bluuebunny/crossref_metadata_2025_split huggingface dataset:
REMOTE ASSESSMENTS OF EMOTIONAL FUNCTIONING FOR INDIVIDUALS WITH DEMENTIA AND THEIR CAREGIVERS
Authors: Brown Casey , Chen Kuan-Hua , Scheffer Julian , Paul Deepak , Levenson Robert 
Published: December 2023

Abstract
Emotional impairments are a common symptom of neurodegenerative disorders that can be devastating for persons with the dementia (PWDs) and family members who provide care (i.e., caregivers). Emotional functioning can be well characterized and quantified using laboratory assessments of behavioral, physiological, and self-reported responses to emotional stimuli. However, continuous declines in functioning make it especially difficult for PWDs and caregivers to visit a research laboratory repeatedly over time. In order to understand changes in emotional functioning across time and their impact on PWDs and caregivers longitudinally, there is a need for technology to support remote assessments of emotional functioning. We developed a portable version of laboratory assessments—Laboratory in a Suitcase Assessment (LISA)—to collect data from PWDs and their caregivers remotely in their homes. In a shippable suitcase, LISA provides the necessary equipment for: (a) presenting emotional stimuli via laptop screen and headphones; (b) obtaining audio and video recordings of participants’ behavior; (c) obtaining continuous ratings of emotional experience via a rating dial; (d) measuring cardiovascular, electrodermal, and somatic responses from PWDs and caregivers via wearable devices; (e) synchronizing behavior and physiology; and (f) maintaining two-way communication with participants via Zoom. We present high quality physiological, behavioral, and self-report data collected using LISA with 17 PWD-caregiver dyads. Data collected with LISA are comparable to data collected in the laboratory, indicating that LISA could enable researchers to continue data collection further into the course of disease when travel to in-person laboratory sessions would no longer be feasible.
ASSESSMENT OF OLDER ADULTS’ BEHAVIORAL SYMPTOMS AND THEIR SOCIAL BEHAVIORS USING SURVEYS AND A TECHNOLOGY PLATFORM
Authors: Au-Yeung Wan-Tai , Miller Lyndsey , Lindauer Allison , Rodrigues Nathaniel , Guerrero Cierra Leon , Gothard Sarah , Beattie Zach , Kaye Jeffrey 
Published: December 2023

Abstract
Behavioral symptoms are highly prevalent during the course of cognitive decline associated with dementia. Studies have shown that the social environment may affect these symptoms. Data sources examining the effect of environment come from two ongoing studies: 1) MOnitoring DEmentia-Related Agitation Using Technology Evaluations (MODERATE), focusing on agitation in individuals with later-stage dementia, and 2) Monitoring Apathy, Depression and Anxiety Using Technology Evaluations (ADA), focusing on apathy, depression and anxiety in older adults with or without cognitive decline. To date, a total of 9 dyads have enrolled in MODERATE while a total of 9 participants have enrolled in ADA. Caregivers (MODERATE) and participants with cognitive impairment (ADA) report symptoms via weekly online surveys. MODERATE integrates a modified Cohen-Mansfield Agitation Inventory-Short Form series of questions regarding weekly agitation-related levels/events. The ADA weekly online survey consists of Withdrawal-Apathy-Vigor, a subscale from Geriatric Depression Scale-30, a 4-item depression subscale from Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29), and a 4-item anxiety subscale from PROMIS-29. A multi-sensor array (bed pressure mats, motion sensors, and wearables) is deployed in homes to objectively measure participants’ behaviors. With this array, duration of time-out of home, duration of simultaneous activities detected in more than one room, and the total number of occupants and pets within the home are extracted. Additionally, weekly online surveys inquire as to whether participants have been out of town or have overnight visitors. Associations between social activity and behavioral symptoms are obtained combining digital behavioral-activity biomarkers with frequently reported online behavioral data.
A THREE-TIER EXAMINATION OF RACIAL DISPARITIES IN PAIN AT THE END OF LIFE
Authors: Suntai Zainab , Beltran Susanny , McMullen Elyse 
Published: December 2023

Abstract
Over the past few decades, research focused on improving end-of-life outcomes has burgeoned within the field of gerontology. Pain is one of the most common symptoms assessed at the end of life and research has shown that Black and Hispanic older adults are significantly more likely to experience pain compared to White older adults. However, few studies have sought to describe racial/ethnic differences in help-seeking behavior for pain and satisfaction with pain management among older adults. This study employed a three-tier approach by investigating 1) differences in the experience of pain at the end of life, 2) differences in help-seeking behavior for pain at the end of life, and 3) differences in satisfaction with pain management at the end of life. Data were derived from the combined 2012 to 2020 last-month-of-life interviews as part of the National Health and Aging Trends Study. Using a multivariate logistic regression model, results showed that Black and Hispanic older adults were more likely to experience pain at the end of life, less likely to have received help for their pain, and less likely to report that they were satisfied with the level of help received. These results point to a disparity in not only the level of pain experienced at the end of life, but the treatment and quality of pain management. Implications for aging research, policy, and practice are discussed.
GENDER INEQUALITIES IN THE DISRUPTION OF LONG-TERM LIFE SATISFACTION TRAJECTORIES DURING COVID-19
Authors: Moreno-Agostino Dario , Das-Munshi Jayati , Ploubidis George 
Published: December 2023

Abstract
Evidence suggests that women’s mental health has been disproportionately impacted by the COVID-19 pandemic. Time-use differences have been hypothesised as an explanatory factor, as women generally spent more time than men on psychologically taxing activities. We used data on life satisfaction spanning 25 years (1996-2021, age 26-51) from a birth cohort representing adults born in Britain in 1970 (n=6,766). We used piecewise latent growth curve models to study gender differences in the long-term trajectories of life satisfaction and in the impact of the pandemic onset on these trajectories, and whether time-use differences partly explained that differential impact. Women had consistently higher life satisfaction levels prior to the pandemic (Δintercept,unadjusted=0.204 [95% CI: 0.073, 0.336], p=.002), and then experienced a more accelerated decline with its onset (Δquad2,unadjusted=-0.019 [-0.026, -0.011], p&lt;.001). This gap remained stable after accounting for time use differences (Δquad2,adjusted=-0.019 [-0.028, -0.011], p&lt;.001). Nevertheless, time spent working was positively related to life satisfaction in women but negatively in men (Δworking1-8h=0.499 [-0.168, 0.829], p= .003; Δworking&gt;8h=0.543 [0.185, 0.902], p=.003), whereas time spent doing housework was negatively related to life satisfaction in women but positively in men (Δhousework1h=-0.723 [-0.749, -0.045], p=.027). Results were robust to adjustment for the concurrent financial situation. Our study shows gender inequalities in the impact of the pandemic on the long-term life satisfaction trajectories of adults in their 50s and suggests that time-use differences do not explain these inequalities. Further research on the mechanisms underlying the differential impact of the pandemic across genders in positive mental health is needed.
BLENDED GAMING COVID-19 TRAINING SYSTEM (BGCTS) FOR RESIDENTIAL CARE HOMES: A CLUSTER RANDOMIZED CONTROLLED TRIAL
Authors: Leung Angela Y M , Lau Terence , Leung Doris Y P 
Published: December 2023

Abstract

Objective
This study aims to assess the effect of the Blended Gaming COVID-19 Training System (BGCTS) on infection control practices, compliance rates and knowledge of standard precautions among all staff in residential care homes (RCHs). Design: A 2-arm single-blinded cluster randomized controlled trial. Setting: Thirty RCHs were recruited and randomized. Due to COVID-19 pandemic and there were infected cases in the homes, 17 RCHs refused or delayed the on-site observations. Participants: 212 staff (from 13 RCHs) were randomized to the intervention group (IG) or the control group (CG) according to their RCHs. Intervention: This is a blended mode of training with contents derived from WHO and local guidelines.

Results
After using the BGCTS , the use of gloves and personal protective equipment (PPE) was significantly improved in IG than that of CG (F=43.206, p&lt; 0.001). The IG has significantly higher scores in self-reported infection control practices (SICP) than that of CG (β= 2.619, Wald χ2 95% CI [4.291, 9.426]).

Discussion
BGCTS improved RCH staff’s performance in infection control practices. BGCTS was shown to be an effective training and it is worth to consider for adopting it as routine training for all staff in residential care homes.
VISITATION SHELTERS FOR THE LONG-TERM CARE SETTING DURING THE PANDEMIC: AN EXPLORATORY STUDY
Authors: Porter Michelle , Mallory-Hill Shauna 
Published: December 2023

Abstract
In 2020, the province of Manitoba in Canada devised a plan to provide external visitation shelters for long-term care (LTC) facilities. The intent of the shelters was to alleviate the problems with visitor restrictions due to the COVID-19 pandemic. Dozens of visitation shelters, which were re-purposed shipping containers, were installed at facilities across the province. The purpose of this research was to: examine the experiences of the users through online surveys; make field measurements of the conditions (CO2 values, lighting, acoustics); and conduct an environmental scan of documents (government, media, etc.). Media and government documents provided insights into: design considerations; timing of installation/use; policies and procedures; how much they were utilized; as well as constraints. Survey findings from family/friends (n=20), LTC staff (n=9) and a resident (n=1) revealed that while many agreed that the shelters made a difference for their emotional well-being, many felt that the shelters did not support meaningful connections between residents and visitors. Furthermore, many respondents described the shelters as institutional/sterile and suggested that the décor should be improved to make them homier. Field measurements showed that the ventilation system ensured that CO2 values remained low, indicating that substantial fresh air exchange occurred. Acoustic values indicated that there could be challenges with residents hearing visitors. Lighting values demonstrated that color temperature was appropriate, but lux values were relatively low depending on the specific location in the shelter. Overall, this study was able to outline the advantages and disadvantages to using external visitation shelters in a pandemic situation.
HOW PATTERNS OF INTERGENERATIONAL SUPPORT RECEIVED PREDICT FUTURE PROVISION OF CARE? EVIDENCE FROM CHINA
Authors: Zhang Yinkai , Chen Yu-Chih 
Published: December 2023

Abstract
Intergenerational support refers to the exchange of financial, emotional, and physical support between generations. The types of support that older adults receive can influence their willingness to provide care in the future. However, there is limited knowledge about the different patterns of support that older adults receive. Examining these patterns can provide insight into how older adults contribute to future financial, emotional, and physical support. Using data from 5,388 older adults aged 60 and older from the China Health and Retirement Longitudinal Study, latent profile analysis was used to explore the patterns of received support. The associations between the patterns and provisions of financial, emotional, and physical support were examined using lagged OLS regression. Results showed that three patterns of received support were identified based on financial and physical aspects: financially and physically disadvantaged (low financial and physical support), engaged but financially disadvantaged (low financial but high physical support), engaged but physically moderate (high financial and medium physical support). Compared to the financially and physically disadvantaged group, those who were engaged but financially disadvantaged offer more financial and emotional support but less physical support, whereas engaged but physically moderate groups are more likely to provide emotional care. Findings suggest that policies and programs should consider the different patterns of support that older adults receive to promote more balanced support across different generations.
REDUCING FINANCIAL TOXICITY IN THE HEALTH CARE SYSTEM USING COST ESTIMATION TOOLS FOR OLDER ADULTS
Authors: Gelburd Robin 
Published: December 2023

Abstract
Financial toxicity— the financial, emotional and mental burden patients experience with medical costs that can lead to diminished access to care and reduced quality of life—is a growing issue among older adults, family caregivers and care partners. Research suggests that financial health literacy tools may reduce financial toxicity. With support from The John A. Hartford Foundation, FAIR Health undertook an 18-month initiative to advance shared decision making (SDM) among older adults (aged 65 and older) with serious health conditions, and their family caregivers/care partners, through the development and dissemination of decision aids that combine clinical and cost information with resources and educational content; these tools are offered for free to consumers on fairhealthconsumer.org and to healthcare providers on fairhealthprovider.org. This presentation will discuss salient findings from the initiative, as detailed in the brief, Advancing Shared Decision Making among Older Adults with Serious Health Conditions: Lessons from FAIR Health’s Grant-Funded Initiative. Feedback from older patients, caregivers/care partners and providers revealed the demand and need for financial health literacy tools that provide cost information and underscored key insights that included: (1) Healthcare costs, billing and lack of transparency in the healthcare system are sources of frustration; (2) Barriers to SDM include low health literacy and poor access to devices; and (3) SDM is viewed by many as a vehicle for patient empowerment. The session will offer a unique insight into how these findings can be used to usher in a new paradigm of healthcare and retool clinical practice and medical education.
WHO, HOW, AND WHEN DOES PRIMARY CARE USE THE 4MS? CLINICIAN PERSPECTIVES OF THE AGE-FRIENDLY FRAMEWORK IN AN FQHC
Authors: Knecht-Fredo Jenny , Husser Erica , Fick Donna , Hogue Angela , Mulvihill Marie , Lorelli Lisa 
Published: December 2023

Abstract
Older adults are at higher risk of living with multiple chronic health conditions and confront health care systems ill-prepared to manage the underlying complexities of providing care to older people. The Geriatric Workforce Enhancement Program (GWEP) aims to transform primary care to improve the health of older adults. Our GWEP is a collaboration between the Penn State College of Nursing and Pennsylvania’s largest Federally Qualified Health Center (FQHC), the Primary Health Network (covering 16 counties [13 rural]). We aim to disseminate the 4Ms of an Age-Friendly Health System (What Matters, Medication, Mentation, and Mobility). Although AFHS is being disseminated across the nation, there is little research regarding clinicians’ perspectives of the 4Ms framework in primary care. After 3 years of program delivery, we administered a PHN system-wide survey to 614 employees with 307 returned (50% response rate) regarding 4Ms knowledge, clinicians’ responsibilities, timing of assessments, how results inform care, perceptions on the role of the electronic medical record (EMR), competence, barriers, and facilitators to providing Age-Friendly care. Analysis includes a subset of 40 registered nurses (n=21) and nurse practitioners/physician’s assistants/physicians (n=19). Results suggest the medical providers were perceived as most likely to assess What Matters and Medication and multiple team members assessed Mentation and Mobility. 65% either agree or strongly agree that the EMR should prompt them to review the 4Ms with their patients. Survey results provide understanding of the barriers, specific roles, workflows, and EMR alterations needed to implement AFHS care into the busy culture of primary care clinics.
IMPACT OF ENVIRONMENTAL CHARACTERISTICS ON SELF-RATED HEALTH AMONG THE VERY OLD IN GERMANY DURING THE COVID-19 PANDEMIC
Authors: Zimmermann Jaroslava 
Published: December 2023

Abstract
Current research demonstrates negative impact of COVID-19 pandemic on health. Nevertheless, there is evidence that older population might be more resilient against the effect of pandemic than younger adults. Since very old adults are often underrepresented or excluded from these studies, the aim of this paper was to examine the link between environmental characteristics and self-reported health in very old population in Germany during COVID-19 pandemic. Data from the representative survey “Old Age in Germany” of the population aged 80 and older were used. The study sample included 10,578 community-dwelling as well as institutionalized persons. Multilevel analysis was conducted to investigate the association of environment characteristics on individual, and community level with self-rated health. The results showed that higher perceived walkability of outdoor environment, better housing condition, being closer attached to home environment, higher neighborhood trust, and living in a house increased self-rated health (individual level). On community level, residency in one of the communities in western Germany (compared to eastern Germany) was associated with better self-rated health. 35% of the variance in self-rated health was explained at individual and 21% at community level. The findings revealed that very old adults who lived in better home environment experienced better health during the COVID-19 pandemic in Germany. These findings may indicate that the capacity of the very old to adapt to health losses depends on available environmental resources. Therefore, improvements of home environment inside and outside of houses and apartments (e.g., ensuring barrier-free accessibility) may strengthen the resilience in later life.
RECIPROCAL RELATIONSHIP BETWEEN FAMILY, FRIENDS, AND COGNITIVE HEALTH AMONG OLDER ADULTS IN CHINA
Authors: Yu Xinfang 
Published: December 2023

Abstract
Existing research links perceived social support from family and friends to cognitive health in later life. Yet we know less about how cognitive functioning may also shape social support and whether these reciprocal relationships vary between rural and urban areas, especially in China where rural-urban migration is common. This study investigates: (1) whether family support and friendship support help maintaining cognitive functioning, (2) whether cognitive functioning improves perceived family support and friendship support, and (3) whether and how these relationships differ between rural and urban areas. I estimate cross-lagged panel models with a sample including 9,553 adults aged 60 years and above, from two waves of the China Longitudinal Aging Social Survey (CLASS). Results show that cognitive functioning was positively associated with perceived friendship support, regardless of the area of residence. There was a reciprocal relationship between friendship support and cognitive functioning only for rural older adults, with friendship support predicting lower cognitive functioning for urban older adults. Findings suggest that rural and urban context matter – perceived social support, whether from friends or family, may have different implications for the cognitive health of older Chinese adults depending on where they live.
ANXIETY AND MEMORY COMPLAINTS IN MIDDLE-AGED AND OLDER ADULTS: THE MODERATING ROLE OF PHYSICAL ACTIVITY
Authors: Costa Amy , Curtis Ashley 
Published: December 2023

Abstract
The relationship between anxiety and memory complaints is well established. Additionally, physical activity has been shown to improve anxiety symptoms and cognition. Little research, however, has examined if physical activity impacts associations between anxiety and memory complaints in cognitively healthy middle-aged and older adults. Given memory complaints are often the first indicator of subsequent cognitive decline, it is important to understand factors that impact complaints. The present study tested whether physical activity moderated associations between anxiety and memory complaints. Adults aged 50+ (N=271, Mage=64.5, SD=7.8, 124 women) completed the International Physical Activity Questionnaire, Hospital Anxiety and Depression scale (HADS), and the Cognitive Failures questionnaire (CFQ). Multiple linear regressions and simple slope analyses were conducted to examine if physical activity moderated associations between anxiety and memory complaints (CFQ-memory), covarying for age, sex, income, difficulty walking, number of medical conditions, number of medications, body mass index, and depressive symptoms (HADS-depression). Results revealed total physical activity (R2-change=.01, p=.04), vigorous activity (R2-change=.02, p=.02), and walking activity (R2-change=.01, p=.03) moderated associations between anxiety and memory complaints. Specifically, higher anxiety was associated with more memory complaints at all levels of physical activity, with the magnitude of the effect largest at highest levels of physical activity. The present findings suggest higher amounts of physical activity may exacerbate the relationship between anxiety and memory complaints. It is possible aging adults with greater perceived memory disruption experience more anxiety and engage in health enhancing behaviors, such as physical activity. Future studies should explore temporal patterns of this relationship.
COGNITION TRAJECTORY AND DISABILITY AMONG OLDER AMERICAN COUPLES: THE MEDIATING ROLE OF DEPRESSIVE SYMPTOMS
Authors: Kong Dexia , Lu Peiyi , Jiang Da , Chan Helen 
Published: December 2023

Abstract

Background
Using a dyadic approach, this study examined the mediating effect of depressive symptoms on the longitudinal relationships between husbands’ and wives’ memory trajectories and their prospective disability status. Method: Longitudinal data from Health and Retirement Study 2004-2018 were used. Older (aged 50+) heterosexual couples married for 5+ years and had no limitations on activity of daily living at baseline (2004) were included (N=1,310). Latent class growth analysis grouped wives and husbands into distinct memory trajectories in 2004-2014. Structural Equation Model examined the actor and partner effects of memory trajectories on depressive symptoms in 2016 and disability status in 2018. The mediating effect of depressive symptoms was tested.

Results
Four distinct trajectories were found: persistently high (wives: 11.83%; husbands: 3.83%); high and slow decline (wives: 36.26%; husbands: 33.66%); moderate and slow decline (wives: 41.30%; husband: 47.97%); low and rapid decline (wives: 10.61%; husbands: 14.54%). Only the wife’s low and rapid decline memory trajectory predicted her own more depressive symptoms (β=0.588, 95% CI=0.209, 0.967) and her husband’s more depressive symptoms (β=0.326, 95% CI=0.004, 0.648). Meanwhile, depressive symptoms had strong and significant actor effects on disability (β=0.046, 95% CI=0.036, 0.057 in the wife’s outcome; β=0.060, 95% CI=0.046, 0.074 in the husband’s outcome).

Conclusions
Wife’s low and rapid decline trajectory was associated with her own and her husband’s more depressive symptoms, which in turn increased the disability risk of both partners. Detection and treatment of cognitive decline among wives have the potential to mitigate the couples’ depressive symptoms and ultimately disability risks.