the aging population on the national level have not been extensively examined. With the older adult population set to increase over the next few years, the need for geriatric-trained human service professionals in diverse disciplines, including medicine, nursing, psychology, social work and public health has become more pronounced. This paper is a review of the current state of gerontological education in higher institutions in Ghana. Specifically, authors examined (1) current geriatric-focused training programs available to students in all public/government owned institutions, (2) existing national level programs, and policies addressing training deficiencies, and (3) the implications of findings for future geriatric workforce as well as the health and wellbeing of older Ghanaians. The findings call attention to the need for a nationwide geriatric-focused training system and policies aimed at prioritizing specialized care for the older population. Culturally appropriate recommendations for integrating gerontological training and education in tertiary institutions are discussed. Guidelines and standards based on the Academy for Gerontology in Higher Education (AGHE) Competencies for Undergraduate and Graduate Education are proposed.
Development of a Virtual Reality Platform to Promote Disaster Preparedness Among Older Adults
Authors: Cong Zhen , Kan Chen , Hagedorn Aaron , Thomas Sam , Yeager Reid 
Published: December 2021

Abstract
This project develops a tailored and adaptive virtual reality platform to innovatively promote older adults’ disaster preparation in a socially engaging environment. The platform serves the following purposes: 1) assist older adults to develop tailored household emergency preparedness plans, 2) simulate extreme weather conditions and warnings for older adults to practice disaster response and develop relevant knowledge and skills as well as test and revise their emergency preparedness plans, 3) use the process as a social engagement tool to reduce social isolation and promote a sense of community. The virtual environments are designed in Unity to simulate extreme weather conditions/natural disasters and older adults are guided to use the HTC VR headset and experience the selected disaster scenario. The pilot VR platform will be tested among community-dwelling older adults in the Dallas-Fort Worth Metropolitan Area.
COVID-19 and Older Adults: Coping With Long-Term Pandemic Precautions
Authors: Emerson Kerstin , Kim Deborah , Mois George , Beer Jenay 
Published: December 2021

Abstract
Studies conducted at the beginning of Covid-19 precautions suggested that older adults were stressed, but hopeful. Less is known how coping has changed for older adults after experiencing months-long pandemic precautions. We explore differences in coping between the initial pandemic declaration in March 2020, and 9 months later, via an internet survey fielded in November 2020 (n= 781). We present summary data, using chi-square tests for subgroup analyses. A majority of respondents (aged M=66 yrs, range 60-89) were women (64%) and White (94%). When asked to compare their feelings to the beginning of the pandemic, 44.8% were more frustrated, 38.7% were more stressed, and 32.7% were more anxious. However, 38.3% were more appreciative. Women were significantly more likely than men to report increases in feeling frustrated, angry, scared, stressed, sad, and hopeless. Introverts were significantly more likely than extroverts to report an increase in loneliness and stress. Since the first few weeks of the pandemic, respondents reported more communication through video calls (45.2%), texting (40.2%), and phone calls (28.8%). Additionally, 61.5% spent more time on computers/tablets, 47.2% spent more time watching TV, and 24.5% spent more time praying. Extroverts were significantly more likely than introverts to report an increase in time with TV, phones, and computers/tablets. Women were significantly more likely than men to report increased texting and praying. These data provide further understanding of the impact of long-term pandemic precautions on older adults and suggest particular subgroups of older adults may benefit from public health and mental health interventions.
The Effectiveness of a Caregiver Support and Education Intervention Designed for Caregivers of Veterans
Authors: Mavandadi Shahrzad , Eaker April , Van Treese Katherine , Jeffries-Silmon Brenda , Wray Laura 
Published: December 2021

Abstract
Veterans are at increased risk for dementia and multiple comorbid conditions, often making the family caregiving experience particularly challenging. The objective of this study was to examine the effectiveness of a telephone-based, collaborative dementia care program for improving caregiver (CG) outcomes in CGs of veterans with dementia. All CGs (n=107) received individual care management and were randomized to either individual intervention alone or individual plus group education and social support. CGs were on average 72.5 (+/-11.0) years old, and the majority were female, spouses/partners of the care recipient (CR), and providing care for ≥1 year. Pre-post analyses indicate that CGs experienced a significant reduction in both the frequency of CRs’ dementia-related symptoms (e.g. memory difficulties, disruptive behaviors, depressive affect) and their own distress in response to these symptoms. Our study adds to the literature on the development and evaluation of understudied CG populations, such as CGs of veterans with dementia.
Disparities in Financial Strain for Older Adults and People With Disabilities in California
Authors: Chen Lei , Kietzman Kathryn , Allen Rebecca 
Published: December 2021

Abstract
This study examines disparities in the experience of financial strain among older adults and people with disabilities by age, gender, race/ethnicity, poverty, and disability type. People with disabilities refer to those who report cognitive impairment, difficulties performing activities of daily living (ADLs) and/or instrumental activities of daily living (IADLs). Financial strain includes challenges that participants incurred during the last 12 months in acquiring food, housing, health care, or income. This study uses the data from the 2019 California Long-Term Services and Supports (LTSS) survey that was merged with data from the omnibus California Health Interview Survey (CHIS) (N=1097). This is the most comprehensive population-level dataset to examine LTSS needs, unmet needs, and uses of LTSS in California. Initial findings show that 50% of participants report spending less on food, while 40% report cutting down on saving for retirement, receiving and borrowing money from others, and experiencing a decline in household income. More than 20% note that they could not make rent or mortgage payments, had debt due to medical bills, and had to spend less on prescription medications or medical care. We also find significant disparities in financial strain by age, gender, poverty, and disability type; however, no significant disparities by race/ethnicity. This study is among the first to examine disparities in various financial strain types for people who need LTSS in California. The findings have policy implications for the Master Plan for Aging (MPA), which serves as a blueprint to build environments that promote an age-friendly California.
Does the Health Insurance Program Reduce Health-Induced Poverty?: New Evidence From the China Household Income Project
Authors: Zhang Yalu , Gao Qin 
Published: December 2021

Abstract
The growing cost of healthcare services has been a concern for many countries in the world. In China, medical expenditures can account for as much as 65% of per capita income in some low-GDP counties in 2011. One of the primary goals of the New Rural Cooperative Medical Insurance (NRCMI) is to provide financial protection and alleviate the financial burdens of rural residents in China. This paper examined whether NRCMI participation impacted the incidence of catastrophic health expenditure (CHE) among middle-aged and older adults (45 years old and above) using the China Household Income Project 2007 rural data and an instrumental variable estimation method in two provinces where there was heterogeneity in NRCMI implementation schedule. The results show that NRCMI enrollment could not impact the likelihood of experiencing CHE among middle-aged and older adults. However, NRCMI participation increased the actual amount of medical expenses in one province but not in the other. Although none of the prior studies have used instruments and village fixed effects or take endogeneity issues into account to investigate the impact of NRCMI on relative financial burden among recipients, the results found in this study are generally aligned with the prior findings, especially with those using quasi-experimental studies. Findings from this study provide empirical evidence to the policymakers that the effect of NRCMI participation on financial protections is limited despite its broad population coverage. The limited effects are probably due to the low reimbursement rate and more utilization of expensive healthcare services.
Vietnamese Families' Strength and Resilience and Healthcare Professionals’ Role During the Pandemic
Authors: Miyawaki Christina , Liu Minhui , Markides Kyriakos 
Published: December 2021

Abstract
Traumatic escape from Vietnam in 1975 brought 1.3 million Vietnamese refugees to the U.S. Today, Vietnamese are the largest Asian subethnic group in Houston, Texas (81,000+), making Houston the 3rd largest Vietnamese-populated city in the U.S. Despite these numbers, health research on Vietnamese population is limited. To address this gap, we developed the Vietnamese Aging and Care Survey and collected data on Vietnamese older adults (≥65 years) and their caregivers (N=199). The purpose of this study was to examine the association between caregivers’ caregiving characteristics and care recipients’ mental health (N=58 dyads). Descriptive statistics and logistic regression models were used. Caregivers were on average 53 years-old, Vietnam-born (97%), and working (66%). The majority (84%) lived with their care recipients and provided care for 20+ hours/week (69%) in good/excellent health (76%). Care recipients were on average 75 years-old, Vietnam-born (100%) in fair/poor health (81%). Regression results showed stressed caregivers with more-depressed care recipients (OR=1.47, 95%CI:1.02, 2.13) but positive caregiving experiences (OR=0.85, 95%CI:0.74, 0.97) and burdened caregivers (OR=0.79, 95%CI:0.65, 0.96) with less-depressed care recipients. We found the association between stressed caregivers and depressed care recipients (Life Stress Paradigm), but care recipients becoming a “helpful company” reduces caregiver burden and care recipients’ depression (Social Exchange Theory). Vietnamese families live in multigenerational households within ethnic enclaves and remain a tightly-knit family unit showing resilience to their low socioeconomic status (≤25K, 91%). Leveraging a family as their strength, healthcare professionals should take a caregiver-care recipient dyad approach when planning COVID-19 pandemic interventions in Vietnamese communities.