bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Peripheral Vascular Disease in the Long Life Family Study (LLFS)
Authors: Kuipers Allison , Cvejkus Ryan , Barinas-Mitchell Emma , Feitosa Mary , Murabito Joanne , Zmuda Joseph 
Published: December 2021

Abstract
Atherosclerotic occlusion of peripheral arteries is a major contributor to morbidity and mortality in older adults. Our aim was to describe the epidemiology of peripheral artery disease (PAD) and other peripheral vascular disease (OPD) in the LLFS. 3248 individuals from 509 families (1182 probands, mean age 89; 2066 offspring, mean age 60) had doppler ankle-brachial index (ABI) assessment. Measures were performed twice for each posterior tibial artery and minimum of the mean ABI was used. PAD was defined as any ABI&lt;0.9. OPD was defined as any ABI &gt;1.4 or ≥1 non-compressible artery. Stepwise linear or logistic regression determined significant independent clinical and demographic predictors (P&lt;0.05) after adjustment for age, sex, study center, and familial relatedness. Overall, ABI had a median of 1.2 with 7.4% PAD (18.1% probands, 1.2% offspring; P&lt;0.001). OPD prevalence was 10.6% and was more common than PAD in offspring (8.1%). Age-adjusted OPD was higher in men (13.3%) than women (8.3%, P&lt;0.001), while age-adjusted PAD did not did not differ by sex (P=0.45). Predictors of PAD included greater age and systolic blood pressure, lower diastolic blood pressure, prevalent kidney disease, antihypertensive use, and current smoking. Predictors of OPD included greater age, male sex, and current smoking. In these exceptionally long-lived families, PAD was low compared to other epidemiologic studies. However, OPD including non-compressible arteries, a marker of arterial stiffness, was more prevalent than PAD. These findings in long-lived families highlight a need for more epidemiologic research in other peripheral vascular disease in adults from the general population.
Racial-Ethnic Disparities in Access to Preventive Services Among Privately Insured Adults With Disabilities
Authors: Mahmoudi Elham , Groskaufmanis lauren , Kamdar Neil , Khan Anam , Peterson Mark 
Published: December 2021

Abstract
Introduction: Cerebral palsy (CP) and spina bifida (SB) are congenital disabilities. Due to life-long disability, adults with CP/SB are with greater needs for preventative care. Little is known about racial/ethnic disparities in use of preventative services in this population. Our objective was to examine racial/ethnic disparities in use of preventative care. Methods: Using 2007-2017 private claims data, we identified White, Black, and Hispanic adults (18+) with CP/SB [n=11,635; White=8,935; Black=1,457; Hispanic=1,243)]. We quantified the National Institute of Medicine (NAM) definition of disparity by matching health related variables (age, sex, comorbid conditions, and Elixhauser index) between Whites and each minority subpopulation. Generalized estimating equations were used and all models were adjusted for age, sex, comorbidities, income, education, and U.S. Census divisions. Outcomes of interest were: (1) any office visit; (2) any physical therapy/ occupational therapy (PT/OT); (3) annual wellness visit; (4) bone density screening; (5) cholesterol screening; (6) diabetes screening. Results: Rate of recommended services for all adults with CP/SB were low and no significant results were found for most preventative services across race/ethnicity. Compared with Whites, Hispanics had lower odds of annual wellness visit (OR: 0.71; 95% CI: 0.53, 0.96) but higher odds of diabetes screening (OR: 1.48; 95% CI: 1.13, 1.93). Blacks had lower odds of bone density screening (OR: 0.54; 95% CI: 0.31-0.95), and annual wellness visit (OR: 0.50; 95% CI: 0.24-1.00). Conclusions: There were no substantial racial/ethnic disparities in use of preventive services among privately insured adults with CP/SB who had a higher-than-average income and education level.
Tracking Progress on Person-Centered Care for Older Adults: Are We Doing Right by Racial and Ethnic Minorities?
Authors: Tavares Jane , Cohen Marc , Hwang Ann 
Published: December 2021

Abstract
Person-Centered care is integral and necessary to high-quality systems of care, providing a holistic approach and addressing the needs and preferences of individuals. Analyzing the 2014 and 2016 Health and Retirement Survey we measure the extent to which the health care system provides person-centered care, to whom and how its receipt affects satisfaction levels and service utilization. About one-third of individuals’ report that their preferences were only rarely or sometimes takes account. Results vary greatly by race, highlighting great disparities in person-centered care. One in four Hispanics and one in six Blacks report never having their preferences taken into account compared to roughly one in ten Whites. When people report that their preferences are ignored, they are more likely to forgo medical care and report lower satisfaction with the system. Strategies exist to strengthen and assure advancements in person-centered care, something particularly needed for people of color and low-income populations.
Positive Psychology, Activation, and Self-Care Adherence in a Diverse Sample of Adults With Heart Failure
Authors: Meraz Rebecca , McGee Jocelyn , Caldwell Elizabeth Perry , Osteen Kathryn 
Published: December 2021

Abstract
Heart failure (HF) self-care is vital to health and wellbeing, yet more than half of all persons with HF do not adhere to the self-care recommendations of taking medications as prescribed, weighing daily, eating low salt foods, or exercising. It has been suggested that disparities in HF among racial/ethnic groups may be reflective of underlying determinants of health, such as poor engagement in self-care activities, rather than genetic or physiological differences. The purpose of this study was to examine direct and indirect effects of perceived social support, positive psychological (PP) characteristics, and patient activation on self-care behaviors in a diverse sample of older adults with HF. A nationwide survey was conducted in cooperation with the recruitment and sampling company Qualtrics. Stratified random sampling was used where 49% of the 174 respondents were persons of color (POC). The mean age was 60. Logistic regression statistical models were used with a lasso procedure. In this study, PP characteristics and activation level were most predictive of HF self-care adherence, particularly medication adherence. Respondents who were resilient, hopeful, and activated also reported higher medication and self-care adherence. Perceived social support and health literacy levels were not associated with self-care adherence. There were no differences in predictive variables by race/ethnicity, gender, or age. Interventions aimed at increasing resilience, hope, and engagement in care or activation may improve HF self-care adherence among persons with HF. Further research is needed to understand the impact of PP characteristics and patient activation level on HF self-care adherence in POC.
The Importance of Redefining Geriatric Expertise in Nursing Homes to Reduce Unnecessary Hospitalizations
Authors: Zúñiga Franziska , Popejoy Lori , Vogelsmeier Amy 
Published: December 2021

Abstract
Unplanned transfers from nursing homes (NHs) are burdensome, associated with adverse outcomes for residents and costly for health care systems. Internationally, NHs are facing similar issues whereby a lack of geriatric expertise combined with a shortage of NH general practitioners require innovative and adaptable models of care tailored to the organizational context. In this symposium, we will present studies from the MOQI project from the United States, which successfully reduced unnecessary hospitalizations by embedding advanced practice registered nurses (APRN) in 16 US NHs over a 6-year period. We will discuss the influence of race on multiple hospital transfers and present possible interventions to reduce transfers. Next, we will present finding from a study with MOQI APRNs that highlighted their contributions to the COVID-19 pandemic response in NHs and discuss the broader implication or infection control practices. In addition, we will present the INTERCARE project which successfully reduced unplanned hospitalizations in 11 Swiss NHs, by implementing a registered nurse with an expanded role, to compensate for the very limited access to APRNs; which is the case for many European countries. Both MOQI and INTERCARE pinpoint the importance of strategies to support the introduction of a new role in NHs. Both projects will give examples of different models of care which can be feasibly implemented to sustainably decrease unnecessary hospitalizations, in different contexts and with different resources. Finally, data from the INTERCARE study will address the issue of potentially avoidable fall-related transfers and which resources are deemed appropriate to mitigate these.
Multiple Hospital Transfers Among MOQI Nursing Home Residents: The Influence of Race
Authors: Canada Kelli , Fritz Elizabeth , Vogelsmeier Amy , Rantz Marilyn , Popejoy Lori 
Published: December 2021

Abstract
Missouri Quality Initiative (MOQI) was a CMS-funded enhanced care and coordination provider demonstration project (2012-2020) that successfully reduced avoidable hospitalizations and improved nursing home (NH) care quality. Little is known about the influence of race in multiple hospital transfers from NHs. Using a mixed-methods approach we analyzed hospitalization root cause analysis data from 2017-2019 for 1410 residents in 16 MOQI NHs. There were 113 residents who were transferred 609 times. Those with multiple transfers (four or more transfers/year) were compared by race and key characteristics (e.g., code status, diagnosis). A subset of residents with multiple transfers were examined qualitatively to identify and describe key cases. Findings suggest that Black residents have a higher probability for multiple transfers. Findings highlight the need for transfer prevention efforts for Black residents including early assessment and intervention, early/frequent discussion about goals of care, advance directives, resuscitation status, and family/resident understanding of treatment effectiveness.
Work Expectations and Trajectories of Depressive Symptoms and Passive Suicidal Ideation Among Baby Boomers
Authors: Dang Linh , Mezuk Briana 
Published: December 2021

Abstract
Expectations regarding work (e.g., probability of retiring at a certain age), whether realized or not, may influence mental health, however there is limited quantitative research on this question. This study examined the longitudinal relationship between expectations of full-time work after age 62 and depressive symptoms and passive suicidal ideation among Baby Boomers, a generation that experienced the Great Recession as they neared retirement. Data came from the Health and Retirement Study, 2008 - 2016 (N = 8,954, mean age = 55.3, 52.2% female, 77.8% non-Hispanic White). Clinically-relevant depressive symptoms were indexed by the Composite International Diagnostic Interview (CIDI). Expectation (probability) of working after age 62 was modeled continuously (range: 0 to 1). Multivariate mixed-effects logistic regression models of screening positive on the CIDI and passive suicide ideation were fit, separately, adjusting for demographics, household income and wealth, and health characteristics. Respondents working at baseline were less likely to screen positive on the CIDI longitudinally (OR: 0.36, 95% CI: 0.26 - 0.51), and while expectations were inversely associated with screening positive on the CIDI this was not significant after accounting for work status (OR: 0.68, 95% CI: 0.43 - 1.09, p=0.104). Longitudinally, higher expectations of working were inversely associated with passive suicidal ideation (OR: 0.54, 95% CI: 0.32 - 0.92) even after accounting for working status. Future research will examine variation in these relationships by contextual factors like wealth, sex, and race/ethnicity to clarify how these features shape the association between work and mental health for this generation of older adults.
Standards and Guidelines for Associate's Degree Programs in Gerontology
Authors: Macaluso Suzie , Faber Michael 
Published: December 2021

Abstract
Associate degree programs in gerontology occupy a unique space in higher education. They must prepare students for a wide variety of careers and opportunities from technical and vocational training to preparation for further gerontology education at a four-year college. It is widely known that there is great variability among the numerous associate degree programs in gerontology; this presentation gives an overview of the revised standards and guidelines for associate degree programs. Associate degree programs will vary based on the faculty, the leadership, the program, and institutional support, this presentation discusses best practices for a variety of program types paying particular attention to competency-based educational strategies.
Standards and Guidelines for Graduate Programs in Gerontology and Geriatrics
Authors: Masters Julie , Karasik Rona 
Published: December 2021

Abstract
Graduate programs in gerontology prepare students for advanced academic and/or applied careers in aging. Programs at this level offer greater depth, breadth, and increased emphasis on theory and research. Persons completing a master’s and/or doctoral degree in gerontology or aging studies have reached the level of “gerontologist” whereby they have completed the necessary coursework in the physical, psychological, social and built environment in order to understand the unique opportunities and challenges of aging in a scholarly manner. While the depth of treatment of each topic will vary across programs, each of the AGHE Core Competencies should be mastered at a level of “analyzation and evaluation” or higher on Bloom’s Taxonomy of Educational Objectives. The current presentation addresses how the AGHE Standards and Guidelines for graduate programs in gerontology were updated as a competency-based curriculum that includes coursework, practicum, and a culminating project (e.g., thesis, comprehensive exam, and/or dissertation).
Quality Health Professions Programs: Path to Program of Merit Designation
Authors: Gugliucci Marilyn 
Published: December 2021

Abstract
In 2015, the AGHE Program of Merit was expanded to implement a voluntary evaluation process for health professions programs that integrate gerontology/geriatrics competencies within their curriculum. These competencies augment students’ competence and confidence in the field of aging, preparing them to work with older adults and their care partners. All health professions and medical education programs are eligible to apply for the Program of Merit designation. This international process of evaluation: (1) Verifies program credibility and quality; (2) Informs campus administrators of global guidelines, expectations, and practice in aging for their health professions programs; (3) Assures quality graduates from POM designated programs; and (4) Clarifies for employers the knowledge and skills imparted to student graduates of POM designated health professions programs. Additionally, graduates from POM programs receive a certificate from AGHE stating the health profession program is a designated AGHE Program of Merit.
Age-Friendly Communities: Research on Promising and Innovative Practices
Authors: Oh Patricia , Dabelko-Schoeny Holly , Armbruster William 
Published: December 2021

Abstract
Age-friendly community (AFC) leaders engage with community residents, groups, and organizations to enhance social, service, and built environments for aging. Despite the growing number of AFCs, academic research remains in its nascence. During this symposium, U.S. scholars will present research on AFC implementation. The first two papers address promising practices among AFC leaders. The first paper presents results from a content analysis of American AFC progress reports. Results indicate strong evidence of progress achieved and opportunities for improving the evaluation, documentation, and dissemination of accomplishments. The second paper presents findings from a qualitative descriptive study on community events by AFC initiatives in northern New Jersey. Results indicate how age-friendly leaders use community events to enhance older adults’ social participation and inclusion, and as a tactic toward longer-term, multi-domain community change. The third and fourth papers describe the development and testing of innovative technologies to guide AFC implementation. The third paper provides an overview of Safe Routes to Age in Place, a community-engaged mixed methods study using the app MyAmble to examine the needs and utilization of alternative transportation in Franklin County, Ohio. The fourth paper provides a case overview of a university-community partnership to develop a geographical information system (GIS) analytical mapping tool to evaluate the age-friendliness of public amenities in San Antonio, Texas. The symposium will conclude with remarks from AARP Livable Communities leadership about how these studies contribute to building knowledge about AFC implementation and avenues for academic and private partnerships to translate these findings to practice.
Safe Routes to Age in Place: A Focus on Alternative Transportation
Authors: Dabelko-Schoeny Holly , Fields Noelle , White Katie , Highfill Christine , Cao Qiuchang , Murphy Ian 
Published: December 2021

Abstract
Informed by social cognitive theory, Age-Friendly Columbus and Franklin County conducted a community-engaged mixed methods study that examined the needs and utilization of alternative transportation by older residents in three pilot neighborhoods in Franklin County, Ohio (n = 32). Participants were provided tablets and used an app (MyAmble) developed at the University of Texas-Arlington to document their traveling experiences. During a 14-day period, 1,190 trips were recorded by older adults and 71.3% of these trips were completed through driving their own personal vehicles. Participants designated 84.5% of trips as important and 72% of the trips improved their mood. Individual (physical and cognitive functioning, cost, time), environmental (lighting, sidewalk conditions, traffic, location of bus stops, weather), and behavioral (no history of bus use, peer to peer information sharing, tracking led to future planning) barriers and facilitators to alternative transportation use such as riding the bus, walking and biking were identified.
Cohort Differences in Well-Being Among Midlife and Older Women: Role of Self-Perceptions of Aging
Authors: Ryan Lindsay 
Published: December 2021

Abstract
The current study examines how cohort differences across two age-matched groups of midlife and older women from the Health and Retirement Study are associated with well-being and self-perceptions of aging (SPA). Women aged 51–60 (n=2318) and 61–70 (n=1650) were selected from the 2008 and 2018 waves. No significant cohort differences were identified for life satisfaction (Diener, Emmons, Larsen & Griffin, 1985) or positive SPA (Lawton, 1975; Liang & Bollen, 1983). The 2008 cohort of midlife women reported significantly higher negative SPA compared to 2018 (p&lt;.05). Linear regression analyses find that cohort and SPA are significantly associated with life satisfaction in both age groups, and that the association of negative SPA differs by cohort for the midlife women (p&lt;.01). Implications are discussed within the life course developmental framework.
Home and Community Features, Perceived Age-Friendliness, and Intention Toward Aging in Place
Authors: Choi Yeon Jin 
Published: December 2021

Abstract
Promoting age-friendliness of communities and supporting aging in place (AIP) are of great importance in aging societies. However, little is known about the mechanism linking home and neighborhood features, older adults’ global assessment of community, and their willingness to age-in-place despite the importance in developing policies and interventions. This study used the 2015 AARP Age-Friendly Community Survey, which includes 66 home and neighborhood features under the eight domains specified by the WHO’s Age-Friendly Cities Guidelines. A series of linear regression models were estimated to examine the interrelationship between the availability of age-friendly features in eight domains, perceived age-friendliness of community, and intention toward AIP. Overall, a greater availability of age-friendly features was positively associated with perceived age-friendliness of community and AIP intention. The relationship between age-friendly features and AIP intention was mediated by perceived age-friendliness of community (50.3% to 96% of the total effects). When perceived age-friendliness of community was introduced to models, the direct effects of housing, outdoor spaces and buildings, and transportation domains remained significant. Findings suggest that a greater availability of age-friendly features influence older adults’ perception on their community, leading to the development of a desire to age-in-place. Domains of housing, outdoor spaces and buildings, and transportation may be the most importance features in promoting age-friendliness of community and the key determinants of aging-in-place. Policy makers and practitioners may need to prioritize promoting age-friendly built environment before social environment in building age-friendly communities.
Community Mobility in Older Adults: Novel Methodologies, Risk Factors, and Interventions
Authors: Rosso Andrea , Carlson Michelle , Hirsch Jana 
Published: December 2021

Abstract
Community mobility is an individual’s movement outside the home. It is essential for the completion of many instrumental activities of daily living, such as shopping and healthcare, and promotes physical function, social engagement, independent living, and quality of life. Mobility research often focuses on gait speed measured in clinical settings, a critical but not sufficient determinant of community mobility. Here we present four talks that assess community mobility and its determinants using novel methodologies to enhance our understanding of how to maintain independence in older ages. First, Andrea Rosso presents characteristics of individuals with the strongest associations between environmental walkability, as assessed by virtual audits, and walking. Second, Kyle Moored demonstrates associations of self-reported fatigability with life space among older men, independent of their physical functioning. Breanna Crane introduces GPS-based objective measures of community mobility and their associations with cognitive and physical function of older adults. Finally, Pam Dunlap presents results of a randomized clinical trial of a physical therapy intervention to improve walking in older adults on subjective and objective measures of life space. These talks will provide a better understanding of the factors related to community mobility, introduce attendees to novel methodologies in the assessment of both community mobility and risk factors associated with the loss of community mobility, and demonstrate approaches to improve community mobility in at-risk older adults. The discussant, Jana Hirsch, will provide perspectives on how these data inform our current view of community mobility and will lead a discussion with the audience.