bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic Stress Patterns Among Older Adults and Associations With Cognitive Functioning
Authors: Wang Kun , Suntai Zainab , Chen Xiayu 
Published: December 2021

Abstract
Chronic stress has been associated with several adverse cognitive outcomes, including impaired judgement, executive functioning, and memory. Chronic stress has also been linked to several neurological conditions, including Dementia and Alzheimer’s. While several biomedical measures of stress exist, stress is often subjective, and research has shown that the ability to cope with stress-known as stress reactivity-is more indicative of stress burden that the actual stressor itself. As such, this study aimed to identify the association between different patterns of stress and cognition among older adults. Data were derived from the 2016 Health and Retirement Study, a nationally representative study of older adults aged 50 and older living in the United States. Latent class analysis was used to identify different classes of stress and hierarchical linear regressions were conduced to identify the associations between identified stress classes and cognition. The latent class analysis resulted in four stress classes: high stress, financial stress, secondary stress, and low stress. The sequential logistic regression models revealed that while high stress and financial stress classes resulted in cognitive decline, the significance was mitigated after controlling for health and body functioning factors. This suggests that older adults are experiencing stressors mostly from health impairments and interventions should target improved health management and financial support for health conditions as an indirect way of reducing disparities in cognitive functioning resulting from chronic stress.
Executive Functioning, Emotion Regulation, and Negative Emotion in Suicidal Older Adults
Authors: Waldman Rachel , Liles Brian , Kiosses Dimitris , Zweig Richard 
Published: December 2021

Abstract
Deficits in executive functioning, emotion regulation, and negative emotion have all been linked to suicidality. Yet, the complex interactions between these three factors and their relationships to suicidal behavior in older adults remain unclear. Participants (N = 39) were depressed middle and older adult (M = 62.0, SD = 9.41) inpatients with recent suicidal attempt or ideation, without psychotic depression or moderate or greater cognitive impairment (DRS&gt;90). Participants were administered measures of executive functioning (Stroop and COWAT), emotion regulation (ERQ Suppression and Reappraisal; RRS-Brooding; UPPS- Premediation Scale), and negative emotion (PANAS-X), in addition to measures of depression (MADRS) and suicidality (C-SSRS). Results indicated that executive functioning was not significantly related to emotion regulation or negative affect, but measures of emotion regulation were related to negative emotion and frequency of suicidal ideation in bivariate analyses. Lower ERQ reappraisal tended to be associated with negative emotion (ß = -.392, p = .067) in multivariate analyses. Although comparisons were non-significant, effect sizes revealed that those who experienced daily suicidal ideation (C-SSRS) had lower reappraisal and higher brooding scores (Cohen’s d = 1.014 - 1.456), as well as higher executive functioning (Stroop Color-Word trial) and overall cognition (DRS) scores (Cohen’s d = 0.625 – 0.792) than less frequent ideators. Findings suggest that older inpatients with frequent suicidal ideation have poorer emotion regulation but may have more intact cognition and executive functioning than those with less frequent suicidal ideation.
Mind-Body Practice, Personality Traits, and Cognitive Performance: A 10-Year Study in US Adults
Authors: Bhattacharyya Kallol Kumar , Hueluer Gizem , Dobbs Debra 
Published: December 2021

Abstract
It is widely established that physical activity is associated with better cognitive outcomes, and accumulating evidence suggests that mind-body practice (MBP) may yield similar benefits. Personality is related to both daily activities and cognition, but its role in the association between MBP and cognition is not well understood. The current study examines bidirectional temporal associations between personality traits, MBP, and cognition in healthy adults. We used data from waves 2 and 3 (2004-2014) of the Midlife in the United States (MIDUS) study from a total of 2,050 individuals (age: M=64 years, SD=11, range=42 to 92; 56% women). We applied a cross-lagged regression analysis to examine bidirectional effects between MBP, Big Five personality traits, and two cognitive domains (episodic memory and executive function) and controlled for sociodemographic factors, health, and functional status covariates in wave 2. After controlling for covariates, MBP was independently associated with a more favorable change in episodic memory, but not in executive function. Regarding cross-lagged effects of cognitive function, episodic memory was related to subsequent MBP and agreeableness, and executive function was related to subsequent MBP, openness, and conscientiousness. Agreeableness had a negative effect on subsequent executive function. The findings point toward bidirectional associations between cognitive function MBP, while there was no evidence for cross-lagged associations between personality and MBP. Future research should guide us whether MBP can counteract cognitive decline as an alternative and complementary practice and the role that personality can play in such interventions.
Retirement Age Modifies the Association Between Education/Occupation and Cognition
Authors: Nelson Monica , Andel Ross 
Published: December 2021

Abstract
Introduction: According to the cognitive reserve and use-it-or-lose-it hypotheses, engagement in stimulating activities seems to benefit cognition, with engagement often associated with more education or higher occupational position. However, whether retirement may modify the association between education/occupation and cognition is unclear. We aimed to assess how age at retirement may modify the relationship between education/occupation and cognition. Methods: Older adults (n=360) from the Alzheimer’s Disease Neuroimaging Initiative who were cognitively normal and retired at baseline participated. Linear regression was used to assess how educational attainment (high/low) or occupational position (managerial, intermediate/clerical, routine/manual) related to executive functioning (EF) or memory, controlling for age, sex, depressive symptoms, and health status. Effect modification by retirement (early, on-time, late). Results: High education (EF: b=0.37, SE=0.08, p&lt;.001; memory: b=0.22, SE=0.05, p&lt;.001), intermediate (EF: b=0.26, SE=0.11, p=.019; memory: b=0.18, SE=0.08, p=.018) and managerial (EF: b=0.23, SE=0.12, p=.045; memory: b=0.16, SE=0.08, p=.045) occupations (compared to routine/manual occupations) were associated with better EF and memory performance. High education was significantly associated with better EF and memory for participants who retired early (EF: b=0.43, SE=0.12, p&lt;.001; memory: b=0.29, SE=0.10, p=.004) or on-time (EF: b=0.51, SE=0.15, p=.001; memory: b=0.24, SE=0.10, p=.014), but not for participants who retired late (EF: b=0.19, SE=0.15, p=.200; memory: b=0.09, SE=0.09, p=.334). Intermediate occupations were associated with EF only for participants who retired on-time (b=0.58, SE=0.21, p=.007). Conclusion: Education and occupational position may influence cognition after retirement differently based on retirement timing, with effects most apparent for on-time retirement and substantially reduced for late retirement.
Marginal Effects of Multiple Years of Volunteering on Objective and Subjective Measures of Cognition
Authors: Wang Yi , Amano Takashi , Wong Roger , Shen Huei-wern 
Published: December 2021

Abstract
Volunteering is conducive to older Americans’ physical and mental health; however, the effect of volunteering on cognitive health is less studied. Using four waves (2010-2016) of the Health and Retirement Study, this study examined the incremental effect of volunteering engagement on older adults’ cognitive health. We included10,718 cognitively unimpaired, community-dwelling individuals aged 51+ in 2010 and were alive through 2016. Volunteering engagement was measured by the number of times respondents participated in volunteering throughout the four waves. Objective cognition was assessed using the Telephone Interview for Cognitive Status (TICS), a standardized test of cognitive functioning. The TICS score was further categorized into three statuses: “No impairment,” “Cognitive impairment no dementia (CIND),” and “Dementia.” Subjective cognition referred to self-rated memory on a 5-point Likert scale. With sampling weights, ordered logit regression was performed controlling for health-related variables (e.g., health conditions, depression), SES (e.g., income, assets), contextual features (e.g., neighborhood safety, urbanicity), and sociodemographics. The average marginal effects (AMEs) were produced. Results show that more volunteering engagement significantly reduced the likelihood of CIND or dementia (OR=0.88, p&lt;0.001). Specifically, every one-time increase in volunteering increased the probability of remaining cognitively normal by 0.01 (p&lt;0.001), whereas it decreased the probability of CIND by 0.008 (p&lt;0.001) and dementia by 0.001 (p&lt;0.001). For subjective cognition, there was no significant relationship with volunteering. Our findings address gaps in literature by adding evidence of the incremental health benefits of volunteering on cognitive functioning. Differences in the findings for subjective and objective cognition warrant further investigation.
Socially Relevant Approaches to the Detection of Dementia in Minority Older Adults
Authors: Sargent Lana , Lageman Sarah , Thacker Leroy , Russell Sally , Mackiewicz Marissa , Price Elvin 
Published: December 2021

Abstract
Substantial gaps remain in the scientific literature regarding low-income minority older adult populations with Alzheimer’s disease and related dementias (ADRDs). Access to care and early cognitive screening are often barriers to advancing ADRD detection in low socioeconomic status (SES) minority older adults. Additionally, there is the need for demographically (age, education, sex, race, ethnicity, and income) corrected normative scores in cognitive measures. Our cross-sectional study evaluated the psychometrics of the Mini-Mental State Exam-2 (MMSE-2) and the NIH Toolbox Cognition Battery (NIHTB-CB). The sample consisted of n=80 community-based older adults without a diagnosis of dementia living in low-income high-rise housing units. Acceptability is assessed with a brief 6-item acceptability survey, multiple linear regression is used to get predicted cognitive scores adjusted for age, education, income, ethnicity, race, and sex, and t-test comparison of the adjusted scores found in this study to established norms. Results found a mean age of 73, 70% black, 48% with &lt; 12th-grade education, 51% have a monthly income of &lt; $1,000, and 49% with undiagnosed cognitive impairment (CI) by both measures. When applying demographic adjustments in the NIHTB-CB 1) standard scores; 2) age-corrected scores, and 3) demographically correct scores all remained significant (p &gt; 0.0001). Participants reported high (80-95%) acceptability for the community-based cognitive screening, 18% reported concerns with cultural appropriateness of the questions in the NIHTB-CB as compared to 5% with the MMSE-2. This research lays the foundation for a community-based cognitive screening and care coordination program for the low SES minority older adult population.
Provider Communication and Loneliness in Senior Living Communities During the COVID-19 Pandemic
Authors: Wilkinson Lindsay , Masters Julie , Boron Julie Blaskewicz 
Published: December 2021

Abstract
Prior research has demonstrated the impact of the COVID-19 pandemic on feelings of loneliness, but relatively little is known about loneliness in the context of senior living communities (SLCs). Indeed, the pandemic has led SLCs to enact new safety precautions, including visitor restrictions, intended to reduce the spread of COVID-19, which may have serious consequences for the psychosocial well-being of residents. Drawing on a sample of 733 adults ages 54 to 100 living in one of nine SLCs in December 2020 (response rate = 60%), linear regression models were used to examine whether perceived communication between SLCs and residents during the COVID-19 pandemic influenced feelings of loneliness. Analyses also considered whether this association varied as a function of education. Our findings reveal that 53% of respondents were very lonely during the pandemic. However, older adults who perceived that their SLC had been helpful to their understanding of the pandemic were significantly less lonely (p &lt; 0.01), adjusting for sociodemographic and health characteristics. Moreover, we found that less educated older adults derived the greatest benefit from effective communication about the pandemic (p &lt; 0.05). Those with less education reported feeling lonelier if they did not perceive that their SLC communicated in a way that helped them better understand the pandemic; there was no such association for those with higher education. The findings from this study provide support for the resource substitution hypothesis and demonstrate the importance of communication in alleviating feelings of loneliness during the COVID-19 pandemic.
Exploring the “New Normal”: Older Adults’ Coping Strategies During COVID-19 Pandemic
Authors: Nurain Novia , Huber Lesa , Caldeira Clara , Connelly Kay 
Published: December 2021

Abstract
COVID-19 stay-at-home orders resulted in social isolation and psychosocial challenges for older adults around the world. To understand their lived experiences during the pandemic, we conducted a qualitative study using semi-structured interviews with 15 older adults living in community settings. Qualitative thematic analysis of the collected data identified themes and patterns of the “new normal” for these participants: ways of living, communication with family and friends, sense of autonomy, psychological responses, coping strategies, and perceived social support. This presentation focuses on participants’ coping strategies. Participants used common coping strategies, customized to the unique challenges of stay-at-home orders. We categorized coping strategies as problem-focused, meaning-focused, and emotion-focused. Participants’ problem-focused strategies aimed to reduce the risk of infection. Meaning-focused strategies included purposeful errands such as going to grocery stores. Emotion-focused strategies emphasized connecting with support networks (e.g., via Zoom) and efforts to maintain psychosocial and emotional well-being (e.g., seeking professional counseling). They also employed self-enhancing comparisons to increase self-concept and self-esteem. At the beginning of the pandemic, some temporarily used distraction/avoidance strategies such as eating comfort food and avoiding news about COVID-19 to maintain a positive emotional state. Our findings imply the applicability of frameworks such as life course perspective and selective optimization with compensation to highlight the successful adaptive strategies developed by older adults through experience. We argue against the ageist view of older adults as vulnerable. Rather, this study suggests that older adults can flexibly employ resilient coping strategies crafted over a lifetime of experiences in response to crises.
Challenges with Conducting an Investigational Drug Study in Older Adults in Nursing Homes During a Pandemic
Authors: Davidson H Edward , Han Lisa , LaMantia Melissa , Trout Michelle , Mannick Joan , Gravenstein Stefan 
Published: December 2021

Abstract
In the early months of the pandemic, SARS-CoV-2 infected nursing home residents in explosive and deadly outbreaks. Nursing home residents disproportionately accounted for over 40% of COVID-19 mortality nationally. This national emergency drove scientific and public health experts to develop and implement administrative, clinical, and research programs to limit the pandemic’s impact, especially for high-risk individuals, such as those hospitalized or living in nursing homes. Nursing home policies, prompted by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) guidance, severely restricted access beginning in March 2020 in an effort to limit disease exposure. In July 2020 we began the process to conduct an investigational SARS-CoV-2 post exposure prophylaxis study of nursing home residents, incorporating FDA guidance developed for conducting investigational drug trials in the context of COVID-19. Our research teams adapted our nursing home engagement, resident consenting and research data collection strategies accordingly. We remotely screened residents living in any of 28 nursing homes for eligibility to participate, ultimately consenting and randomizing individuals in 11 facilities. Of the 2,683 nursing home residents 65 years or older we screened, 48 (1.8%) agreed to consent individually or through proxy, most often a legally authorized representative. We will describe our research methods, with emphasis on how we addressed challenges presented due to performing all research tasks remotely and identify strategies that can qualitatively improve the remote nursing home research experience.
Discriminant COVID-19 Outcomes Based on Safety Adherence in an Active Lifestyle Retirement Community
Authors: Roberts Mitchell , Sappington Erica , Guerra Leonardo , Collins Lindsey , Yalcin Ali , VandeWerd Carla , Lowenkron Jeff 
Published: December 2021

Abstract
Compliance with preventive behaviors recommended by public health officials plays a critical role in the control and prevention of COVID-19. Data were collected from those living in The Villages, FL, and surrounding communities via The Villages Health COVID-19 Rapid Testing Program in partnership with The UFHealth Precision Health Research Center. A descriptive ecological study was conducted to model COVID-19 positivity result variations by age, sex and adherence to CDC safety recommendations using chi-square tests. 9,993 tests were performed using Abbott's BinaxNOW™ COVID-19 Ag Card, and 931 (9.30%) positive cases were confirmed between 10/19/2020-2/26/2021. Median age was 69 years (range:12-103), and 5,578 (55.8%) individuals were female. No significant differences were found in positive test status (≥65=9.8%,&lt;65=8.8%) amongst those over 65 (n=6567) and under 65 (n=3180) years old [X2 (1, N=9847)=2.49,p=.114]; however, positive test result differed by sex with males (10.6%) testing positive at higher rates than females [8.3%, X2(1, N =9993)=14.888, p&lt; .001)]. A significant relationship between preventative behaviors and positive test status was also found. Not engaging in regular handwashing (p&lt; .001) and failing to stay 6 feet or more away from others outdoors (p&lt; .001) was significantly associated with positive test status. Further, not wearing a face mask in businesses/shops (p&lt;.001) or indoors around 6+ people, (p&lt;.001) was significantly associated with positive test status. In light of debate around the efficacy of mask wearing, these findings signal the importance of following CDC recommended public health behaviors for all ages across the lifespan to reduce the spread of COVID-19 infection.
Exploring Caregiver Challenges And Coping Mechanisms In The Midst Of Covid 19
Authors: Chandran Devyani , Eaton Marie 
Published: December 2021

Abstract
This paper reports on the the challenges faced and coping strategies employed community-based care providers in a mid sized city in the Pacific Northwest in the midst of the Covid 19 pandemic. Researchers from a Palliative Care Institute conducted six online focus groups using the zoom platform. The project aimed at gathering important information on the experiences of caregivers as well as providing a virtual space where caregivers could support each other. A purposive sampling technique was used to gather data where participants were not chosen randomly but because they could best answer the research question. Membership of the focus groups included representatives from skilled nursing facilities, home-care agencies, elder law services, memory-care facilities, adult family homes, medical supply facilities, chaplains and nutritionists. Data gathered from the focus group were transcribed. A constant comparison method of analysis were employed and categories and themes were created from open coded data. Six key themes were identified which included: dealing with the impact of social isolation on caregiver-client relationships, assessing personal risk when dealing with clients living with dementia, facing challenges seeking continuing employment, struggling with social support and self care, using technology for professional and personal support and grappling with the challenges reentering a face to face environment once the pandemic is controlled.. Findings point to the importance developing and sustaining technological innovations that support workforce retention, fostering communication between the larger community, care providers and clients in various care settings and planning for safe reentry into a post Covid world.
Mobility and Muscle Strength Trajectories: The Effect of Mediterranean Diet, Physical Activity, and Social Support
Authors: Saadeh Marguerita , Prinelli Federica , Vetrano Davide , Xu Weili , Welmer Anna-Karin , Dekhtyar Serhiy , Fratiglioni Laura , Calderón-Larrañaga Amaia 
Published: December 2021

Abstract
Decline in physical function varies substantially across older individuals due to several biological and extrinsic factors. We aimed to determine the effect of modifiable factors -such as dietary patterns, physical activity and social support- and their interaction with mobility and muscle strength decline after age 60. We analyzed data from 1686 individuals aged 60+ from the population-based Swedish National study on Aging and Care in Kungsholmen. The Mediterranean Diet Score was calculated based on a validated food frequency questionnaire. Physical activity was categorized based on current recommendations, and social support was measured according to participants' perceived material and psychological support. Participants’ physical function was assessed over 12 years through changes in walking speed (m/s) and chair stand time (s). Linear mixed models adjusted for socio-demographic and clinical factors were used. Subjects with high adherence to Mediterranean diet were &lt;78 years (82.3%), women (56.1%), married (61.1%), with university education (52.8%), high levels of social support (39.3%) and health-enhancing physical activity (51.5%). One-point (over nine) increase in the MDS was associated with a slower annual worsening in walking speed (β*time=0.001; p=0.024) and chair stand time (β*time=-0.014; p=0.008). The protective effect of Mediterranean diet was highest among subjects reporting high social support (β*time=-0.065, p=0.026 for chair stands) and high physical activity (β*time=0.010, p=0.001 for walking speed), beyond the effect of each exposure individually. A higher adherence to Mediterranean diet, especially in combination with recommended levels of physical activity and high social support, contribute to delay the decline in physical function observed with aging.