bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE COSTS OF GENERATIVITY FOR OLDER ADULTS’ MENTAL HEALTH DURING THE COVID-19 PANDEMIC
Authors: So Christine , Fiori Katherine , Rauer Amy , Marini Christina 
Published: December 2023

Abstract
Generativity, the capacity to be productive, caring, and concerned with the well-being of the next generation, promotes positive mental health and posttraumatic growth in later life (Bellizzi, 2004). Generativity may be particularly important in recent years as older adults have faced the pandemic and its aftermath. For example, our previous work showed that generativity was associated with better mental health concurrently during this initial post-vaccine adjustment period (June - September 2021; So et al., 2022). The current study builds upon this work by using longitudinal evidence from a community sample of 95 older adults (M age = 68.4, range 50-91; 68% females; 93% White) to explore whether generativity predicted older adults’ anxiety, depressive symptoms, and life satisfaction six months later (December 2021-February 2022). Using structural equation modeling controlling for age, gender, and baseline depressive symptoms, we found that generativity positively predicted depressive symptoms six months later. In contrast, generativity at baseline was not associated with anxiety or life satisfaction six months later. It is possible that older adults who were more generative at baseline (when many still believed that COVID-19 pandemic would end with vaccinations) reported more depressive symptoms six months later when the highly contagious Omicron variant took over. Our findings thus underscore the complexity of the role of generativity in mental health outcomes, with associations sensitive to historical events.
FORECASTING THE FUTURE: OLDER ADULTS’ ANTICIPATED STRESSORS AND REWARDS IN THE CONTEXT OF COVID-19
Authors: Marini Christina , Basinger Erin , Stewart Meagan , Fiori Katherine , Rauer Amy 
Published: December 2023

Abstract
Stress research typically focuses on past/current events as opposed to future ones. We identified future anticipated stressful and rewarding events at 2 timepoints utilizing qualitative data from older adults (N = 103, Mage = 68.11, 68.9% female, 93.2% white) who participated in a study of social reintegration after vaccines were available in the US. COVID-19 cases were typically below 1 million during T1 (Fall 2021), but exceeded 5 million during T2 (Winter 2022), coinciding with the Omicron variant. This afforded the opportunity to examine anticipated stressors and rewards at timepoints with different levels of COVID-19 threat. We used content analysis to identify anticipated stressors and rewards, which fit into 13 categories (Cohen’s κ = .86-.96) and examined rates of ambivalence (i.e., same event was a stressor and reward within timepoints) and chronicity (i.e., same stressor or reward was named across timepoints). At T1, the modal stressor was own transition/change (13.6%; e.g., relocating). At T2, it was the pandemic (20.4%; e.g., family member recovering from COVID). Family/friend relationships (e.g., celebrating grandkids’ birthdays) was the modal reward at T1 (32%) and T2 (24.3%). A quarter of participants demonstrated ambivalence (T1 = 23.3%; T2 = 28.2%). Stressor and reward chronicity (22.3% and 32%, respectively) were low. Findings highlight variability in the events older adults were concerned and excited about within and across timepoints. Salience of the pandemic as an anticipated stressor ebbed and flowed alongside emerging variants, despite vaccine availability.
SOCIAL INTERACTIONS AND LONELINESS AMONG THE ADULT LIFESPAN: A COVID-19 COORDINATED ANALYSIS
Authors: Zavala Daisy , Hughes MacKenzie , Hu Rita , Ali Sumbleen , Kincaid Reilly , Ogle Destiny 
Published: December 2023

Abstract
The COVID-19 pandemic included physical distancing mandates. Examining responses to isolation across the lifespan during the first year of the pandemic may shed light on age differences in social interactions and loneliness during a time of uncertainty. This coordinated analysis of 2 intensive longitudinal datasets (DCF, EAS) examines social interactions, loneliness, and age during the COVID-19 pandemic. It is a component of a larger, pre-registered coordinated analysis involving traditional longitudinal and cross-sectional studies (https://osf.io/jt4wf). DCF was a diary study of 221 adults ages 21-78 years (M = 48.92, SD = 14.81) who completed online questionnaires every day for 21 consecutive days. DCF participants were drawn from across the USA via MTurk and Qualtrics. Data collection spanned Oct-29-2020 to Nov-18-2020. EAS is an ongoing ecological momentary assessment measurement burst study; data from 82 adults aged 73-96 years (M = 79, SD = 5.41) who completed a 2 week burst of 4 EMA per day between Feb-1-2020 and July-1-2020 were used in this analysis. EAS participants were recruited from registered voter lists in Bronx, NY USA. Separate multilevel models (DCF: 2 level, EAS: 3 level) were conducted with the same covariates and constraints. Between and within individuals, social interactions did not predict loneliness in DCF; older age predicted lower loneliness. In EAS, individuals with more social interactions were less lonely, males reported higher levels of loneliness and relatively younger individuals had lower loneliness following interactions. Results illustrate the value of coordinated analysis for understanding loneliness under pandemic conditions.
THE INTERSECTION OF SOCIAL DETERMINANTS OF HEALTH AND FAMILY CARE OF PEOPLE LIVING WITH DEMENTIA
Authors: Gaugler Joseph , Borson Soo , Epps Fayron , Shih Regina , Parker Lauren , McGuire Lisa 
Published: December 2023

Abstract
In this presentation, we will synthesize current research to illustrate the intersection of social determinants of health (SDOHs) and Alzheimer’s disease and related dementia (ADRD) caregiving, and outline how public health can support ADRD family caregivers in the U.S. There is an abundance of research that demonstrates family caregivers of relatives living with ADRD experience adverse health outcomes. In addition, family care for persons with ADRD overlaps with SDOHs. Public health actions such as improved surveillance and identification of ADRD caregivers; building and enhancing community partnerships; advancing dementia-capable health care and related payment incentives; and reducing the stigma of dementia and ADRD caregiving can enhance support and services for families. By engaging in these actions, public health practitioners could more effectively address the myriad of challenges facing ADRD caregivers most at risk for emotional, social, financial, psychological, and health disruption.
THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH ON DETECTING DEMENTIA: REFRAMING HEALTH EQUITY
Authors: Chodosh Joshua , Borson Soo 
Published: December 2023

Abstract
Social determinants of health (SDoH) contribute to the incidence of Alzheimer’s disease and related dementia (ADRD) and to missed opportunities to reduce the impact of its symptoms. They also play a fundamental role in detection of ADRD, leading to disparities in diagnosis as well as care. Public health practitioners have an outsize role in addressing the intersection between ADRD prevalence and related SDoH, especially for persons from minoritized and under-resourced communities. We will delineate the effects of this intersectionality and the need to reframe dementia detection strategies to promote health equity, reduce related stigma, and repair the mistrust that is integral to care inequities. We will highlight the ongoing efforts of our public health partners who are committed to ensuring that dementia is detected before a crisis occurs and opportunities they offer to support the efforts of our PHCOE partners in dementia prevention and caregiving.
IMPLEMENTATION MODELS FOR FOLLOWING UP AFTER A DEMENTIA-RELATED MISSING INCIDENT
Authors: Daum Christine , Letts Elyse , McLennan Lauren , Conway Cathy , Liu Lili 
Published: December 2023

Abstract
The rate of persons living with dementia who go missing is a growing concern, especially those who go missing repeatedly. Drawing upon the practices of other populations such as at-risk youth, following up with persons living with dementia and their supports after an incident could reveal contributing factors and also connect people with supports to mitigate the risk for going missing again. In Canada, models for such follow-ups are limited. The purpose of this presentation is to describe two implementation models for following up with persons living with dementia and their care partners after a missing incident has occurred. We conducted 20 individual semi-structured online interviews with police and service providers in Canada and the United Kingdom to understand the scope of and approaches to following up with this population. Generic qualitative description and conventional content analysis were used. We developed a resource guide that describes these approaches and proposes how follow-ups could be consistently employed. Two focus groups with police officers and community service providers (n= 11) were conducted to obtain feedback on the guide. We are now working with community partners in two Canadian provinces to develop implementation models unique to their existing processes, resources, and systems; these models put into practice approaches in the resource guide. Our presentation will showcase the guide and the models developed in collaboration with our partners. These models can guide police organizations, Alzheimer Societies, and communities who support persons living with dementia at risk of going missing.
THE MANY FACES OF DEMENTIA IN CANADA: EXAMINING SEX, ETHNICITY, AND AGE OF ONSET IN THE LANDMARK STUDY
Authors: Armstrong Joshua , Sivananthan Saskia , Guimond Josée 
Published: December 2023

Abstract
With the rapidly increasing size of the dementia population, it is important to enhance our understanding of the similarities and differences that are found across the people living with condition. This work takes a closer look at the many faces of dementia in Canada by highlighting the diversity that is found within the national population projections for dementia. To conduct these forecasts, a simulation model was developed using demographic characteristics and risk factors for dementia to estimate the numbers of people living with dementia in Canada from 2020-2050. From the results of the Landmark Study, we will highlight findings related to sex, Indigenous Peoples, ethnic origins, and young-onset dementia. In 2020, 61.3% of dementia diagnoses were in females and this sex ratio is projected to stay constant over the three decades. For Indigenous Peoples of Canada, dementia numbers are estimated to increase by 273% (2020: 10,800; 2050: 40,300). People of Asian origin will increase from 8% of people living with dementia in 2020 to 24% by 2050. The changes are driven both by future immigration, and by people who have already immigrated to Canada in the past few decades. The Landmark Study also projects that there could be over 40,000 people under the age of 65 living with dementia in Canada by 2050.These findings illustrate the changing landscape of people living with dementia in Canada. These demographic characteristics, as well as other distinctions across population groups, profoundly affect the way in which dementia is experienced and their care needs.
HEARING INTERVENTION TO REDUCE COGNITIVE DECLINE: DESIGN AND FINDINGS OF THE ACHIEVE RANDOMIZED CONTROLLED TRIAL
Authors: Deal Jennifer , Reed Nicholas , Ferrucci Luigi 
Published: December 2023

Abstract
Epidemiologic data consistently link age-related hearing loss with accelerated cognitive decline and incident dementia in large, population-based studies. Mechanistic pathways that could underlie this association include the effects of distorted peripheral encoding of sound on cognitive load, changes to brain structure/function, and/or reduced social engagement and increased loneliness. Importantly, these pathways may be amenable to comprehensive hearing rehabilitative treatment including hearing assistive technologies (e.g., hearing aids, other integrated hearing assistive devices) and rehabilitative training. To date, however, there has never been a randomized trial that has investigated whether hearing loss treatment could reduce cognitive and other functional decline in older adults without dementia. The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) trial is a multicenter randomized control trial of 977 cognitively intact adults with untreated, mild-to-moderate hearing loss aged 70-84 years at baseline (2018-19) to determine efficacy of best-practices hearing intervention to reduce cognitive decline over 3 years (Clinicaltrials.gov Identifier: NCT03243422). This session, on behalf of the ACHIEVE Collaborative Research Group, will describe the overall design of the ACHIEVE trial including details about recruitment and implementation of both the hearing (amplification, auditory rehabilitation) and successful aging health education control interventions. We will also present the primary findings of the study – the effect of the hearing intervention vs. control on 3-year cognitive decline – as well as the effect of the hearing intervention on several pre-specified outcomes important for the health of older adults, including social engagement, mood disorders and quality of life.
DESIGN AND IMPLEMENTATION OF THE ACHIEVE HEARING INTERVENTION
Authors: Chisolm Theresa , Sanchez Victora , Arnold Michelle 
Published: December 2023

Abstract
The ACHIEVE trial required the development of a manualized best-practice hearing intervention designed to meet the needs of older adults with mild-moderate hearing loss. The hearing intervention (HI) was developed using an iterative process including input from a diverse professional panel and a feasibility study to confirm that expected outcomes from a best-practices, evidence-based HI would be obtained. The HI involves use of hearing aids and related technologies along with counselling, coaching and education to support self-management of hearing loss. The HI is delivered in four sessions after the completion of a comprehensive hearing evaluation. Individualized goals are developed using the Client Oriented Scale of Improvement (COSI), which guides selection of hearing aids and other technologies to meet prioritized listening needs and assessment of how well those needs are met. The most frequent COSI listening goal categories included: Conversation in Noise (n= 413; 29%), Conversations in Quiet (n= 296; 21%), and TV/Radio at Normal Volume (n= 280; 20%). Three levels of hearing aid technology differing by the number of signal processing approaches included were: Basic (n=223, 20%), Advanced (n=662, 56%), and Premium (n=283, 24%). Additional hearing assistive technologies included streaming devices, TV connectors, and remote microphones were provided. We discuss how the baseline audiological results and individualized goal setting informed delivery of the HI and how the use of manualization allowed us to maintain excellent treatment fidelity throughout the clinical trial.
ASSOCIATION OF BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA WITH ADVERSE OUTCOMES POSTHOSPITALIZATION
Authors: Berish Diane 
Published: December 2023

Abstract
In hospitalized persons with dementia, behavioral and psychological symptoms of dementia (BPSD), also known as behavioral symptoms of distress, are associated with increased morbidity, long-term care admissions, and reduced care partner well-being. The Fam-FFC study provided the opportunity to examine the association between BPSD severity and adverse, post-acute outcomes (falls, emergency department transfers, hospital admissions). Logistic regression analysis examined the association of behavioral symptoms (Neuropsychiatric Inventory Questionnaire, NPI) and odds of having a fall, emergency department transfer, and hospital admission, controlling for the intervention, and caregiver and patient characteristics. NPI scores decreased from admission (M = 7.81, SD = 6.12), to discharge (M = 6.4, SD = 5.93), to two months (M = 5.38, SD = 5.91), to six-month follow-up (M = 5.08, SD = 5.94). Higher admission NPI scores were associated with greater odds of experiencing at least one fall (OR = 1.067, p = 0.042) by discharge. Higher discharge NPI scores were associated with higher odds of ED transfer (OR = 1.062, p = 0.006) and at least one hospitalization (OR = 1.06, p = 0.008) after two months. Higher NPI scores at 2-month follow-up were associated with increased odds of ED transfer (OR = 1.062, p = 0.004), experiencing at least one injury (OR = 1.055, p = 0.031), falls (OR = 1.056, p = 0.012), and hospitalizations (OR = 1.065, p = 0.004) at six months. Results underscore the importance of providing interventions to reduce BPSD as a potentially modifiable risk factor to reduce adverse outcomes.
DEMENTIA STAGING, NEUROPSYCHIATRIC SYMPTOMS, AND DIVORCE OR SEPARATION IN LATE LIFE: A CASE CONTROL STUDY
Authors: Monin Joan , McAvay Gail , Zang Emma , Wyck Brent Vander , Carrión Carmen , Allore Heather 
Published: December 2023

Abstract
Dementia can be difficult on marriages for many reasons, including but not limited to caregiving burden, loss of intimacy, and financial burden. This study examined the impact of dementia staging and neuropsychiatric behavioral symptoms on the likelihood of divorce or separation for older adult married couples. For this case-control study, we used data from the National Alzheimer’s Coordinating Center (NACC) Uniform dataset (UDS) versions 2 and 3. This dataset was from 2007 to 2021 and contains standardized clinical information submitted by NIA/NIH Alzheimer’s Disease Research Centers (ADRCs) across the United States (US). This data was from 37 ADRCs. We selected participants who were married or living as married/domestic partners at their initial visit. Cases were defined by a first divorce/separation occurring during the follow-up period, resulting in 291 participants. We selected 5 controls for each married/living as married case and matched on age. Conditional logistic regression estimated the association between overall Neuro Psychiatric Inventory (NPI) score and severity of NPI symptoms with case/control status, adjusted for education, the CDR® Dementia Staging Instrument score, living situation, symptom informant, sex, and race. Separate analyses were conducted for each symptom. Multiple comparisons were accounted for with the Hochberg method. Later stage of dementia was negatively associated with divorce/separation with an adjusted odds ratio. A higher overall NPI score was positively associated with divorce/separation. More severe ratings of agitation/aggression, depression/dysphoria, and disinhibition with divorce/separation were associated with greater odds of divorce/separation. Treating NPI symptoms may be away to protect relationships.
JUST THE TWO OF US? THE PSYCHOLOGICAL IMPACT OF MARITAL DISSOLUTION ON CHILDLESS OLDER ADULTS
Authors: Carr Deborah , Choi Shinae 
Published: December 2023

Abstract
An estimated 15% of U.S. adults ages 55+ are childless, with this proportion projected to increase among future cohorts. Of the 15 million childless older adults today, 40 percent are married – challenging the notion that childlessness is the domain of never married persons only. Little is known about the experiences of childless older adults who become widowed or divorced, and whether they suffer poorer mental health than their peers with children. Widowed and divorced persons lack the support of children yet may possess other resources or strengths as they age on their own. We use data from the 2016 and 2018 waves of the Health and Retirement Study (N = 16244) to evaluate whether parental status (childless, any living biological child(ren), stepchild(ren) only, all child(ren) now deceased) moderates the association between marital status (married, cohabiting, divorced/separated, widowed) and mental health (depressive symptoms, and social and emotional loneliness) and whether these patterns differ by gender. Multivariate moderation analyses show that childless widowed men and divorced men who lost a child to death have dramatically higher levels of social loneliness, relative to other men. Childlessness does not moderate the effect of marital status on loneliness or depressive symptoms among women. However, widowed and divorced women with stepchildren only evidence significantly higher depression and emotional loneliness. We discuss implications for understanding late-life mental health, underscoring that childlessness does not uniformly compromise mental health among unmarried persons, and that some parent-child relations (especially step-relations) may be a source of stress rather than solace.
CASE STUDIES OF A SENOR-ENHANCED CARE COORDINATION MODEL TO ADDRESS OLDER ADULT HEALTH
Authors: Robinson Erin , Curtis Elizabeth Heaton , Bacon Suzette Mizutani , Roberts Ashley , Conrow Elizabeth , Popejoy Lori , Vogelsmeier Amy 
Published: December 2023

Abstract
Smart technologies hold enormous potential in the early detection of activity change that may indicate illness or functional decline among older adults. However, little research currently exists on the application of such technologies to community-dwelling older adults. Our program, Age-friendly Sustainable Smart and Equitable Technologies for Aging in Place (ASSETs for AIP) uses open-source smart home technologies and consumer-grade wearable devices to monitor community-dwelling older adults recently discharged from the Show-Me Home program. We employ a novel approach; pairing technology with a care coordination team, comprised of a registered nurse, occupational therapist, and a licensed social worker. This presentation will highlight the function of this team, and how they leverage sensor-generated health information to provide care coordination. Using a clinical interface that displays the sensor-generated health data, this team provides ongoing monitoring of daily activity to identify early changes in routine that may indicate the development of a health problem. As significant changes in health data present, our clinical team works with clients to understand the change and formulate a plan of action. For example, an unexplained spike in heart rate may lead the clinician to discuss recent activity, exertion, and potential modifications in routine for a client. An increase in middle-of-the night bathroom trips may indicate a health change, for the which the client will be coached in what to communicate to their provider. Case studies from our program will be discussed in this presentation, to highlight this model of sensor-enhanced care coordination.