bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHALLENGES AND NOVEL SOLUTIONS TO PROMOTING ADHERENCE TO HOME-BASED COGNITIVE ASSESSMENT
Authors: Boot Walter , Fowe Ibukun , Zhang Shenghao , Dieciuc Michael , Dilanchian Andrew 
Published: December 2023

Abstract
New technologies now allow for home-based self-assessment of cognition to promote the early detection and treatment of cognitive decline. Early detection has a multitude of benefits for the individual and for our scientific understanding of cognitive impairments and possible treatments. However, for these solutions to be effective, they will likely require long-term adherence to assessment protocols to detect longitudinal change, and like many health behaviors, adherence can be a major challenge. This presentation will provide an overview of the Adherence Promotion with Person-centered Technology (APPT) project, which aims to develop a tailored, smart reminder system that infers participants’ contexts and motivations to provide just-in-time support to facilitate cognitive assessment adherence. Among other studies, this overview will include discussion of a recently completed focus group study (N = 42) that was used to understand motivations and potential barriers to home-based assessment and preferences for adherence support, a recently completed pilot study (N = 44) in which the adherence support system was initially tested and refined, and a series of survey studies (total N &gt; 200) that examined older adults’ attitudes toward wearable technologies to detect cognitive decline. The talk will conclude with discussion of an upcoming randomized controlled trial to test the efficacy of the newly developed system with respect to promoting long-term adherence to cognitive assessment via smartphone technologies.
ALZHEIMER’S DISEASE AND RELATED DEMENTIAS IN A FAMILY CONTEXT
Authors: Suitor J Jill , Gilligan Megan 
Published: December 2023

Abstract
This symposium considers the ways in which the presence of Alzheimer’s Disease and Related Dementias (ADRD) shapes functional and affective relationships between family members, and raises questions about the future public health implications of ADRD family caregiving. In the first paper, Huo and Kim use dyadic data collected from husbands and wives in which one partner lives with mild-to-moderate cognitive AD to explore the role of relationship quality in caregiver stress. Next, Suitor and colleagues use mixed-methods data from the Within-Family Differences Study to examine how mothers’ cognitive impairment moderates the impact of maternal favoritism/disfavoritism on the psychological well-being of adult sons and daughters. Third, Gilligan, Suitor and Ogle investigate the role of adult children’s care provision in the association between parents’ cognitive impairment and adult sibling tension, also using mixed-methods data from the WFDS. Next, Savla and Roberto use mixed-methods data to explore how extended family caregivers manage their care responsibilities and how care arrangements impact the provision of future care for persons living with ADRD. Finally, Gaugler considers the public health ramifications of family caregiving, summarizing the scientific literature on estimating the future supply of family caregivers, and presenting a research agenda to address the potential family care gap. Taken together, this diverse set of papers highlights the complex ways in which the presence of ADRD shapes patterns of care, relationship quality, and well-being of members of later-life families. This is a collaborative symposium between the Alzheimer’s Disease and Related Dementias and Family Caregiving Interest Groups.
THE LONELINESS OF LOW-INCOME OLDER ADULTS IN A FEDERAL VOLUNTEERING PROGRAM: A MIXED-METHOD NETWORK PERSPECTIVE
Authors: Cao Katy (Qiuchang) 
Published: December 2023

Abstract
Volunteering is considered an important way to prevent and address loneliness for community-living older adults by fostering social interactions. However, some social network studies conducted outside of the volunteering context suggest that increased interactions among lonely individuals can elevate network members’ loneliness through the co-rumination of negative emotions. To understand how and why interactions among older volunteers might protect against loneliness, this study conducted a concurrent mixed-method social network analysis among older volunteers within the Senior Companion Program (SCP) in Columbus, Ohio. These volunteers are 55 years or older, at or below 200% of the federal poverty line, and culturally/linguistically diverse. Qualitative and quantitative data were collected using focus groups and surveys respectively during an SCP monthly in-service training, N=41. A linear network autocorrelation model (LNAM) was constructed to quantify how individuals’ loneliness was correlated in SCP. A grounded theory approach informed the qualitative analysis. Mixed-method integration was conducted through a joint display table. LNAM results on the covariates were consistent with previous loneliness studies on diverse older adults. Furthermore, the negative network autocorrelation indicated that less lonely volunteers tended to interact with lonelier volunteers (ρ= -0.06, p&lt; 0.05). Qualitative results also supported the aforementioned socialization pattern suggestive of altruistic motivations. In other words, the altruistic tendency to interact with other volunteers differing in loneliness may be an important pathway by which volunteering addresses loneliness. Future research shall further examine the mechanism between volunteering and older adults’ psychosocial well-being. Findings have implications for maximizing the health and social benefits of volunteering.
A QUALITATIVE STUDY OF THE WRITINGS OF LONELY OLDER CHRONICALLY ILL ADULTS LIVING IN APPALACHIA
Authors: Theeke Laurie , Dowling Maritza , Hutto Lashawn , Odlum Michelle 
Published: December 2023

Abstract
Loneliness is a well-known growing public health risk that affects a large proportion of our aging population. The perspectives of older adults experiencing loneliness are essential to identify areas of potential support and intervention but have been understudied. We collected writings from older adults who participated in LISTEN intervention studies focusing on belonging, relationships, getting out in the community, challenges of loneliness, and finding meaning. Thirty-three community dwelling elders (81% female; mean age=71.77, SD=10.09 years) with multiple chronic conditions (mean number=2.63, SD=1.55) who reported high loneliness scores in the UCLA Loneliness Scale (mean=52.27; SD=8.302) contributed 50 minutes of writings or recordings (for those who were unable to write). These were accomplished in 10-minute increments during five weekly sessions of LISTEN. Thematic content analysis was conducted on the writings and the transcribed recordings. Five themes emerged: Lost Connections and Self-isolation, Empty Relationships, Life is Upside Down and Can’t Be Controlled, Doing Something is Better than Doing Nothing, and Loneliness is Haunting and Relentless. Participants admitted not reaching out to others, worried about being a burden, feeling lonely while with family, and ‘not being in the loop’. The downside of life was described as an uncertainty for the future and imminent functional decline. They described how loneliness ‘screams’ at you and is ‘always lurking’. Activities that ameliorated loneliness included painting, reading, crafting, puzzles, television, and faith activities. These findings will inform the refinement of the LISTEN intervention and the design of new interventions for loneliness.
THE MODERATING ROLE OF PURPOSE IN LIFE IN THE RELATIONSHIP BETWEEN DISCRIMINATION AND COGNITION
Authors: Farmer Heather , Ambroise Alexis 
Published: December 2023

Abstract
Discrimination is a source of chronic stress disproportionately experienced by Black adults that has been associated with worse cognitive outcomes in older adults. Few studies have explored modifiable resilience resources that may protect people from the possible negative impacts of discrimination on cognition. Sense of purpose refers to an individual’s perception of future-oriented goals and direction in life, and is a key resource associated with better cognition. However, no studies have explored whether greater purpose may buffer older adults against the negative impacts of discrimination on cognition or whether there are race differences in the stress-buffering impact of purpose on cognition. We use data from 9,775 Non-Hispanic White and 1,687 Black adults in the 2006 to 2016 waves of the Health and Retirement Study (HRS) to explore whether purpose in life moderates the association between everyday discrimination and cognitive functioning and whether this relationship varies by race. Discrimination was measured using the Everyday Discrimination Scale, which assesses how frequently an individual reports unfair and differential treatment (range, 0-5, where higher scores indicate more frequent discrimination). Multilevel linear regression models revealed that frequent discrimination was associated with worse cognition (b=-0.34, p&lt;.001), controlling for age, gender, race/ethnicity, region, and urbanicity. There was a significant discrimination x purpose interaction (b=0.16, p&lt;.001), suggesting that purpose may buffer the discrimination-cognition association. However, there was a non-significant discrimination x purpose x race interaction. This research suggests a strong sense of purpose can protect people from experiencing worse cognition when faced with frequent discrimination.
CARE-RESISTANT BEHAVIOR TRAJECTORIES OF PERSONS WITH DEMENTIA IN NURSING HOMES AND DISTAL OUTCOMES IN ORAL HEALTH
Authors: Xiao Chunhong , Puga Frank , Pickering Carolyn , Cain Cindy , Geisinger Maria , Jablonski Rita 
Published: December 2023

Abstract
Persons with dementia (PWD) who exhibit care-resistant behaviors (CRB) are likely to resist mouthcare and have poor oral health. This study aimed to examine predictors and describe the characteristics of CRB trajectories and their distal outcome in oral health among PWD in nursing homes (NH). Group-based trajectory modeling was used to analyze dynamic changes in CRB intensity over 21 days with two time-points (morning and afternoon) among 75 PWD. Sub-group analysis demonstrated the characteristics of each trajectory group membership. Distal-outcome models explored the association between oral health variation and mouthcare completion to CRB trajectories. The most influential predictors included CRB intensity at baseline, duration of mouthcare, and the number of antipsychotics prescribed. Three distinctive CRB trajectories were identified for both morning and afternoon in the context of mouthcare. Oral health status and the mouthcare completion rates differed by CRB trajectory groups, and worse oral health status was associated with higher level of CRB intensity trajectories. The High-start CRB groups had the worst oral health status and lowest mouthcare completion in both model estimation and pre-post test. Oral health showed improvement across all three trajectory groups. A tailored individual-level strategy based on a daily pattern of CRB intensity may provide the key to developing interventions that find the “sweet spot” between providing optimal mouthcare while minimizing CRB. Results imply that balancing CRB and mouthcare by providing morning-only mouthcare to those with high CRBs may allocate resources to PLWD most in need of mouthcare. Antipsychotics have not shown usefulness in managing CRB.
EMPOWERING ALL AGES THROUGH INTERGENERATIONAL CONNECTION AND LIFELONG LEARNING
Authors: Hollis-Sawyer Lisa , Donorfio Laura 
Published: December 2023

Abstract
This symposium will share a variety of pedagogical approaches designed to foster age-inclusivity and intergenerational learning. The authors will share research and outcomes of different educational designs utilizing intergenerational programming and other approaches to engage older and younger adult learners. The first presentation will explore how intergenerational discussions can be used in the classroom to facilitate collaborative learning among older adults, students, and instructors. The second presentation will discuss the development of a course abroad in Scotland called “Global Aging & Age-Friendly Initiatives,” aiming to promote intergenerational connection and global age-inclusivity. The third presentation will discuss “Between Islands,” an intergenerational virtual contact intervention designed to promote creativity and intergenerational connection between younger and older adults while challenging stereotypes about aging. The fourth presentation will explore the experiences of emeriti faculty in engaging online with Introduction to Gerontology students in a novel intergenerational classroom activity. The final presentation will review intergenerational classroom design guidelines to optimize multiple generations’ learning experiences, aging understanding/appreciation of others, and age-inclusivity. The empowerment and benefits of these efforts for the life-long learning of the generations involved will be discussed.
CANCER SURVIVORSHIP AND SUBJECTIVE COGNITIVE DECLINE IN THE US: RESULTS FROM A NATIONALLY REPRESENTATIVE SAMPLE
Authors: Brown Monique , Hucek Ally , Wei Jingkai , Anderson Loretta , Na Muzi 
Published: December 2023

Abstract
Cancer may be associated with objective cognitive decline. However, studies examining the link between cancer and subjective cognitive decline (SCD), which occurs earlier during cognitive trajectories, are lacking. In addition, research assessing risk factors for SCD among cancer survivors is scant. Therefore, this study aimed to examine the association between cancer and SCD in the past year, and assess the association between age of diagnosis, cancer treatment, and SCD among cancer survivors. Data were obtained from the 2021 Behavioral Risk Factor Surveillance System (N=15,447). Crude and adjusted logistic regression models, controlling for sociodemographic characteristics, were used to determine the association between cancer diagnosis, age at diagnosis, cancer treatment, and SCD. The association between ever having cancer and SCD in the past year was not statistically significant. However, disparities occurred among those who were cancer survivors. For example, those who were diagnosed with cancer in middle age (aged 35 to 44) had higher odds of SCD compared to being diagnosed at aged 45 and older (adjusted OR (aOR): 2.25; 95% CI: 1.10 – 4.58). Those who were currently undergoing treatment were more likely to have SCD compared to those who completed treatment (aOR: 1.86; 95% CI: 1.06 – 3.27). Respondents who had not started treatment and those who reported treatment was not necessary also had higher odds of SCD compared to those who completed treatment. Findings suggest that age and treatment disparities exist in SCD among cancer survivors. Future studies may include longitudinal observational studies examining cancer-related risks and SCD.
AGE DIFFERENCES IN SOCIAL NETWORK PREFERENCES: IMPLICATIONS FOR DECISION MAKING
Authors: Wild Tess , Löckenhoff Corinna 
Published: December 2023

Abstract
Many consequential decisions are made in the context of a social network, but it is not clear how lifespan developmental changes may influence the way people integrate others into their decision-making processes. Research shows that, compared to younger adults, older adults perform less exhaustive pre-decisional information searches, have smaller and more close-knit social networks, and place more value on harmonious relationships (e.g., Hess et al., 2015). Drawing on these findings, a pre-registered survey study examined age differences in the size, composition, and utilization of decision-related social networks as well as subjective goals and perceptions regarding joint decisions. An adult lifespan sample (N = 432; M age = 50.9375; SD age = 19.53267, range age = 18-96 years) considered hypothetical decisions involving specific (apartment, car, physician, and insurance plan) and generic (important vs. minor) scenarios. As predicted, linear regressions revealed that compared to younger respondents, older respondents reported that they would consult fewer people fewer times, and they were less likely to recruit distant social partners or professionals (ps&lt;.05). Contrary to predictions, the tendency to prioritize relationship harmony over decision quality was negatively associated with age (p&lt;.05). Further, there was no significant relationship between age and the perceived helpfulness of involving others. Findings remained robust when controlling for scenario type and demographic characteristics (gender, education level, race, income). This indicates that the size, composition, and utilization of decision-related social networks differs by age. Further research is needed to examine potential implications for decision quality and satisfaction.
NATIONAL POST–ACUTE AND LONG-TERM CARE STUDY: VARIATION IN OPERATING STATUS OF ADULT DAY CENTERS DUE TO COVID-19
Authors: Lendon Jessica , Singh Priyanka , Lu Zhaohui , Caffrey Christine , Sengupta Manisha 
Published: December 2023

Abstract
The 2020 and 2022 National Post-acute and Long-term Care Study (NPALS) captured nationally representative data on ADSCs’ operating statuses to mitigate COVID-19 among participants and staff. In 2020/2021, 35% of ADSCs were physically open and only served participants onsite, 32% were physically closed but serving participants at places of residence (i.e. virtually, meal delivery, home-visits), 20% served participants onsite and at places of residence, and 13% were temporarily closed and not serving participants. There was statistically significant variation in operating status by region, policy-relevant organizational and participant-level characteristics, and in the types of services provided. Discussion of results will highlight how NPALS data can be used to assess disparities in ADSC availability during the pandemic. Additional information from the forthcoming 2022 survey data will also be discussed, focusing on potential differences in operating status and ADSC characteristics between the two survey waves.
NURSING HOME SOCIAL WORK: CONFLICTING VALUES AND ETHICAL PRACTICE WITH RESIDENTS, FAMILIES, AND STAFF
Authors: Bern-Klug Mercedes , Gammonley Denise 
Published: December 2023

Abstract
People who live in nursing homes and those who spend weeks or months there recuperating from a hip replacement or stroke have a broad range of needs, many urgent and others enduring. Despite the high needs of residents—which have increased over the past decade as resident acuity has increased-- the settings are typically under-staffed both in terms of the number of direct care staff and the preparation of direct care staff (NASEM Report, 2022). Social workers and others in the social service role (i.e., those without a social work education) step into or are tapped to intervene when resident rights conflict with family wishes and/or staff rights and wishes. In this session using findings from both qualitative and quantitative studies, we will describe how and what type of conflicts social workers are involved with and the training they report they need to be better prepared to serve as a resource in this important role.
THE HEALTH CARE COSTS OF DEMENTIA FOR MEXICANS AND MEXICAN AMERICANS IN MÉXICO AND THE UNITED STATES
Authors: Anuarbe Mónika López , Gutierrez Angela 
Published: December 2023

Abstract
Dementia prevalence and costs affect subpopulations differently, generating healthcare and aging disparities. Most research on healthcare costs associated with dementia has overlooked cross-national comparisons among Hispanics in general and Mexicans in particular. This study utilizes the 2012-2018 Mexican Health and Aging Study (MHAS) and Health and Retirement Study (HRS) to assess: 1) relationships between geographic context and healthcare costs (hospitalization, medical, outpatient, prescription, dental); and 2) whether dementia status moderates the geographic context-healthcare costs relationship. We hypothesized that persons with dementia incurred higher healthcare costs in both countries, and that residents in less populated areas had lower healthcare costs than their counterparts. We used multivariable logistic regressions and generalized linear models, accounting for personal, healthcare access, and utilization factors. Results suggest that in 2012 (MHAS n = 15,723), persons with dementia in México had average healthcare costs that were 60.3% greater compared to those without dementia. Individuals with dementia also had a higher probability (11.9% p = 0.040) of incurring any healthcare costs in less densely populated areas (under 15,000 persons). In contrast, Hispanics participating in the HRS during that period (n=15,567), 58% of whom were of Mexican origin, did not have higher total healthcare costs if diagnosed with dementia, but incurred larger expenses in rural areas compared to their urban counterparts (p&lt; 0.001). These results underscore how geographical context varies across countries and how dementia status can leave some individuals more financially vulnerable than others, affecting their access to healthcare services and overall health.
METHODS AND BASELINE CHARACTERISTICS FOR THE TECHSAGE TELE TAI CHI CLINICAL TRIAL
Authors: Mitzner Tracy , Mumma Kara , Remillard Elena 
Published: December 2023

Abstract
Individuals aging with long-term mobility disabilities encounter a range of significant barriers to participating in physical and social activities, from challenges with transportation, to lack of accessibility and access to appropriate instruction. We developed a Tai Chi telewellness intervention to facilitate both physical and social wellness through accessible, virtual group classes. The intervention translated an in-person, evidence-based tai chi program (Tai Chi for Health Institute’s Tai Chi for Arthritis) to be 1) a virtual experience (via Zoom) that includes a social component and 2) accessible and appropriate for those aging with mobility disabilities. We conducted the TechSAge Tele Tai Chi clinical trial to examine the effect of the intervention on physical activity and social connectedness (primary outcomes), as well as exercise self-efficacy, falls efficacy, depression, quality of life, and pain (secondary outcomes) for this population. The participant sample was community-dwelling adults (60-80 years of age) with a self-identified mobility disability (i.e., using a mobility aid or having serious difficulty walking or climbing stairs) for at least 10 years. The presentation will describe the rationale for the study, as well as the study design, methodology, and baseline data for the trial. We will also highlight the user-centered, iterative design approach we used in the design and evaluation of the intervention protocol.