bluuebunny/crossref_metadata_2025_split huggingface dataset:
PURPOSE PROMOTES MENTAL HEALTH FOR RETIREES, BUT THEY NEED TO HELP FINDING IT
Authors: Best Rachel , Ogliore Anthony , Rule Payton , Hill Patrick 
Published: December 2023

Abstract
Previous research shows that sense of purpose is significantly related to mental health outcomes, including depression and anxiety (Crego et al., 2021; Dixon, 2007). Retirees are at higher risk for having a lower sense of purpose (Hill & Weston, 2019; Pinquart, 2002). Accordingly, helping retirees increase their sense of purpose may be a good way to also improve their mental health. First, research is needed to understand the relationship between sense of purpose and anxiety and depression in retirees. The current study uses cross-sectional data from 1975 adults (516 retirees and 1459 non-retirees; mean age = 49.23, SD = 18.29 ). Pearson r correlations were run between sense of purpose (Life Engagement Test), depression (PHQ-9) and anxiety (GAD-7) in retirees and non-retirees. T-tests were run between retirement status, sense of purpose, depression, and anxiety. As expected, sense of purpose was associated with lower depression (retirees r = -.33, p &lt;.001 ; non-retirees r = -.28, p &lt;.001) and anxiety (retirees r = -.32, p &lt;.001 ; non-retirees r = -.29, p &lt;.001) for both retirees and non-retirees. Results also showed that retired older adults had lower sense of purpose than older adults who are still working (t(1090) = -4.8778, p &lt; .001). These data suggest that targeting sense of purpose in retirees is a worthwhile goal that may also indirectly improve mental health outcomes.
QUALITY OF LONG-TERM CARE FACILITIES AND COVID-19 OUTCOMES: A SYSTEMATIC REVIEW
Authors: Wang Xiaochuan , Eyler Gabriella 
Published: December 2023

Abstract
U.S. long-term care facilities (LTCFs) have been disproportionally and negatively impacted by the COVID-19 pandemic, reporting high shares of COVID-19 cases and deaths. It is critical to understand whether and how quality of these facilities is related to COVID-19 outcomes, to inform policy and practice to better protect the vulnerable LTCF residents and prepare for future outbreaks. Yet, research on this topic has primarily focused on nursing homes which has yielded inconsistent findings, and less is known in the assisted living care setting. To help address this gap, we systematically reviewed existing literature describing quality indicators and examining their impacts on COVID-19 outcomes in LTCFs. Using PRISMA guidelines, we searched electronic databases (e.g., PubMed) for peer-reviewed articles published in English between 2020 and 2023. The search yielded 1,487 unduplicated publications. After screening articles for relevance based on titles and abstracts, 123 were reviewed in full text. A total of 25 articles were included in this review. The included articles examined a range of quality indicators, such as CMS overall and sub-domain 5-star ratings and previous infection prevention and control deficiencies. Overall, the studies revealed mixed results regarding the association between quality and COVID-19 outcomes in LTCFs. Most studies found that higher quality is generally indicative of better COVID-19 outcomes, and some further suggested that the association varied across pandemic phases. Whereas another 7 studies found no significant relationship. This systematic review highlights the need for future research and evidenced-based policy and practice to better protect the at-risk LTCF resident population.
RACIAL DISCRIMINATION TRAJECTORIES AND MULTIMORBIDITY BURDEN AND CHANGE AMONG MIDDLE-AGED AND OLDER BLACKS
Authors: Whilby Kellee White , Robinson-Ector Kaitlynn , Quiñones Ana 
Published: December 2023

Abstract
Racial discrimination is a chronic psychosocial stressor that can accelerate aging. Characterizing longitudinal patterns of racial discrimination may provide greater precision in predicting health risk particularly for outcomes such as multimorbidity that is considered a proxy of multisystem dysregulation and a marker of cumulative disease burden. However, longitudinal patterns of racial discrimination and its relationship with multimorbidity has received limited attention. We investigate the association between racial discrimination trajectories (RDT) and multimorbidity among a subsample of middle-aged and older Black adults from the Health and Retirement Study (2006–2020, N = 2,167, 50+). RDTs were constructed based on the Everyday Discrimination Scale using repeated measures latent profile analyses. Multimorbidity was operationalized using the multimorbidity weighted index (MWI) score. Linear mixed models, adjusted for sociodemographic, behavioral, and clinical covariates, estimated the association between RDT and MWI score and change in score over time. Average MWI scores varied across RDT classes: low (5.9), moderate (6.5), and high (5.9). Individuals characterized in the moderate RDT had the highest multimorbidity burden (3.03; 95% confidence interval [CI]: 1.46, 4.58) and was the only group that experienced an accelerated rate of multimorbidity accumulation, as measured by change in MWI score over time. This relationship was not observed among respondents in the persistently high RDT. Our findings suggest that there are differences in the relationship between RDT and multimorbidity burden. Uncovering specific characteristics associated with the profiles of RDT may advance our understanding of healthy aging processes.
RACIAL REPRESENTATIVENESS AND AFFORDABLE HOUSING DISPARITIES: A NATIONAL STUDY OF NURSING ASSISTANTS
Authors: Holmes Sarah , Gurlu Merve , Zhu Shijun , Murray Briana , Lepore Michael 
Published: December 2023

Abstract
Occupational racial representation is increasingly recognized as a health equity issue. In the US, racial unrepresentativeness in the healthcare workforce, including nursing homes (NHs), is a pervasive aspect of economic inequality: racially minoritized women are disproportionately overrepresented among nursing assistants (NAs) in NHs, and racially minoritized NAs commonly live in poverty and lack affordable housing. Despite evidence of associations between occupational racial representation and affordable housing, there is limited research on these associations among NAs in NHs. We examined how state-level racial representativeness of NAs in NHs relates to housing affordability using data from the PHI Workforce Data Center, LTCFocus, and US Census. Racial representativeness was calculated as the difference between the percentage of racial group (Black, White) in NA workforce in the state and the percentage of racial group in state working-age population. Multivariable linear regression was used to examine associations between housing affordability and racial representation. The national sample included 527,480 NAs. Results showed overrepresentation of Black NAs (M=17.5%, SD=.166) and underrepresentation of White NAs (M=-18.2%, SD=.127) in most states. Controlling for NH primary payer source and NA education level, lack of affordable housing was associated with higher representation of Black NAs in the workforce (b=1.78, p&lt;.001, R2=.66) and lower representation of White NAs in the workforce (b=-1.45, p&lt;.001, R2=.61). These findings indicate racial disparities in NA access to affordable housing and highlight the need for additional research on these associations and related outcomes to develop equity-centered strategies in the NH workforce that will address housing affordability.
RECRUITMENT LESSONS LEARNED FROM A RANDOMIZED PSYCHOEDUCATIONAL TRIAL FOR DEMENTIA FAMILY CAREGIVERS
Authors: Aranda Maria 
Published: December 2023

Abstract
Family caregivers/care partners are the backbone of long-term services and support on behalf of persons living with memory loss such as Alzheimer’s and related dementias. Although there has been increased attention on family caregivers overall, documented recruitment strategies to participate in research—and clinical trials in particular—are lacking. This paper addresses the individual and system-level factors addressed in order to reach target recruitment goals in a community-based dementia caregiver trial conducted online with a racially- and ethnically-diverse cohort of mostly spousal/partner and adult children caregivers. Based on a sample of 231 trial participants and 105 focus group interviewees, we drew from our theoretical model—the Micro-Meso-Macro Framework—to elucidate factors that facilitated or impeded diverse cohort recruitment. We analyzed data from two data sources: a) source of referral and reason for contacting the recruitment team; and b) content analysis from focus group interviews. Based on our multi-level analysis we documented the following factors that facilitated trial participation: 1) MICRO: prior encounters with the research enterprise; educational attainment and occupational status; sense of altruism and beneficence; monetary incentivization; comfort with disclosure of private matters; starting from ground zero; and addressing gender issues; and 2) MESO/MACRO: assembling a proactive scientific team; leveraging logos and reputation; training trial staff and community partners; writing project budgets that incentivize diverse trial recruitment; making inroads with community partners; navigating technological challenges; and tapping into resources to alleviate barriers. In our paper, we will discuss lessons learned, and address future research directions including recruiting underrepresented groups.
REDEFINING OBESITY: A RATIO OF FAT AND MUSCLE MASS COMPARED TO BODY MASS INDEX IN OLDER ADULTS
Authors: Lafontant Kworweinski , Thiamwong Ladda , Stout Jeffery , Park Joon-Hyuk , Xie Rui , Fukuda David 
Published: December 2023

Abstract
Body composition is an important determinant of physical fitness and overall health in older adults. Body mass index (BMI) is currently the standard used to categorize clinical thresholds for body composition (underweight, normal weight, overweight, obese). However, BMI does not account for key aspects of body composition like skeletal muscle mass (SMM) and fat mass (FM). This can lead to misclassification and inaccurate inferences about metabolic health. A FM/SMM ratio may better capture age-related changes in body composition like sarcopenia and obesity, but it is unknown whether FM/SMM correlates more closely with muscularity and adiposity than BMI. This cross-sectional study assessed 103 older adults (16 men, 87 women; mean age 75.7 ± 7.19 years; BMI 26.8 ± 5.22 kg/m2) for SMM, FM, and body fat percentage (BF%) using bioelectrical impedance analysis (InBody S10). BF% was more highly correlated with FM/SMM (r = 0.979, p &lt; 0.001) than BMI (r = 0.702, p &lt; 0.001), and a Fisher’s R-to-Z analysis indicates that the difference is significant (95% CI [0.826, 0.926], z = 12.217, p &lt; 0.001). However, SMM showed weak correlation with both FM/SMM (r = -0.306, p = 0.002) and BMI (r = 0.349, p &lt; 0.001). FM/SMM may better detect changes in adiposity compared to BMI, suggesting utility as an obesity measure. Further research should examine the longitudinal validity of FM/SMM in older adults and its ability to predict metabolic and musculoskeletal health.
TELEWORKING TO SUPPORT ACCOMMODATION, INCLUSION, AND HEALTH OF OLDER WORKERS: ISSUES FACED BY MANAGERS
Authors: Lecours Alexandra 
Published: December 2023

Abstract
Telework is increasingly present and has the potential to be used as an accommodation modality to facilitate inclusion and healthy participation in the workplace for older workers (i.e. aged 55 and over). However, there is a need for a practical tool to guide the application of telework with this population. This poster presents the first stage of a study aiming to develop a reflective guide for applying telework to support the accommodation, inclusion, and health of older workers. Following a three-stage developmental research design, this first stage consists in conducting individual interviews with older teleworkers and managers to gather qualitative data on their experience. During the second stage, the issues, considerations, and good practices that emerged from the first stage are compiled into a guide. In the third stage, this guide will be validated by workers and managers to ensure its acceptability and applicability. Preliminary results from the first stage allowed to identify issues faced by managers concerning accommodation (n=8, e.g. ensuring that accommodating older workers does not add extra pressure on colleagues), inclusion (n=5, e.g. difficulty to mobilize older teleworkers for face-to-face social gatherings), and health (n=2, e.g. managers feel powerless to manage older teleworkers’ emotions). Managers play a key role in implementing practices that promote the accommodation and inclusion of older workers through teleworking, but they have few tools to support them. The reflective application guide that will be created during this study represents an innovative tool likely to have positive impacts at individual, organizational and societal levels.
REMOTE FAMILY CAREGIVERS: INVISIBLE YET INDISPENSABLE DURING HOSPITALIZATION OF OLDER ADULTS
Authors: Tonkikh Orly , Johnson Yuuko , Young Heather , Siegel Elena O 
Published: December 2023

Abstract
Limited research has addressed the interplay between the roles of nursing staff and families of older adults in acute care settings, including those families involved in-person and those who are unable to be physically present (remote). This descriptive qualitative study explores nurses’ and family members’ perspectives on the roles and engaging family members or friends during an acute hospitalization in medical-surgical units. Semi-structured interviews were conducted via Zoom or phone with a convenience sample of 19 nurses and families between February and August 2023. Thematic analysis inductively captured key patterns in data. Nurses proactively engaged family members who were present in the hospital, while they engaged with remote family members in a more limited way, mostly during discharge planning. Nurses describe making decisions about including families based on their presence (e.g., education about medications, encouraging to engage the patient in the recommended care, ask to support with ADLs). In contrast, families describe providing support regardless of physical presence, including socio-emotional support, help with medical/nursing tasks, encouragement to recover, mediation of information provided by staff, learning to perform medical-nursing tasks and communication and interpretation of the information with other family members. The findings reveal a gap in nurses and family’s perspectives about the feasibility and contribution of remote family involvement during an acute hospitalization. This provides direction for further exploration of acute care structures and nursing care processes needed to support the preferred mode for family involvement.
RESEARCH BEST PRACTICES TO SUPPORT RESILIENCE IN EYE STROKE VISION REHABILITATION
Authors: Hreha Kimberly , Boucher Nathan , Whitson Heather 
Published: December 2023

Abstract
While effective rehabilitation exists to promote independence and community participation for age-related vision impairment, no rehabilitation program has been developed specifically for eye stroke impairment. We are adapting a macular degeneration self-management program using input from key partners to inform future intervention. The pilot phase objective was to inform future study design for eye stroke survivors. We conducted semi-structured interviews, and applied the 5T Framework (Target population identification, Team composition, Time considerations, Tips to accommodate older adults, and Tools for inclusive enrollment of older adults) to develop the interview guide. Twenty-five people recruited from clinical settings were consented/interviewed over six months. This included 10 stroke survivors (M age= 66 years; 70% male--90% visual field defect), 4 care partners (M age= 57 years; 100% female--1 mother, 1 sister and 2 spouses), and 11 providers (M age= 37 years; 54.5% female--3 occupational therapists, 4 ophthalmologists, 2 optical technicians, 1 optometrist, 1 physical therapist). The most meaningful outcomes identified were driving and returning to full independence. The most frequently identified “facilitator of recovery” after eye stroke was family support. The most frequently identified barriers to participation in intervention research were lack of accessibility of the research building and transportation. Optimal lighting and scanning strategies were identified as key elements of any future intervention as well as approaches to support enrollment and retention in study activities. Interview data are now being used to inform phase two: adaptation of the self-management program and design of the study that will evaluate its effectiveness.
RESILIENCE AND PSYCHOLOGICAL DISTRESS IN GENETIC TESTING FOR ALZHEIMER’S DISEASE
Authors: Burgei Alicia 
Published: December 2023

Abstract
This research project examines the relationship between resilience and psychological distress resulting from genetic testing for Alzheimer’s disease among individuals who are non-cognitively impaired. Preventative genetic testing is increasingly important to determine the likelihood of developing or passing on genetic disorders. However, receiving genetic information, especially regarding incurable diseases like Alzheimer’s disease, can lead to significant psychological distress. Resilience, the ability to cope with adversity and recover quickly, is considered a protective factor against psychological distress. The purpose of this study is to investigate whether higher levels of resilience are associated with lower psychological distress from genetic testing for Alzheimer’s disease. A cross-sectional survey was conducted online using the Impact of Genetic Testing for Alzheimer’s Disease (IGT-AD) scale and the Brief Resilience Scale (BRS), along with a question about family history of Alzheimer’s disease. The results indicated a significant negative correlation between resilience and psychological distress, suggesting that individuals with higher resilience experienced lower distress related to genetic testing. However, family history did not moderate the relationship, meaning the protective effect of resilience was consistent regardless of familial risk. These findings have implications for developing targeted support services and resilience-based interventions to help individuals cope with the emotional impact of genetic testing for Alzheimer’s disease. Further research could explore other potential protective factors and examine the long-term impact of genetic testing results on psychological well-being and behavior.
RETIRING AFTER A JOB WELL DONE: HOW SUBJECTIVE CAREER EVALUATIONS IMPACT RETIREMENT ADJUSTMENT
Authors: Tunney Orlaith , Henkens Kène , van Solinge Hanna 
Published: December 2023

Abstract
An individual’s past, and how they reflect on it, may influence current and future well-being, with recent qualitative studies suggesting retirees’ reflections on their careers may relate to well-being in retirement. Establishing factors that may promote successful transition to retirement is vital. Particularly in light of population ageing and the subsequent increase in both the number of retirees and the length of retirement. The aim of our study was to investigate the impact subjective career evaluations on retirement adjustment at follow-up. Using data from across three waves of the NIDI Pension Panel Study, (conducted in 2015,2018, and 2023) we examined the pre-retirement career evaluations of a sample of Dutch older workers (N= 3566), factors associated with these evaluations, and the impact of subjective career evaluations on retirement at five or eight-year follow-up. The results of our ordinal logistic regression models showed that how individuals evaluated both the work (b= 0.15 p=.001) and family (b= 0.12 p=.001) domain of career was positively associated with retirement adjustment, with those who evaluated their careers more favorably reporting fewer problems adjusting to retirement. Our results demonstrate the long-term impact of subjective career evaluations and highlight the need for additional research evaluating their predictive utility for other important outcomes in older adulthood such as life satisfaction and health. These findings could also be applied to identify and deliver interventions for those at risk of less favorable retirement outcomes.
SEDENTARY BEHAVIOR DIFFERENTIALLY INFLUENCES COGNITIVE HEALTH IN OLDER ADULTS AT DIFFERENT TIMESCALES
Authors: Qiu Tian , Elbich Daniel , Alwerdt Jessie , Hakun Jonathan 
Published: December 2023

Abstract
The negative health effects of sedentary behavior have received increased attention over the past decade. Whether sedentary behavior negatively influences cognitive health at any timescale remains poorly understood. Our study sought to determine whether sedentary behavior negatively affects cognitive health throughout the adult lifespan at multiple timescales (acute within-day, day-to-day, cross-sectionally). We examined ambulatory assessment data generated by an adult lifespan sample (N=161; age range:19-88 years; 84% F) where cognition was repeatedly assessed via ultra-brief cognitive assessments of processing speed and working memory in an ecological momentary assessment (EMA) framework (6 assessments/day for 14 days). Activity was measured continuously via thigh-worn ActivPAL monitors. ActivPAL and EMA data were combined and modeled in a multi-level (3-level; moments within days within persons) isotemporal substitution modeling framework. Increased sedentary behavior was associated with acute decreases in processing speed for older participants (65+ years of age) and substitution modeling indicated that exchanging bouts of walking or standing for sedentary time would result in short-term improvements. In contrast, a consistent result across younger and older adults indicated that days with generally more sedentary time (as well as lying and standing) were associated with overall better processing speed and working memory capacity. No cross-sectional associations were observed. A lack of cross-sectional associations between sedentary behavior and cognitive performance was consistent with previous studies. Our current results extend previous findings by showing that sedentary behavior might influence cognitive performance differently at different timescales in younger and older adults.