bluuebunny/crossref_metadata_2025_split huggingface dataset:
Respite Service Use among Dementia and Nondementia Caregivers: Findings from the Caregiving in the U.S. 2015 Survey
Authors: Lee Yura , Choi Wonchan , Park Min Sook 
Published: December 2021

Abstract
Caring for persons with dementia places a significant physical, emotional, and financial burden on caregivers. Although dementia caregivers may be exposed to more challenging caregiving environment than caregivers of those with other chronic conditions, little is known about how specific factors related to respite service use differ between dementia and nondementia caregivers. Thus, this study first examined factors related to respite service use among caregivers and further tested the moderating effect of dementia caregiver status in these relationships using nationally representative U.S. data. Logistic regression analyses were conducted among 1,203 caregivers (276 dementia and 927 nondementia caregivers) from the national Caregiving in the U.S. 2015 data. Caregivers’ race and ethnicity as a predisposing factor, caregivers’ self-rated health as an enabling factor, and care recipients’ living arrangement and functional limitations as need factors were significantly related to respite service use among caregivers. Moreover, dementia caregiver status moderated the association between enabling factors (i.e., household income, work status, and self-rated health) and respite service use. Our findings imply that dementia caregivers may be more in need of respite service use than nondementia caregivers when they have limited enabling factors (e.g., lower household income, nonworking status, poorer health). Policy and practice efforts that specifically support enabling factors are suggested to promote more respite service use among dementia caregivers.
Social Connectedness, Meals on Wheels Services and Healthcare Utilization Among High-Need Older Adults
Authors: Walsh Sarah , Chubinski Jennifer , Weaver France 
Published: December 2021

Abstract
Homebound vulnerable adults 65+ are at an increased risk for social isolation and loneliness. The adverse consequences of loneliness are profound – including increased health care utilization, burden of dementia, chronic diseases, and mortality. Meals on Wheels (MOW) is a familiar source of nutritional support for homebound individuals who wish to stay in their homes and has additional important benefits. A growing body of evidence demonstrates that MOW provides mental and social health benefits beyond nutrition, but less is known about the interplay between MOW, social cohesion, and health services use. This project will address this gap in the literature using data from the 2013-2020 National Health and Aging Trends Study (NHATS), a nationally-representative panel study of 65+ Medicare enrollees. Using matching and longitudinal multivariate techniques, the risks of hospitalization and permanent nursing home entry are compared between MOW users and non-users. Our longitudinal dataset includes 11,266 observations. Of those, 12.8% rely on MOW or other food assistance (N= 1,488) and 16.6% experience low social cohesion (N= 1,936). Some 6.6% of participants are nursing home residents (N= 748) and the 39.1% report an overnight hospital stay in the prior year (N= 4,560). MOW is a comparatively low-cost intervention to help homebound older adults retain their independence and limit costlier healthcare utilization. This work extends our understanding of MOW services beyond simple nutrition benefits to its potential impact on social health.
The (Un)Willingness to Keep Living at Very Advanced Ages
Authors: Ribeiro Oscar , Araujo Lia , Teixeira Laetitia , Afonso Rosa Marina 
Published: December 2021

Abstract
A long life is a general desire that will be reached by more and more people, particularly in developed countries. But the delay of mortality raises important questions about quality of life in the later years. Centenarians have received attention from different disciplines, particularly from demography and genetics, but a psychological approach on whether life at age 100 is perceived as worth living is still very limited. This study explores centenarians’ will to live and associated factors in a sample of 121 centenarians (mean age 101 years; SD 1.63 years; 84.3% female), who answered to a questionnaire comprising sociodemographic characteristics, health status, social functioning, and well-being as well as open questions on their will to live and end-of-life issues. Of the total sample, 31.4% expressed willingness to live longer, 30.6% did not, and 38% presented no clear positioning. From the qualitative thematic analysis, annoyance, uselessness, loss of meaning, disconnection, and loneliness were the most common justifications for being reluctant to live longer. Positive valuation of life and good self-rated health, followed by having a confidant and reduced pain frequency, were the reasons for being willing to live longer. From the quantitative analysis, associated factors of will to live include pain frequency, self-rated health, having a friend confidant and valuation of life. This study provides researchers suggestions for further investigation and highlight the importance of inquiring and understanding very old people’s values and views on their will to live, future wishes, and meaning in life.
The Financial and Operational Effects of COVID-19 on Ohio’s Long-Term Care Residential Settings
Authors: Kennedy Katherine , Applebaum Robert , Brod Kathryn 
Published: December 2021

Abstract
The COVID-19 pandemic has had a drastic impact on Ohio’s long-term care facilities. Yet, months into the crisis, the financial ramifications and workforce shortage were unknown. In partnership with the Scripps Gerontology Center at Miami University, LeadingAge Ohio and the Ohio Health Care Association developed an online survey that was launched in July 2021. Response rates were 46.4% for skilled nursing facilities (SNFs; N=446) and 35.8% for residential care facilities (RCFs; N=287). Core questions compared the first quarters of 2020 and 2021. Declines in operating revenues (-11.7% SNFs; -10% RCFs) and rising labor costs per patient day (17.9% SNFs; 16.1% RCFs) contributed to most providers experiencing a financial loss in the most recent month (78% SNFs; 66% RCFs). The increased documented use of agency staff is an important finding of this work; 62% of SNFs and 34% of RCFs spent money on agency staff. Despite increases in starting wages, the labor crisis remains severe. As of July 2021, SNFs had an average of 19.51 open positions, of which 9.82 were for state-tested nurse aides and 5.65 were for nurses. RCFs had an average of 8.83 open positions, of which 4.24 were for resident care assistants and 1.89 were for nurses. The challenges faced by the long-term care industry have rightly focused on the deleterious impacts of COVID on residents and staff. But these data also suggest that the financial impacts on the industry are serious and will likely shape access and provision of care in the future.
Antipsychotic and Psychopharmacological Medications: Care Transitions Among Nursing Home Residents
Authors: Holmes Sarah , Kuzucan Aida , Olopoenia Abisola , Brandt Nicole , Briesacher Becky , Qato Danya , Zarowitz Barbara , Wastila Linda 
Published: December 2021

Abstract
Nursing home residents are frequently prescribed antipsychotic and other psychopharmacologic medications (AP/PPM) to manage behavioral and psychological symptoms. Residents also experience care transitions between nursing homes and other healthcare institutions. Limited research exists on the relationship between AP/PPM use and care transitions in this population. The purpose of this study is to compare odds of care transitions among those with and without AP/PPM use, controlling for resident characteristics. This cross-sectional study used data from a 5% random sample of Medicare beneficiaries between 2011-2015 who resided in a nursing home and were continuously enrolled in Medicare Parts A, B, and D. Chi-square tests compared resident characteristics and AP/PPM use between those with &lt;2 and ≥2 transitions. Multivariate logistic regression evaluated the odds of transitions in those with and without AP/PPM use during a one-year follow-up, including interaction effects among AP and PPM use. Among 132,263 eligible residents, the majority were female(68%), white(85%), and &gt;75 years old(63%). Of residents who experienced ≥2 transitions, 17% received AP and 82% received PPM, compared to those with &lt;2 transitions for which 9% and 66% received AP/PPM, respectively (p&lt;.001). Logistic results showed that for residents with PPM use, those who take AP have 1.33 the odds of experiencing ≥2 transitions than PPM users who do not take AP (p&lt;.001). Findings demonstrate a significant association between AP/PPM use and care transitions in nursing home residents. Prudent use of AP/PPM should thus be optimized with a goal of reducing care transitions and improving quality of care.
Acetylation of Tau Induces Alzheimer's Disease-Associated Tau in Transgenic Mice
Authors: Ali Addison , Pareja Kristeen , Tracy Tara 
Published: December 2021

Abstract
Alzheimer’s disease (AD) is a neurodegenerative disorder that is characterized by neurofibrillary tangles (NFTs) and amyloid beta plaques. These NFTs are made up of aggregated tau proteins. Tau is involved in stabilizing microtubules and does not usually display aggregation. Acetylation of tau protein causes an increase in tau aggregation but its role in AD progression is still not well understood. I hypothesized that enhanced acetylated tau results in an increase in AD-like tau pathology. To test this, a murine prion promoter-tauKQ transgene was injected into the mouse fertilized oocyte. The tauKQ mutation alters lysine to glutamine to mimic acetylation of tau. Nontransgenic mice were used as controls. AT8 and GT-38 antibodies were used in immunohistochemistry (IHC) to target phosphorylated tau and AD-associated tau, respectively. GT-38 is conformation-dependent and requires 3R and 4R tau isoforms which makes it specific to AD. Through immunofluorescence, increased phosphorylated tau was observed in the hippocampus of the tauKQ mice compared to the nontransgenic mice. I focused on the dentate gyrus, CA1 region, and the mossy fibers of the CA3 region since they are involved in many memory processes. Through chromogenic IHC, the tauKQ mice exhibited more 3R+4R tau isoform pathology in the mossy fibers than the nontransgenic mice. This data suggests that an acetylation mimic is sufficient to stimulate an abundance of AD-related tau pathology in transgenic mice which is consistent with my hypothesis. The tauKQ mouse model can assist in understanding the role of tau acetylation and tau progression for AD.
Assessing Cardiometabolic Health Risk in Children Living With Grandparent Primary Caregivers: Interim Analysis
Authors: Song MinKyoung , Hayman Laura , Lyons Karen , Bessette Hannah , Davis Mary Roberts , Winters-Stone Kerri , Musil Carol 
Published: December 2021

Abstract
Minimal research has been conducted on the effect that grandparents as primary caregivers have on the cardiometabolic health of children who live with them, even though a number of studies have examined the influence of parent caregivers. As a first step towards filling that gap, we examined physiological and behavioral indicators of cardiometabolic health risk among children (aged 7 to 12 years) living with grandparent primary caregivers in Oregon and Washington. We measured body mass index and total cholesterol/glycohemoglobin (HbA1c), as well as physical activity/sleep and diet. In this preliminary analysis of our findings with 10 dyads (mean age 64.2 ± 4.0 years for grandparents; 9.3 ± 1.9 years for grandchildren), we report that on most of the indicators - obesity, physical activity, sleep, and diet - these children’s levels were comparable to national averages across all household types (not differentiated by type of family structure). However, 25% of the grandchildren (n=2) participating in our study had a total cholesterol level ≥ 200, compared to 7.4% of children from a nationally representative dataset. Similarly, 14% of the grandchildren (n=1) participating in our study had HbA1c ≥ 6.5%, compared to &lt; 0.5% of children from a nationally representative dataset. Our findings suggest that these children may be at higher cardiometabolic health risk (e.g., hyperlipidemia). Further investigations with a larger sample and more examination of cardiometabolic risk profiles including lipids/blood glucose assessment are required to validate our preliminary findings.
Associations Between HIV Stigma and Mental Health Among Older Hispanics and Whites Living With HIV
Authors: Karcher Kayle , Kamalyan Lily , Gonzalez Veronica , Brody Lilla , Heaton Robert , Moore Raeanne , Jeste Dilip , Marquine Maria 
Published: December 2021

Abstract
Hispanics/Latinos/as/x (henceforth Hispanics) have higher rates of HIV infection than non-Hispanic (NH) Whites, particularly in older age. People living with HIV (PWH) are at increased risk of stigma and poor mental health, but these associations have not been thoroughly examined in older PWH. We investigated ethnic differences in HIV stigma and its association with mental health in older Hispanic and NH White PWH. Participants included 116 PWH ages 50-75 (58 Hispanic and 58 NH White) from southern California (for the overall cohort: 82.7% male; 57.7% AIDS, 93.9% on antiretroviral therapy). Participants completed self-report measures of HIV-stigma, depression (Beck Depression Inventory-II; BDI-II), and cumulative alcohol use (i.e., lifetime total quantity/total days). Covariates examined included sociodemographic and HIV-disease characteristics. An independent sample t-test showed no significant ethnic differences in HIV stigma (p=.82). Separate multivariable linear regression models on mental health outcomes (adjusting for significant covariates) showed no significant interaction between HIV stigma and ethnicity on BDI-II scores (p=.83) or cumulative alcohol use (p=.51). Follow up models removing the interaction term, showed that increased HIV stigma was associated with higher BDI-II scores (B=0.34, 95% Cl=0.21-0.48; p&lt;.001), but not with cumulative alcohol use (p=.49) in the overall sample. Findings indicate a significant link between HIV stigma and depression symptoms in older PWH, with comparable associations among Hispanics and NH Whites. Future studies examining factors that may moderate the link between HIV stigma and depression in diverse older PWH would help guide the development of interventions aimed at improving mental health in this population.
I’m the Only Son She Got Left: Male Caregivers’ Experiences Managing Older Adults’ Post-Acute Care
Authors: Bueno Michael , Russell David , Chase Jo-Ana 
Published: December 2021

Abstract
Family caregivers (FCGs) play an integral role supporting older adults transitioning to post-acute care following a hospitalization. FCGs function as advocates, information agents, and most importantly, care managers and providers. Although, caregiving has been traditionally seen as a female role, men are increasingly undertaking these roles and responsibilities. This research addresses a gap in the existing literature by exploring the subjective experiences of male FCGs of older adults in the post-acute setting. Using data from two parent qualitative studies on caregiving in the post-acute setting (N=40), we conducted a qualitative secondary analysis using conventional content analysis of male caregiver participants’ interview data (n=11). Interviews explored the subjective experiences of male caregivers’ interactions with home health care supportive personnel and conducting medical/nursing tasks for older adults. Five themes emerged: areas of abandonment, financial needs, masculinity, organization of care, and preparation. These themes highlighted areas of both confidence and struggle for male FCGs and captured their unique experiences managing the care of an older adult in the post-acute setting. Furthermore, the themes illustrate male FCGs’ feelings of guilt, financial impact, work disruptions, and the perceived effect of masculinity on their caregiving role. Findings can inform clinicians’ provision of focused and tailored resources to meet the specific needs of male FCGs. Future research should explore the evolving experiences of male FCGs over time, particularly those FCGs of older adults with chronic illnesses.
Conceptualizing the Value of Aging: What is it Like to Be An Older Woman in the 21st Century?
Authors: Shilvock-Cinefro Karen 
Published: December 2021

Abstract
The basis for this hermeneutic phenomenological research was to identify common themes in women 65 years of age and older and determine whether these women felt valued in ageing. The best description of this research becomes the study of the phenomena as real living or “entering the lifeworld “(Finlay, 2012). The research sought to increase the knowledge of how older women feel about their own ageing and the effect of society’s response to them. The participants covered a large age range of 66 to 93 years of age all of which experienced physical, emotional, and social changes involving age. The participants' response to these changes of ageing and society’s response to them ranged from very positive to very distressing. Twelve women were interviewed from a vast range of locations throughout the United States through zoom due to COVID 19. Their responses reflect four main categories: ageism, successful ageing, active engagement, and social support. The interviews focused on seven main questions: Tell me about being your age? Is there a time you can recall when you first felt older? Have you ever felt mistreated as an older adult? Have you ever felt you were discounted or ignored as being an older woman? Have you done anything to maintain your youth? Have you done anything to feel youthful? Have you ever felt dismissed related to your age? Utilizing seven questions and the conversation with these questions brought forth this study. This became a platform for these women to tell their stories.
Dementia Ready: Comparing Approaches for Building Caregiver Readiness and Knowledge of Dementia
Authors: Lepore Michael , Keefe Kate , DeFrancesco Erica , Robison Julie , Ohlheiser Alis , Bailey Christine , Kellett Kathy 
Published: December 2021

Abstract
Despite the rising prevalence of dementia and the high cost and complexity of care for people with dementia, most dementia care is provided at home by informal caregivers who are not clinically trained. Building caregiver readiness and knowledge of dementia is key to supporting quality care and desirable health outcomes, such as preventing falls and reducing nursing home admissions. We sought to determine and compare the impact of two interventions—Resilient Living with Dementia (RLWD) and Care of Persons with Dementia in their Environments (COPE)—and of their combined delivery (both RLWD and COPE) on increasing caregiver readiness and knowledge of dementia. Between January 2019 and March 2021, 77 caregivers of people with dementia in Connecticut participated in RLWD and/or COPE and completed the Alzheimer’s Disease Knowledge Scale (ADKS) and the Preparedness for Caregiving Scale (PCGS) at baseline and at four-month and ten-month follow-ups. Analyses were conducted to compare outcomes by intervention(s). From baseline to four months and to ten months, we observed statistically significant (p &lt; .05) improvement on the ADKS among participants in RLWD, and on the PCGS among participants in COPE and among participants in RLWD. The most substantial impact on PCGS was observed among participants in both COPE and RLWD. No improvement in the ADKS was observed among participants in only COPE, but ADKS improvement was observed at four months among participants in COPE and RLWD. Findings suggest that the benefits of COPE and RLWD for building dementia caregiver readiness are complementary and mutually reinforcing.
Functional Status in Older Adults with Peripheral Artery Disease in Korea: A Cross-Sectional Study
Authors: Kim Yesol , Kim Mihui , Ryu Gi Wook , Choi Mona 
Published: December 2021

Abstract
Peripheral artery disease (PAD) is a chronic, progressive atherosclerotic disease resulting in worse functional status. It is an important factor that affects mobility and quality of life in older adults with PAD. This study aimed to identify the functional status and its associated factors of older adults diagnosed with PAD. We conducted a cross-sectional study among older adults aged 65 above diagnosed with PAD at a tertiary hospital in Seoul, Korea. Participants' functional status was measured using a Walking Impairment Questionnaire (WIQ) which consisted of distance, speed, and stair-climbing. We measured cardiac health behavior, social support, health perception, and clinical manifestation through self-administered questionnaires. Among 94 participants, the mean age was 74.98±6.21 years, and 91.5% were male. The mean score of WIQ was 0.59±0.30 out of 1; the mean scores for distance, speed, and stair-climbing of WIQ were 0.67±0.40, 0.45±0.27, and 0.64±0.37, respectively. Participants' functional status was significantly associated with age (β=-0.012, P=.002), sex (β=-0.284, P=.001), ulcers of the lower extremity (LE) (β=-0.242, P=.031), using a walking-assist device (β=-0.240, P=.002), walking difficulty due to pain of LE (β=-0.142, P=.006), and health behavior about physical activity (β=0.099, P=.021). This regression model predicted 53.5% of participants' functional status (F=8.63, P&lt;.001). This study indicated that younger age, female, independent walking, no ulcers of LE, no walking difficulty, and higher physical activity behavior were significantly associated with better functional status in older adults with PAD. Therefore, healthcare professionals should develop and provide interventions to promote physical activity and alleviate symptoms to enhance functional status.
Generativity in Life Review: Discovering Life Lessons and Wisdom in Naturalistic Intergenerational Conversations
Authors: Chilton Patricia , Woolverton Cindy , Glisky Elizabeth , Mehl Matthias , Grilli Matthew 
Published: December 2021

Abstract
According to the theory of generativity, one would expect older adults to inherently feature life lessons in naturalistic conversations with younger adults. Little though, is known about the process of these conversations, and to what extent they convey wisdom characteristics. In this project, intergenerational conversations between university students and older adults living in assisted and independent living communities were analyzed to identify life lessons within older adults’ informal life reviews. In the original study, 37 young and 52 older adults engaged in an intergenerational interaction as part of an undergraduate course. These conversations were recorded with participants’ consent, and transcribed with identifying information removed. For the current project, we analyzed 15 of these recorded conversations, averaging 46 minutes each between 10 students and 5 older adults to (1) develop a coding scheme and procedure to examine life lessons in intergenerational conversations, and (2) investigate whether wisdom characteristics are embedded into life lessons shared in this context. On average, each older adult referenced 4 life lessons (SD = 2) per conversation, which were coded for the following constructs: meaning making, personal growth, emotional valence, wisdom characteristics, life lesson type, and autobiographical memory type. Exploratory analyses suggest life lessons are inherently integrated into naturalistic intergenerational conversations, and that reflectivity is the most frequently expressed wisdom characteristic. This supports previous research identifying reflectivity as key to wisdom, and to the process of generativity. Further analysis is needed to illuminate the value of intergenerational conversations, particularly in a time of age segregation and ageism.