bluuebunny/crossref_metadata_2025_split huggingface dataset:
Machine Learning Prediction Models for Mobility Limitation Over Time in Older Adults: The Health ABC Study
Authors: Speiser Jaime , Callahan Kathryn , Ip Edward , Miller Michael , Tooze Janet , Krtichevsky Stephen , Houston Denise 
Published: December 2021

Abstract
Mobility limitation in older adults is common and associated with poor health outcomes and loss of independence. Identification of at-risk individuals remains challenging because of time-consuming clinical assessments and limitations of statistical models for dynamic outcomes over time. Therefore, we aimed to develop machine learning models for predicting mobility limitation in older adults using repeated measures and variable selection. We used nine years of follow-up data from the Health, Aging, and Body Composition study to model mobility limitation, defined as self-report of any difficulty walking ¼ mile or up a flight of stairs, assessed annually. We considered 46 predictors for modeling, including demographic, lifestyle, chronic condition and physical function variables. We developed three models with Binary Mixed Model Forest, using: 1) all 46 predictors, 2) an automated variable selection algorithm, and 3) the top five most important predictors. Area under the receiver operating curve ranged from 0.78 to 0.84 for the models for two validation datasets (with and without previous annual visit data for participants). Across the three models, the most important predictors of mobility limitation were ease of getting up from chair, gait speed, self-reported health status, body mass index and depression. Longitudinal, machine learning models predicting mobility limitation had good performance for identifying at-risk older adults based on current and previous annual visit data. Future studies should evaluate the utility and efficiency of the prediction models as a tool in a clinical setting for identifying at-risk older adults who may benefit from interventions aimed to prevent mobility limitation.
Cognitive Interviewing to Evaluate the Content Validity of a Photo-Supported Preference Assessment
Authors: Neal Vanessa , Knollman-Porter Kelly , Topper Rachel , McConnell Eleanor , Abbott Katherine , Van Haitsma Kimberly 
Published: December 2021

Abstract
Photo-supported verbal assessments have shown to improve comprehension and expression of choices by older adults living with cognitive-communication challenges. The purpose of this study was to assess content validity (CV) of photographs used to supplement the Preferences for Everyday Living Inventory-Nursing Home (PELI-NH) from the perspective of older adults, using cognitive interviewing methods. Participants (N=21) were average age 75 (SD=5.67), mostly male (62%) and white (90%), living in residential communities (86%), with no known cognitive or communication deficits. Interview data was used to iteratively assess and revise photographs. A total of 46 photographs demonstrated CV; 26 demonstrated CV after revisions; 3 did not demonstrate CV after revisions. Content analysis revealed thematic codes describing participants’ photograph preferences including image quality, context, subject diversity, and relevance to long-term care. Discussion will include implications for clinicians and researchers on how to evaluate and improve CV of photo-supported verbal assessments.
Life Course Adversity and Early Retirement Due to Poor Health
Authors: Sonnega Amanda , Helppie-McFall Brooke , Lee Haena 
Published: December 2021

Abstract
The relationship between life adversity and physical and mental health is well documented. The present research investigates life course adversity and early retirement due to poor health. Data are from the Health and Retirement Study, including the Life History Mail Survey (LHMS), HRS core surveys, and HRS Psychosocial Leave-Behind surveys. We create measures of childhood financial and social adversity and young-mid adulthood financial and social adversity. Early retirement is defined as self-report of “full” retirement between age 50 and 62. We use a Cox proportional hazards model competing risk framework comparing early retirement when poor health is a major reason for retirement with early retirement for any other reason. Models include covariates for age, gender, marital status, cohort, log household income, and log household wealth. Childhood financial adversity and homelessness in young-mid adulthood increases the instantaneous hazard of early retirement due to poor health.
Bridging Age-Friendly Health Systems Into the Community
Authors: Emery-Tiburcio Erin , Snyder Rani 
Published: December 2021

Abstract
As the Age-Friendly Health Systems initiative is implemented across the country, building bridges into the community assures that older adults live safely, enjoy good health and stay involved in their communities. In this symposium, we present innovative approaches that bridge the Age-Friendly Health Systems initiative into the community. Each presentation explores how the 4Ms concepts are integrated into their programs and enhance community with older adults. CATCH-ON Connect provides free cellular-enabled tablets and individual training to older adults to help them do What Matters to them by using their tablets. Rush@Home is a home-based primary care program that addresses the 4Ms in the comfort of an older adult’s home. Social Connections was co-designed with older adults to decrease loneliness by connecting older adults to each other. The Caregiver Initiative identifies and supports caregivers of older adults by meeting the 4Ms health needs of both caregiver and care recipient. Dementia Friendly Communities engage community stakeholders in a process to become educated, creating safe and respectful environments for individuals with dementia. By exploring these approaches, we can bridge the Age-Friendly Health Systems initiative into the community to support older adults outside the four walls of the health system.
Implementing and Sustaining Family Care Programs in Real-World Settings: Barriers and Facilitators
Authors: Hodgson Nancy 
Published: December 2021

Abstract
This presentation will summarize the extant published studies on the translation of proven family care programs for dementia in different care settings. This review is the first to our knowledge to examine the specific implementation efforts deployed in care settings for different family caregiver programs. In this review, we sought to answer three basic questions: (1) What theory base(s) or conceptual framework(s) guided the implementation of evidence-based family care programs?; (2) What implementation strategies were used to support translation into practice?; and (3) What were the identified drivers of and barriers to organizational change required for adoption of an evidence-based program? Understanding the frameworks and strategies deployed in translational studies published to date can help guide future translation efforts, inform the design of new family caregiver support programs that optimize their implementation potential, and ultimately help to minimize the “family care gap.”
Do Life Course Physical Activity Profiles Reduce the Effects of Childhood Exposures on Cognition?
Authors: Williams-Farrelly Monica , Smith Jacqui 
Published: December 2021

Abstract
Although physical activity throughout life is one of the most reliable predictors of healthy aging, can less consistent or favorable trajectories also improve cognition trajectories among older adults? Drawing from accumulation theories, we use longitudinal data from the Health and Retirement Study and Life History Mail Survey (N=9,309) to examine the early antecedents of cognitive decline and the extent to which different life course physical activity profiles can slow such a decline. Results from latent class analysis reveal seven distinct profiles: consistently low, consistently high, consistently average (reference), improvers, decliners, midlife motivators, and previously athletic “couch potatoes.” Growth curve modeling analyses show that membership in the consistently high class and midlife motivators were associated with better cognition initially and over time, with no difference between the two classes. Additionally, though poor health and learning problems in childhood were associated with worse initial cognition, physical activity does not mediate the relationship.
COVID-19 Perspectives of Assisted Living and Health Care Providers in Seven States
Authors: Zimmerman Sheryl , Sloane Philip , Hickey Johanna , Thomas Kali , Thorp Julia , Poole Meredith , Chaudhry Aisha , Carder Paula 
Published: December 2021

Abstract
Thirty percent of COVID-19 deaths in long-term care were in assisted living (AL), indicating challenges providing care. This project recruited AL administrators and medical and mental health care providers in a seven-state stratified random sample of 250 communities; it asked what was most challenging responding to COVID-19, what was successful, how to have better dealt with COVID-19, and how others could have helped. The most common challenge was addressing residents’ psychosocial needs, explained as “No contact - no hugging. The seniors require touch. It's something we've always done, and we can't do; we're required not to do it.” Successes included infection prevention, and in hindsight, administrators discussed staffing. Related to external entities, one commented, “Come in the building and see what we're doing. Don't sit behind a freaking screen and act like you know what we're doing.” Providers stressed patient access to care and social isolation. Implications will be discussed.
Disruption to Transformation: Aging in the New Normal: A Chat With NIA Senior Leadership
Authors: Kelley Melinda , Kelley Melinda 
Published: December 2021

Abstract
The National Institute on Aging (NIA) at the National Institutes of Health, Department of Health and Human Services, is the federally designated lead agency on aging research and supports significant research on aging as a lifelong process. In the last six years, NIA has experienced a tripling of its budget. Although much of this funding is targeted to Alzheimer’s disease (AD) and AD-related dementias research, there has been an increase in funds allocated to non-AD research in keeping with the overall growth of NIH. This symposium will provide a forum for exploration of the implications of the budget increases for the general research community. NIA’s senior staff will discuss research priorities and programs supported by the Institute. A question-and-answer session will follow these remarks on current funding and future priorities and research directions of NIA.
Perspectives From the 85+ Lifestyle Leaders on Social Isolation and Multigenerational Relationships
Authors: Patskanick Taylor 
Published: December 2021

Abstract
The oldest of older adults are especially impacted by many of the measures recommended to slow the spread of COVID-19. This presentation explores changes in Lifestyle Leaders’ experiences with loneliness and their beliefs about the impact of COVID-19 on multigenerational relationships and intergenerational programming. For example, 55.6% strongly agreed or agreed with the statement, “The pandemic will have been more socially impactful on younger generations than older generations.” Lifestyle Leaders remain interested (68%) in virtual or socially distanced intergenerational programming. Particular activities of interest included technology tutoring, pen pals, and outdoor or virtual socializing. Additionally, this presentation will highlight how the Lifestyle Leaders have been impacted by a loss in weak ties and the extent to which the pandemic has prompted them to take on new roles in their families, including “accepting” paid and unpaid caregiving and experiences living with children and grandchildren during the pandemic.
Does Personal Goal Pursuit Alleviate Family Caregiver Stress?
Authors: Turner Shelbie , Hooker Karen 
Published: December 2021

Abstract
Family caregivers may experience reduced stress by maintaining their sense of self throughout their time in a caregiving role. Working towards personal goals is helpful for maintaining a sense of self, but pursuing one’s own goals amidst caregiving responsibilities may be challenging. In this study, we analyze the processes by which caregivers pursue their own personal goals – and how those processes impact daily stress – in an effort to develop a deeper understanding of goal-pursuit as a potential caregiver stress-reducing strategy. We utilized daily data from spousal (N=256 days) and adult-child (N=400 days) caregivers who participated in the PULSE (Personal Understandings of Life and Social Experiences) Project, a 100-day microlongitudinal study on goal pursuit amongst people 50 and older (Hooker et al., 2013). In daily surveys, caregivers reported progress made towards a personally-identified health and social goal, along with a 4-item measure of daily stress. We ran multi-level models to assess how daily goal progress was associated with same-day stress. Spousal caregivers’ daily stress was lower on days when their health goal (Estimate = -1.07, SE = 0.20, p&lt;.0001) and social goal (Estimate = -0.97, SE = 0.15, p&lt;.0001) progress was higher. Similarly, adult-child caregivers’ daily stress was lower on days when their health goal (Estimate = -0.67, SE = 0.19, p&lt;.001) and social goal (Estimate = -0.52, SE 0.24, p=0.03) progress was higher. Results support the hypothesis that maintaining personally-meaningful goals can alleviate caregiver stress, and is a promising tool for caregiver health promotion.
Lessons Learned in the Delivery of Live Remote Group Weight Loss and Physical Activity Interventions for Older Adults
Authors: Fanning Jason , Nicklas Barbara 
Published: December 2021

Abstract
Social connection lies at the root of lasting health behavior change, and as such most effective interventions are built around social tools. Group leaders and peers provide education, and act as models of successful change and collaborators in addressing common barriers to behavioral adoption and maintenance. Unfortunately, many older adults do not have access to high quality group programs due to factors such as limited transport options, lack of local availability, or worries over personal safety. Importantly, developing effective, synchronous remote group programming is not as simple as delivering an in-person session via teleconference software. Instead, careful consideration must be paid to technology selection, fostering effective group communication, and developing confidence for use of remote intervention tools. This symposium provides key lessons learned from three group-based activity and weight loss interventions for older adults that focused on live, remote interaction. Jason Fanning will share lessons from the MORPH study, which paired remote group-mediated behavioral counseling with dietary weight loss and the accumulation of aerobic activity across the day. Christina Hugenschmidt will share her experiences adapting a group program involving improvisational dance or social gaming for remote delivery. Kushang Patel will present results from a mixed-methods study on the feasibility and acceptability of a remotely-delivered exercise program for older adults with knee osteoarthritis. Finally, Barbara Nicklas will place these experiences in the context of the development of exercise interventions for older adults over time, and highlighting vital next steps for ensuring more older adults have access to this important behavioral medicine.
New Developments in Views on Aging Research: Variability, Innovative Concepts, and Contextual Perspectives
Authors: Kornadt Anna , Wahl Hans-Werner , Wurm Susanne 
Published: December 2021

Abstract
Views on aging (VoA) such as attitudes toward own aging, awareness of aging or subjective age, have a large impact on outcomes related to positive development in later life. Recent research in this domain has focused on complex research designs and inter-systemic linkages at different levels. Indicators of short-term variability of VoA have increasingly been investigated, linking the respective findings with performance indicators, biomarkers, and trait-like data. In addition, bidirectional relationships of VoA and outcomes over time as well as data contextualizing VoA across historical time may offer new insights on the plasticity of VoA seen in bio-cultural co-construction. The symposium will showcase these recent trends with studies from the U.S. and Germany. First, Zhu and Neupert extend previous studies by linking established VoA indicators with future time perspective, all assessed by means of a daily diary study with 60-90 year-old adults. Kornadt et al. examined the variability of subjective age within a day and the relationship with trait subjective age and cortisol levels. Mejia et al. extend VoA to the area of subjective awareness of fall risks in daily life and links them with physical performance. Wettstein et al. investigate the bidirectional relationship of VoA indicators and perceived stress over time. Finally, we move from the micro to a macro-micro design in Wahl et al.’s presentation addressing historical change in VoA across 20 years in the Berlin Aging Study and in MIDUS. Susanne Wurm will discuss how different levels of VoA analysis will find better interlinkage in the future.
Caregiver-Assisted Pain Coping Skills Training for Patients With Dementia: A Pilot Study
Authors: Porter Laura , Keefe Francis , Barnes Deborah , Gwyther Lisa , Schmader Kenneth , Ritchie Christine 
Published: December 2021

Abstract
Pain is common and undertreated in patients with dementia, and contributes to disability, psychological distress, neuropsychiatric symptoms and caregiver stress. The goal of this study was to develop a caregiver-assisted pain coping skills training protocol tailored for community-dwelling adults with mild-moderate dementia and their family caregivers. We conducted interviews with patients and caregivers to develop the protocol. We then conducted a single arm pilot test of the intervention’s feasibility and acceptability. Patients were recruited from an outpatient memory care clinic and screened for pain using the validated Pain, Enjoyment, General Activity (PEG) scale. The intervention included five sessions of training in pain assessment, relaxation, pleasant activity scheduling, and integrative movement. Initially sessions were conducted in person or by videoconference according to the dyad’s preference; during COVID-19 (latter half of study) all sessions were conducted remotely. Eleven dyads consented and provided baseline data [patients: mean age=77.7 years (SD=4.8), 70% non-Hispanic white; caregivers: mean age=69.6 years (SD=13.3); 91% non-Hispanic white; 73% spouses]. Nine dyads (82%) completed all five sessions. Caregivers reported high levels of satisfaction with the intervention (mean=3.4 on 1-4 scale) and frequent use of pain coping skills (mean=3-4 days/week). On average, patients reported pre-post decreases in pain severity (mean=-1.2, SD=1.8) and pain interference (mean=-0.64, SD=0.67) on the Brief Pain Inventory. Overall these findings suggest that a behavioral pain coping intervention for patients with mild-moderate dementia and their caregivers is feasible, acceptable, and potentially helpful for managing pain.
Social Isolation and Accelerated Tooth Loss Among Chinese Older Adults
Authors: Qi Xiang , Pei Yaolin , Wang Katherine , Han Shuyu , Wu Bei 
Published: December 2021

Abstract
Social isolation and loneliness in older adults are major global public health concerns. Tooth loss is also a common problem in this population. This study examined the effects of social isolation and loneliness on the number of remaining teeth and the rate of tooth loss among Chinese older adults. We included 4,268 older adults age 65+ from three waves of the Chinese Longitudinal Healthy Longevity Survey (2011/2012, 2014, 2018). Linear mixed-effect models showed higher levels of social isolation were associated with fewer remaining teeth (β = -1.59, P &lt; 0.05) and accelerated tooth loss (β=-0.10, P&lt;0.05) controlled for socio-demographic, lifestyle, oral hygiene behavior, and health status. Loneliness was neither associated with the number of remaining teeth (β=0.64, P&gt;0.05) nor with the rate of tooth loss (β=-0.09, P&gt;0.05) before and after controlling for covariates. These findings expand our knowledge regarding the correlation between social connection and tooth loss in non-Western populations.
Aging in the Right Place? Photovoice With Older Adults Residing in Shelters During COVID-19
Authors: Kaushik Vibha , Hoselton Jill , Walsh Christine 
Published: December 2021

Abstract
Aging in the right place (AIRP) involves supporting older adults to live as long as possible in their homes and communities, recognizing that where an older person lives impacts their ability to age optimally and must match their unique lifestyles and vulnerabilities. Photovoice, a participatory action research strategy, allows people to document their experiences through photography, promoting critical dialogue about issues such as AIRP and rights-based housing. This presentation highlights the concept of AIRP from the perspectives of a diverse group of older adults living in promising practices shelters in Vancouver, Montreal, and Calgary, Canada using photovoice. Findings indicate that the process promoted a sense of empowerment among participants. Insights about older adults’ perceptions of AIRP residing in shelters to best meet their intersectional identities, housing, and support needs will be shared. Findings inform policy initiatives that promote AIRP and the right to adequate housing for older adults experiencing homelessness.
Disparities in Dental Services Use Among Urban and Rural Adults in China’s Megacities
Authors: Qu Xiaomin , Qi Xiang , Wu Bei 
Published: December 2021

Abstract
Using data from the ‘2019 New Era and Living Conditions in Megacities Survey’ that included 4,049 residents aged 18-65, we examined the urban-rural disparities in dental visits among adults living in China’s 10 megacities. All of China’s megacities are metropolitan regions that include urban, peri-urban and rural land, and all have rural populations within the city boundaries. The results show that 43.3% (n=595) rural and 23.8% urban (n=637) residents had never visited dentists. Urban residents were more likely to visit dentists than rural residents after controlling for covariates (OR=1.57, 95%CI=1.30 to 1.91). The rates of visits were similar across age groups. Higher socioeconomic status, having urban insurances, having positive attitudes towards healthy diets and visited physicians regularly, and having poorer oral health was associated with higher odds of visiting dentists (P&lt;0.05). These findings can help develop policies to increase dental care access to underserved populations in Chinese megacities.