bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Intergenerational Relationships and Later Support Provided to Older Parents: Time-to-Death as a Contingency
Authors: Silverstein Merril , Zhang Wencheng , Wolf Douglas , Brown Maria 
Published: December 2021

Abstract
This paper focuses on whether stronger relationships with parents early in the family lifecycle results in adult children providing more support to them 45 years later, and whether this association is contingent on parents’ remaining years of life. We test time-to-death of parents as an indicator of vulnerability, an easy to ascertain and potentially powerful predictor of support. Data derived from the Longitudinal Study of Generations, a panel of three-generation families, originally fielded in 1971 and continuing to 2016. Focusing on the youngest generation (mean age = 19 in 1971), the analytic sample consists of 356 child-father relationships 473 child-mother relationships. We examined trajectories of instrumental support provided to parents over four waves between 1997 and 2016 as a function of each parent’s remaining years of life (mortality data from the National Death Index). We also examined variation in those trajectories based on frequency of shared activities and intensity of emotional closeness in 1971. Ordinal multi-level growth curve analysis revealed that proximity to death was a significant predictor of instrumental support provided over time. Only in child-father relationships did greater emotional closeness, as expressed in 1971, produce stronger associations between remaining years of life and provision of instrumental support. Findings are discussed in terms of understanding intergenerational dynamics that unfold over many decades and the utility of time-to-death as an alternative metric for assessing vulnerability. This research is timely in light of growing uncertainty about the family as a reliable source of care in later life, particularly for older men.
Dehumanization of Older Family Members: Novel Determinants of Elder Abuse Proclivity by Caregivers
Authors: Chang E-Shien , Monin Joan , Zelterman Daniel , Isenberg Naomi , Levy Becca 
Published: December 2021

Abstract
Elder abuse affects one in six older persons globally. Three limitations converge to impede progress in prevention: most research is victim- rather than perpetrator-based; the reliance on explicit, self-reported factors; and failure to account for psychological factors that motivate abuse in the first place. The current study will be the first to address these gaps by examining whether family caregivers’ dehumanization of older persons, or the denial of humanness to older persons as one of the most hateful age stereotypes, could explain elder abuse proclivity. Implicit dehumanization of older persons was measured by a novel implicit-association-test developed for this study. Explicit dehumanization was measured by a semantic differential question widely used in the literature. We used the reliable and validated 8-item Caregiver Abuse Screen to measure elder abuse proclivity. In the final survey of 585 caregivers, dehumanization was found to be prevalent with 51% of the caregivers implicitly and 31% explicitly dehumanizing older persons. As predicted, implicit and explicit dehumanization uniquely contributed to elder abuse proclivity (OR=1.23, 95% CI=1.02-1.50, p=.03) and (OR=1.26, 95% CI=1.05-1.51, p=.01), respectively, after adjusting for relevant covariates including caregiver burden, and caregivers’ and care-recipients' health. Also as predicted, implicit dehumanization improved the prediction of abuse proclivity above and beyond the explicit dehumanization of older persons and caregiver burden. Socio-etiological models of elder abuse perpetration and corresponding prevention design should consider the inclusion of dehumanization as a key risk factor for abuse proclivity in family caregivers.
Addressing the New Normal in Health Care Using an Interprofessional Model of Care Coordination
Authors: Cotton Sam , Faul Anna , Yankeelov Pamela 
Published: December 2021

Abstract
There has been significant discourse surrounding the widespread system failures within healthcare during COVID-19. Older, frailer, and poorer persons across the United States have been the most impacted by the pandemic. Given this, our FlourishCare team, received funding through the COVID Cares Act, as part of our Geriatric Workforce Enhancement Program (GWEP) grant, to create innovative programming for individuals that were the most impacted by the pandemic. Remote patient monitoring (RPM) is one intervention been shown as an effective way to assist persons in managing their conditions. Patients from our Optimal Aging Clinic were identified as struggling with hypertension, diabetes and/or COPD. Interprofessional teams of nursing and social work learners were assigned to work with patients. The kits contain all of the necessary technology and a virtual app platform that allows a patient to check their heart rate, blood pressure, oxygen levels, and glucose levels. This information was then disseminated to the team coordinating the patient’s care. The sample was mostly female (88%), African American (64%) and retired (70%). The mean age was 60 (SD=4), and 40% had less than a high school diploma. After 3 months in the program, we saw a significant improvement across all determinants of health, with a particular overall change in access to health services and individual health behaviors. This study showed the importance of providing patients with access to technology and the support of an interprofessional team can improve patient outcomes, lead to improvements in individual health behaviors and improve health literacy.
Person-Centered Care for Family Caregivers: Co-Designing an Education Program for the Healthcare Workforce
Authors: Parmar Jasneet , Anderson Sharon , Pollard Cheryl , Charles Lesley , Dobbs Bonnie , Leslie Myles , Marion Cecelia , McGhan Gwen 
Published: December 2021

Abstract
Background: Research recommends the healthcare workforce receive competency-based education to support family-caregivers [FCGs}. typically, education has been directed at FCG’s to increase their care skills rather that at healthcare providers to provide person-centered care to FCGs. Objectives: We present the co-design process used to create a competency-based education program for the healthcare workforce that ensures a person-centered focus on FCGs and introduce our Health Workforce Caregiver-Centered Care Education. Approach: Co-design is the act of creating with stakeholders to ensure useable results that meet stakeholder’s needs. We began by coining the concept “caregiver-centered care,” defined as a collaborative working relationship between families and healthcare providers aimed at supporting FCGs in their caregiving role, decisions about care management, and advocacy. From this definition we co-designed, then validated the Caregiver-Centered Care Competency Framework in a Delphi Process. Stakeholders (n= 101) including FCGs, providers, policy makers, community organizations, researchers, and educational designers then used effective practices for health workforce education to co-design the ‘foundational’ level of a Caregiver Centered Care education. Results: Teaching and learning resources include six competency-aligned educational modules with videos and interactive exercises that encourage reflection. With the COVID-19 pandemic, we moved the education online (caregivercare.ca). In the first four months online, 815healthcare providers completed the education. We continue to use mixed methods to evaluate the Caregiver-Centered Care Education, for acceptability and effectiveness, in five care contexts (primary, acute, home, supportive living, long-term care). Conclusion: We expect that our education will support caregiver-centered care in all healthcare settings.
Biological Aging Predicts Vulnerability to COVID-19 Severity in UK Biobank Participants
Authors: Kuo Chia-Ling , Pilling Luke , Atkins Janice , Masoli Jane , Delgado Joao , Kuchel George , Melzer David , Levine Morgan 
Published: December 2021

Abstract
Age and disease prevalence are the two biggest risk factors for COVID-19 symptom severity and death. We therefore hypothesized that increased biological age, beyond chronological age, may be driving disease-related trends in COVID-19 severity. Using the UK Biobank England data, we tested whether a biological age estimate (PhenoAge) measured more than a decade prior to the COVID-19 pandemic was predictive of two COVID-19 severity outcomes (inpatient test positivity and COVID-19 related mortality with inpatient test-confirmed COVID-19). Logistic regression models were used with adjustment for age at the pandemic, sex, ethnicity, baseline assessment centers, and pre-existing diseases/conditions. 613 participants tested positive at inpatient settings between March 16 and April 27, 2020, 154 of whom succumbed to COVID-19. PhenoAge was associated with increased risks of inpatient test positivity and COVID-19 related mortality (ORMortality=1.63 per 5 years, 95% CI: 1.43-1.86, p=4.7x10E-13) adjusting for demographics including age at the pandemic. Further adjustment for pre-existing disease s/conditions at baseline (OR_M=1.50, 95% CI: 1.30-1.73 per 5 years, p=3.1x10E-8) and at the early pandemic (OR_M=1.21, 95% CI: 1.04-1.40 per 5 years, p=0.011) decreased the association. PhenoAge measured in 2006-2010 was associated with COVID-19 severity outcomes more than 10 years later. These associations were partly accounted for by prevalent chronic diseases proximate to COVID-19 infection. Overall, our results suggest that aging biomarkers, like PhenoAge may capture long-term vulnerability to diseases like COVID-19, even before the accumulation of age-related comorbid conditions.
Antipsychotic Prescribing in VA-Contracted Community Nursing Homes and Incident Use Among Veterans
Authors: Moyo Patience , Corneau Emily , Cornell Portia , Mochel Amy , Magid Kate , Levy Cari , Mor Vincent 
Published: December 2021

Abstract
The Veterans Health Administration (VA) is increasingly purchasing long-term care for eligible Veterans from non-VA, community nursing homes (CNHs). Antipsychotics present safety risks for older adults, but it is unknown how the prevalent use of antipsychotics at CNHs influences whether newly admitted Veterans will initiate antipsychotic therapy. This study used 2013-2016 VA data, Medicare claims, Nursing Home Compare, and Minimum Data Set (MDS) assessments. We identified 10,531 long-stay CNH episodes for Veterans not prescribed antipsychotics 6 months before CNH admission. We categorized Veterans by whether, 12 months before admission, they were diagnosed with FDA-approved indications (including schizophrenia, Tourette’s syndrome, Huntington’s disease) for antipsychotic use. The exposure was the proportion of all CNH residents prescribed antipsychotics in the quarter preceding a Veteran’s admission. Using adjusted logistic regression, we analyzed two outcomes measured using MDS assessments collected ~100 days after CNH admission: 1) new antipsychotic use, and 2) new diagnosis for an FDA-approved indication among Veterans without these conditions at admission. Among antipsychotic-naïve Veterans admitted to CNHs, 7,924 (75.2%) lacked an antipsychotic indication. Prevalent antipsychotic use in CNHs ranged 0%-10.9% (quintile 1) and 25.7%-91.4% (quintile 5). The odds of initiating antipsychotic use increased with higher CNH antipsychotic use rates (OR=2.52, 95% CI:2.05-3.10, quintile 5 vs. 1), as did the odds of acquiring a new indication (OR=2.08, 95% CI:1.27-3.40, quintile 5 vs. 1). Provider practices may be influencing new diagnoses indicating antipsychotic use at CNHs with high antipsychotic use. It may be important for VA to consider antipsychotic use when contracting with CNHs.
Impact of Informal Care on Health Care Utilization Among Older People in China
Authors: Wang Yixiao 
Published: December 2021

Abstract
Population aging has become a challenge to long-term care and health care for the society. Using China as a case study, this paper assesses allocative efficiency of resources in informal care and health care, to explore the effectiveness of the policy, i.e., encouraging informal care as a more cost-effective way to reduce public health care spending. Drawing data from the 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey, this study examines the impact of informal care on utilization of health care as well as amount of health care expenditures among older people with functional limitations in China. Using random effects model with instrumental variable approach, our findings suggest that informal care significantly reduces the utilization of health care, primarily by reducing the utilization of outpatient care. However, informal care significantly increases the amount of inpatient care expenditures for inpatient care users. We do not observe significant association between informal care and amount of outpatient care expenditures for outpatient care users. This study highlights a pressing need for the Chinese government to support informal caregivers by taking economic values of informal caregiving into consideration, and to improve efficiency in inpatient care by a more integrated resource allocation mechanism
The Effectiveness of FFC-AL-EIT on Psychosocial Outcomes and Care Interactions
Authors: Galik Elizabeth 
Published: December 2021

Abstract
This study included a subset of 59 communities and 550 residents from the full FFC-AL-EIT study. Participants were mostly white (98%), female (69%) and had a mean age of 89.30 (SD=7.63). Sites were randomized to the four step FFC-AL-EIT intervention implemented by a function focused care nurse facilitator working with a facility champion over 12 months versus education only. Resident measures included depression, agitation, resistiveness to care and the quality of care interactions and were obtained at baseline, 4 and 12 months. There was a significant positive treatment effect related to depression, agitation, resistiveness to care and quality of care interactions with either less decline or some improvement in these behaviors and symptoms and improvement in the quality of care provided between the treatment versus control group. The study suggests there is some benefit to implementing FFC-AL-EIT for psychosocial outcomes and care interactions among residents in assisted living communities.
Understanding Resident, Family, and Staff Safety Priorities to Guide Development of an Engagement Toolkit
Authors: Cho Youngmin , Bartoldus Victoria , Chiong Cloie , Linville Tabitha , Palmertree Stephanie , Beeber Anna 
Published: December 2021

Abstract
Resident and family engagement (the desire, ability, and activation as a partner in care) is a necessary component of keeping assisted living (AL) residents safe. Barriers to engagement include differing priorities between the resident/family and staff. This presentation outlines the results of a content analysis of qualitative interviews with 105 AL staff, residents, and family members, in which we examined AL stakeholder priorities for safety. Qualitative interviews were analyzed to first identify safety priorities by stakeholder type (staff, resident, and families), and then compared across stakeholder group. Stakeholder-specific safety priorities were identified, including infection management (COVID-19 and others), medications errors, falls, elopement, lack of AL resources/staffing, conflict, adverse events, nutrition, physical hazards, building security, chemical agents, fire/natural disasters, and abuse/neglect – the importance of these priorities vary by stakeholder type. Presentation discussion will include implications for future intervention to address the top safety problems in AL.
Can We Replace Our Human Connection With Technology?
Authors: Cone Nicholas , Lee Jeongeun 
Published: December 2021

Abstract
The COVID-19 pandemic has led to social distancing protocols, subsequently increasing social isolation for older adults. The purpose of this study was to explore the relationship between social connectedness and mental health outcomes. Leveraging NHATS, a nationally representative study (n = 2,558, Mage = 79.20, SDage = 6.25), we examined the association between the method of social connectedness and mental health outcomes. Descriptive analyses revealed older adults are using various methods (e.g., in-person, phone, and video calls) to remain connected with their social networks during COVID-19. Findings from all of the linear regression analyses indicated phone or video calls are associated with negative affect, whereas in-person visits are associated with lower levels of negative affect. These findings suggest substituting in-person visits with video calls or phones may not be sufficient to relieve their loneliness and negative affect. Future studies should investigate this effect on physical or emotional health outcomes.
Immunometabolic Stress and Ketone Bodies in Disorders of the Aging Brain
Authors: Newman John 
Published: December 2021

Abstract
Delirium is an acute confusional state that is a common complication of acute illness in older adults, and is associated with increased risk of death, disability, and dementia. Delirium in older adults is an example of a geriatric syndrome, with multifactorial, multi-system causes that include existing aging-related physiological changes as well as external acute stressors. Its pathophysiology delirium is not well understood but may include glycolytic energy deficits associated with acute inflammation in the brain. The endogenous ketogenic system provides ketone bodies as a lipid-derived alternative to glucose for cellular energy, and ketone bodies are increasingly understood to have immunomodulatory effects particularly on innate immune cells. We used a mouse model of acute inflammation-associated behavioral change to investigate how age-related differences in energy utilization in the brain affect delirium-like phenotypes, focusing on energy metabolism and innate immune activation in the brain as an example of immunometabolic approaches to geriatric syndromes.
Behavioral Health and Most-Interested Topics Among Older Adults in Three Aging-in-Community Programs in Florida
Authors: Hou Su-I 
Published: December 2021

Abstract
This study compares behavioral health and most-interested topics among older adults in three aging-in-community (AIC) programs: a university-based lifelong learning program (LLP; 38%), a county neighborhood lunch program (NLP; 29%), and a village program sample (33%) (total n=289). Mean age was 72.4 (SD=8.68) years. Although perceived health was similar (mean=3.76), LLP and village members reported higher quality of life than NLP participants (p=.004). Two-thirds of the participants indicated at least half of their daily plates filled with fruits and vegetables, and at least 10 min. walking in 4.5 days during a typical week. The duration of each walking was lower among NLP members (23 min.), compared with village (31 min.) or LLP members (35 min.) (p=.002). The top three most interested topics were brain health, giving back, and keep community healthy. Older adults in AIC programs were overall healthy and active. Results have implication on tailored program development.
A Comparison of Long-Term Care Use by Community-Dwelling Older Adults With and Without Dementia
Authors: Young Yuchi , Stone Arianna , Chung Kuo-Piao , Chen Hsiu-Hsi , Yeh Yen-Po 
Published: December 2021

Abstract
Introduction. This study compares long-term care (LTC) use among community-dwelling older adults with and without dementia. Methods. Participants (n=14,483) were aged 65+ residents of Changhua County, Taiwan who qualified for LTC services. Data were collected (4/1/2017-10/26/2018) through health assessments. Multivariate logistic regression quantifies the study aim. Results. Preliminary results show that on average participants with dementia are older than people without dementia (81.1 vs. 80.5; p&lt;.001), more females (13.4% vs. 8.0%; p&lt;.001), higher mean ADL (12,4 vs. 9.8; p&lt; .001) and IADL (21.4 vs. 17.8; p&lt;.001), and lower mean comorbidity (2.5 vs. 2.8; p&lt;.001). Multivariate regression results indicate people with dementia use twice the health-related LTC services than their counterpart (OR= 2.0; 95% CI 1.90–2.14). Discussion. People with dementia use more health-related LTC services. Future dementia studies should examine the pattern of non-health-related LTC services concomitant with health-related services, so that person-centered care can be tailored to foster aging-in-community.
Disaster Preparedness and Coping Among Older Adults: Empirical Analysis and Virtual Reality Platform Development
Authors: Cong Zhen 
Published: December 2021

Abstract
This symposium included 4 studies that use national and regional data to examine older adults’ disaster preparedness and coping. The first study examined age differences in preparedness for the continuation of COVID-19 with a sample of 443 residents in Dallas, TX. The findings highlight older adults’ resilience and special needs for different types of support during the pandemic. The second study examined the association of having COVID-19 and intergenerational relationships using the COVID-19 module of the Health and Retirement Study with a sample of 3266 respondents. Using a national sample of 1,467 respondents from the 2017 U.S. National Household Survey, the third study examined age differences relationships among the type of disasters (i.e., disasters with different lead-time), response efficacy, and disaster preparedness. The findings highlighted older adults’ unique vulnerability and resilience in different types of disasters. The fourth study discussed a pilot virtual reality platform under development to assist older adults to develop tailored household emergency preparedness plans and practice those plans with simulated 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. Overall, this symposium emphasizes the uniqueness of older adults’ needs, vulnerability, and resilience to disasters.
Embracing Age-Inclusivity Through Multimodal, Active Student Learning in a Health and Aging Policy Course
Authors: Leedahl Skye 
Published: December 2021

Abstract
One of the goals for an upper-level undergraduate seminar course is for students to identify and discuss existing policies, programs, and resources for meeting the needs of the aging population. To encourage active student learning, the course provides a mix of readings and assignments, six intergenerational discussions, and reflective writing. The idea is that these varying experiences help foster a deep understanding of how these policies and related issues pertain and matter to everyone, not only older individuals, and how their future career and family experiences will benefit from the knowledge gained in the course regardless of their next career steps. This course model has been effective for challenging ageism, and has been taught four times, each time with modifications based on student numbers, current issues, and the pandemic. The presenter will discuss assessment methods, identify best practices, and offer suggestions for others interested in utilizing a similar model.