bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigating Elder Abuse and Neglect in Diverse Refugee Communities in Greensboro, NC
Authors: Sudha S , Khadka Narayan 
Published: December 2021

Abstract
Elder abuse and neglect (EAN) comprises multiple dimensions, is experienced by about 10% of older adults in the U.S in diverse communities, and is severely detrimental to older adults’ (OA) health and wellbeing. However, documentation of EAN among refugee OA is greatly lacking as are services for these communities. Refugee OA are overall underserved members of marginalized communities. This paper reports on a community-engaged study to collect information and raise awareness of EAN among OA in 2 North Carolina refugee communities - Nepali-speaking Bhutanese and Congolese. Research partners included University researchers and community refugee-serving organizations. Surveys and focus group interviews were conducted. 17 Nepali-speaking Bhutanese and 13 Congolese filled out survey questions, including the Elder Abuse Suspicion Index. They participated in focus group discussions (FGDs), separately for men and women of each community. Survey results indicated EAN more among Congolese than Nepali-speaking Bhutanese. FGD results showed both communities prefer to depend on family members, and experience difficulties with language, transportation, and economic insecurity. No EAN was reported in the FGDs. In line with principles of community-engaged approaches, a capacity-building event to increase awareness of EAN was held, attended by 25 persons from the two communities. This study adds documentation on an under-researched area and marginalized communities. Action recommendations include disseminating culturally appropriate EAN information, strengthening English language and job skills and transportation options, encouraging cooperation across state, nonprofit, educational, and service organizations to address needs of older refugee adults.
Optimizing the Geriatric Mental Health Workforce Through Innovative Approaches
Authors: Alfaro Ana Jessica , Rodriguez Rachel , Karel Michele 
Published: December 2021

Abstract
The drastic demand for geriatrics-trained providers in medical and mental healthcare persists years after the Institute of Medicine first highlighted this need (2008; 2012). New innovative approaches must instead optimize the current workforce through leveraging existing geriatric experts’ knowledge and skills related to working aging adults. This symposium will highlight four approaches spanning post-licensure education to using technology to deliver specialized services and training. First, Dr. Gregg will discuss the evaluation of an advanced topics workshop in Geropsychology which has significantly enhanced depth of Geropsychology competencies for psychologists working in primarily rural areas. Next, Dr. Asghar-Ali will describe the multi-modal interactive geriatric educational opportunities for interprofessional staff developed by the South East Texas Geriatric Workforce Enhancement Program (SETx GWEP). He will discuss how these training opportunities have been tailored to address the impact of COVID-19 and healthcare disparities among older adults. Third, Dr. Filips will present an evaluation of a consultation model in which a geriatric psychiatrist provides tele-consultation in a 5-state region to rural aging Veterans with complex medical and behavioral comorbidities. Finally, Dr. Beaudreau will describe adaptations to a national VA Problem Solving Training program for mental health clinicians of older Veterans with complex comorbidities. Dr. Karel, VA National Geriatric Mental Health Director, will serve as discussant and comment on the ways in which these novel approaches are meeting the ever-growing need for competent geriatric mental health providers.
Decomposition of Disparities in Alzheimer’s Disease and Related Dementia
Authors: Akushevich Igor 
Published: December 2021

Abstract
This study uses Medicare data to non-parametrically evaluate race- and place-of-residence-related disparities in AD/ADRD prevalence and incidence-based mortality, separate them out into the epidemiological causal components including race-related disparities in incidence and survival, and finally explain these in terms of health-care-related factors using causal methods of group variable effects (propensity scores and the rank-and-replace method) and regression-based analyses (extended Fairlie’s model and generalized Oaxaca-Blinder approach for censoring outcomes). Partitioning analysis showed that the incidence rate is the main predictor for temporal changes and racial disparities in AD/ADRD prevalence and mortality, though survival began to play a role after 2010. Arterial hypertension is the leading predictor responsible for racial disparities in AD/ADRD risks. This study demonstrated that Medicare data has sufficient statistical power and potential for studying disparities in AD/ADRD in three interacting directions: multi-ethnic structure of population, place of residence, and time period.
Disparities in Disease-Specific Remaining Life Expectancy Among Medicare Beneficiaries in the United States
Authors: Kravchenko Julia , Yu Bin 
Published: December 2021

Abstract
Racial and geographic disparities in life expectancy (LE) in the US are a persistent problem. We used 5% Medicare Claims for 2000-2017 to investigate the patterns of remaining LE (RLE) in the U.S. with the highest and the lowest LE. RLEs in race-/ethnicity specific populations aged 65+ were calculated in patients with specific diseases and in the total population using the area under the Kaplan-Meier estimator. The Cox model was used to investigate the effect of state-specific residence on total LE and RLE. Between-the-states differences in RLE were most pronounced for cerebrovascular disease, atherosclerotic heart disease, breast and prostate cancer. RLE was the lowest for lung cancer and sepsis, followed by Alzheimer’s disease, dementia, pneumonia, and heart failure. RLE for myocardial infarction and cerebrovascular disease decreased over time, while for renal failure, diabetes, atherosclerotic heart disease, and cancers of breast and prostate RLE increased.
Mental Health and Resilience Among the 85+ Lifestyle Leaders Throughout the COVID-19 Pandemic
Authors: Miller Julie 
Published: December 2021

Abstract
Recent research suggests older adults may be uniquely able to cope and cultivate psychological resilience during the COVID-19 pandemic. This presentation will describe how the Lifestyle Leaders’ overall mental health (including worries and experiences of social isolation and loneliness) and thoughts about the future have changed throughout the pandemic, as well as the ways in which they remained resilient throughout. For example, a survey in March 2020 indicated that 68% of Lifestyle Leaders were very or extremely worried about COVID-19, compared to only 33% in November 2020. Interviews with Lifestyle Leaders revealed that the pandemic led many to engage in more focused thinking about their own mortality and, for some, presented or compounded challenges of older age (e.g., widowhood, downsizing, etc.). The presentation will also highlight ways in which Lifestyle Leaders’ past experiences and current activities have contributed to their mental health and fortitude during the ongoing pandemic.
Lifestyle Leaders’ Experiences in Senior Housing During the COVID-19 Pandemic
Authors: Chan Kathryn , Patskanick Taylor , Miller Julie 
Published: December 2021

Abstract
Millions of older adults living in close communal contact in senior housing communities remain vulnerable during the COVID-19 pandemic. Approximately 30% of Lifestyle Leaders currently live in senior housing. This presentation will cover the unique challenges these participants have encountered, including experiences with and the impact of changing norms and pandemic-related policies within communities over time. In March 2020, 75% of Lifestyle Leaders rated the response of their senior housing community to COVID-19 as “Excellent” or “Very Good.” In August 2020, they reported they believed they were less likely to contract COVID-19 living in senior housing compared to people not living in senior housing (80%). Interview data revealed Lifestyle Leaders in these environments held favorable views toward their communities. This presentation will further discuss how the Lifestyle Leaders who do not live in senior housing perceive senior living and how these perceptions have shifted during the pandemic.
Continuity of Caregivers’ Ensuring Medical Care and Care-Transition Preparedness: A Mediation Model
Authors: Rayan-Gharra Nosaiba , Tonkikh Orly , Gur-Yaish Nurit 
Published: December 2021

Abstract
Studies show that informal support provided during hospitalization is essential for communicating with the healthcare team and explaining medical care. Less is known about factors explaining family caregivers' Ensuring and Explaining Medical Care (EEMC) during hospitalization and its impact on care-transition-preparedness of patients in terms of their understanding of the explanations and instructions for continued care. This study examined whether EEMC during the current hospitalization mediates the association between involvement of the caregiver in ensuring and explaining medical care prior the current hospitalization and patients’ care-transition-preparedness for discharge. A prospective cohort study includes 456 internal-medicine-patients at a tertiary medical center in Israel, who were accompanied by an informal caregiver. Involvement in EEMC prior and during the hospitalization, covariates such as health literacy (HL) levels, demographic, health, and functional status were reported by the patients during the hospitalization; and care-transition-preparedness was reported by the patients in a week after discharge. After controlling for covariates, only high HL levels of patients and their caregivers were positively associated with EEMC during hospitalization and care-transition-preparedness (P&lt;0.05). Moreover, mediation analysis indicated significant direct (B(unstandardized)=1.69; p=0.003) and indirect effect (Mediated effect (ME)=1.28; CI= 0.81 to 1.87) of prior involvement in EEMC on care-transition-preparedness through high EEMC during the current hospitalization, controlling for baseline characteristics of patients and their caregivers (total effect: B=2.95; p&lt;0.001). These findings suggest that caregivers' experience and involvement prior the hospitalization may be an essential factor in improving EEMC during the current hospitalization, and in turn improve transition outcomes.
Health Disparities in Alzheimer's Disease: A Wakeup Call for Transformation
Authors: Gibson Allison , Smith Lenora , Turner Robert 
Published: December 2021

Abstract
It is well documented in the scientific literature that health disparities exist within the Alzheimer’s disease and related dementias (ADRD) population, particularly among socially disadvantaged individuals experiencing limited opportunities to achieve optimal health. In this symposium, presenters will introduce some of the significant health disparities observed across varying ADRD research. The first presentation, by Robinson-Lane and colleagues, examines caregiving coping and health among Black ADRD families. Findings suggest in addition to traditional stress and coping strategies, additional interventions are needed that improve physical health for family caregivers. Next, Yu and colleagues will discuss the higher levels of emotional distress reported among individuals diagnosed with mild cognitive impairment, compared to their cognitively normal counterparts. In the third presentation, Lin and colleagues share their work on changes in dementia-related behavioral symptoms observed by hospice staff during COVID-19. The pandemic has affected nearly every aspect of healthcare delivery, and many hospice staff are reporting patients diagnosed with dementia have also felt the effects. Next, Xu et al identified that non-Hispanic Black older adults in their help-seeking behaviors and diagnosis process of ADRD, and often were not seen in healthcare settings by an ADRD specialist compared to their White counterparts. In the final session, Agboji will speak on the issue on findings from a systematic examination of the literature that demonstrates apathy being underrecognized and undertreated in healthcare settings. This symposium will conclude with a discussion on how researchers can disrupt these disparities by promoting health equity across ADRD healthcare and social services.
Barriers to and Facilitators for Optimal Intervention for Apathy in Older Adults With Dementia
Authors: Agboji Aderonke , Freeman Shannon 
Published: December 2021

Abstract
Apathy is a persistent symptom in brain disorders. It affects 84% of people with brain disorders. Those affected are more than two times likely to die early than those without. Yet it is often ignored and undertreated. An integrative review guided by Whittemore and Knafl's (2005) framework was carried out to identify the factors that inhibit or facilitate the diagnosis and management of apathy among older adults with dementia. The result of the findings revealed five barriers and three facilitators. Barriers included inconsistencies in the definition and diagnostic criteria, lack of awareness, overlap with other neuropsychiatric disorders, a paucity of evidence-based information, and lack of familiarity. Facilitators were standardized definition and assessment tools, good communication among the interdisciplinary team, and adequate training, education, and experience. In conclusion, efforts should be geared towards raising awareness and developing a practice guideline to aid healthcare professionals in detecting and managing apathy optimally.
Perceptions of Partner Affect Mediate Affect Contagion in Older Couples' Daily Life: An Experience-Sampling Study
Authors: Weber Elisa , Hueluer Gizem 
Published: December 2021

Abstract
Intimate relationship partners dynamically covary in their affective states. One mechanism through which intimate relationship partners experience and shape each other’s affective states is affect contagion, i.e., the spread of affective states from one person to another. The degree to which social-cognitive processes are involved in affect contagion in daily life remains unclear. The majority of older adults live together with a spouse/partner, and intimate relationships are one of the most important social contexts in their daily lives. Expanding on previous research, we focused on contagion of positive and negative affect between older relationship partners, and examined whether processes of affect contagion were mediated by perceptions of partner affect, i.e., how individuals thought their partners felt at previous moments. We used data from an experience sampling study with 152 older heterosexual couples (304 participants; 65+ years old) who reported on their positive and negative affect, perceptions of their partner’s positive and negative affect, and presence or absence of partners 6 times a day for 14 days. Dyadic multilevel mediation models were used to evaluate our hypotheses. We observed strong evidence that processes of positive affect contagion between partners were mediated by perceptions of partner’s affective states. Negative affect contagion was directed from men to women, but not vice versa, and mediated by perceptions of partner’s affective states. Partner presence was unrelated to processes of affect contagion. Our findings help identify underlying mechanisms of affect contagion and support the notion that perceptions of close others’ emotions might shape our own feelings.
Romantic Attachment, Stress, and Cognitive Functioning in a Large Sample of Middle-Aged and Older Couples
Authors: Weidmann Rebekka , Chopik William 
Published: December 2021

Abstract
Romantic relationships are a key factor contributing to health across the lifespan. Within this research line, attachment theory has been a useful framework to understand how relationships impact health. One primary health concern in late adulthood is reduced cognitive functioning: Alzheimer’s disease and related neurodegenerative disorders become increasingly prevalent with age affecting millions of people. Even though much research has identified various sociodemographic, medical, and behavioral risk factors, little knowledge exists on romantic attachment’s psychosocial role for cognitive decline. The purpose of this study was to examine the link between insecure attachment, stress, and cognitive functioning in a large sample of middle-aged and older couples. In particular, we wanted to investigate how insecure attachment is linked to both partners’ cognitive functioning and whether stress mediates these associations. To that aim, we used data of 1,043 romantic couples (Mage = 64.7 years; 38.5% same-sex couples) who reported on their attachment anxiety and avoidance, their stress levels, their cognitive decline, and their and their partners’ dementia symptoms. Couple members also participated in a memory performance task. The results suggest that anxiety is linked to participants’ cognitive decline, while avoidance was linked to partners’ cognitive decline and poorer memory performance. We also detected significant mediational effects for stress in the association between insecure attachment and cognitive functioning. We conclude that potentially malleable psychosocial factors, such as insecure attachment and stress, are important research objects when understanding cognitive functioning in middle and late adulthood.
The Crush: A Proto-Romantic Relationship Across the Life Course
Authors: Kotarba Joseph , Couve Amanda 
Published: December 2021

Abstract
This presentation describes the “crush” experience as it occurs among older adults. A basic definition of a crush is a one-sided, proto-romantic relationship. The scholarly and commonsense understanding in American culture focuses on the crush as most commonly occurring during the developmental phases of adolescence and pre-adolescence. Symbolic interactionists view life course as a somewhat fluid process of adapting to changing situations in life. Experiences like the crush can potentially occur at almost any age at which romantic thoughts and feelings are possible. Our ethnographic research on older adults residing either in group facilities or in domiciliary locations indicates that crushes are fairly common. These crushes follow the same general narrative as crushes among younger people: a beginning, a middle and an end. There are two narrative styles among older adults: face-to-face and mediated. The crush in a group facility is encouraged by interaction during social hours, meals, entertainment, and religious/spiritual activities. Crushes are more observable among women who do not have to delve into their past for objects of their affection. Available paramours from the mass media include young celebrities such as Michael Buble and Josh Groban. These crushes differ from those among younger women in the denouement, to the degree affection generally fades away from memory rather than comes to a distinct end. Factors such as increased access to electronic media and music, and increased sociality in the community and in residential environments will create situations in which the security, excitement and rewards of a crush are plausible.
The Association Between Midlife Education and Depressive Symptoms in Late Life: The AGES-Reykjavik Study
Authors: Chang Milan , Nishizuka Chiharu , Eymundsdottir Hrafnhildur , Sigurdardottir Sigurveig , Ramel Alfons , Gudnasson Vilmundur , Jonsson Palmi 
Published: December 2021

Abstract
BACKGROUND: Disability and depression are associated with cumulative health adversities such as socioeconomic status (SES), nutrition, medical care, and education among older adults. However, there is little evidence on the longitudinal association between mid-life education level with a disability and depressive symptoms in older adults in Iceland. The aim of the study was to examine the association between mid-life education and prevalence of activity of daily living (ADL) dependency and high depressive symptoms in late-life. METHODS: A large community-based population residing in Reykjavik, Iceland (n=4991, 57.3% women, 76.9±5.8 yrs) participated in a longitudinal study with an average of 25 years of follow-up. Mid-life education was categorized into 4 groups (primary, secondary, college, and university). ADL dependency and high depressive symptoms were assessed on average 25 (±4) years later. The 5-item ADL dependency score ranged between 0 (no difficulty) and 18. Depressive symptoms were assessed by the 15-item Geriatric Depression Scale (GDS). RESULTS: After controlling for demographic and health-related risk factors, those with higher education at mid-life were significantly less likely to have high depressive symptomatology (6 or higher GDS scores, Odds Ratio (OR) = 0.65, 95% Confidence Interval (CI): 0.52 ~ 0.82, P &lt; 0.0001). However, mid-life education was not associated with ADL dependency in later life. CONCLUSION: Our study shows that mid-life education is associated with depressive symptoms 25 years later, while no association found with ADL dependency among Icelandic older adults.
Multiple Perspectives on Disaster Preparedness in Long-Term Care: From Heat to Hospice
Authors: Dosa David , Andel Ross , Brown Lisa 
Published: December 2021

Abstract
Preparedness of residents in long-term care (LTC) exposed to disasters continues to warrant concern. Prior work by our research team highlights explicit evidence of the profound vulnerability of Florida nursing home (NH) residents exposed to Hurricane Irma in 2017. This research adds to our knowledge of the profound effect of disasters on long term care residents. This symposium will utilize mixed methodologies to discuss the varied effects of Hurricane Irma on vulnerable older adults residing in Florida NHs and Assisted Living communities (ALCs). Using a novel methodology for identifying a cohort of ALC residents, the first presentation will present the morbidity and mortality effects of Hurricane Irma on Florida ALC residents and identify high risk groups by health condition. The second presentation will document the effect of Hurricane Irma on NH Residents previously enrolled in Hospice and expound on the effect of the disaster on hospice enrollment after the storm. The third presentation will present qualitative results of interviews with ALC administrators highlighting the effect of the storm on both large and small ( &lt;25 beds) facilities. The fourth presentation will address the issue of heat exposure in the days after Hurricane Irma and consider the preventative effect of generators on morbidity and mortality. Finally, a fifth presentation will examine NH staffing level variation in the days leading to the hurricane. To conclude, this symposium offers a multi-faceted view of a disaster’s effects on LTC residents across Florida, including novel data from the NH environment and lesser-examined ALCs.