bluuebunny/crossref_metadata_2025_split huggingface dataset:
PHYSICAL SYMPTOMS REACTIVITY TO DAILY STRESSORS AND CARDIOVASCULAR DISEASE: A COMPARISON OF BLACK AND WHITE ADULTS
Authors: Moore Sebastiana , Smith Claire , Mu Christina , Lee Soomi 
Published: December 2023

Abstract
Black adults have higher risk for cardiovascular disease (CVD) compared to their White counterparts. Biopsychosocial frameworks suggest that this racial difference may not only be due to higher stressor exposure (e.g., discrimination) but also to stressor reactivity (i.e., heightened automatic reactions to stressors). This study examined if racial disparities in CVD is explained by elevated physical symptoms in response to daily stressors (“physical symptom reactivity to stressors”). Data came from 1,727 adults (non-Hispanic Black=38%, non-Hispanic White=62%) who participated in the Midlife in the United States Study at Time-1 (T1: 2004-2009). A subset (n=1,482) was reassessed at Time-2 (T2: 2013-2019). Race, daily physical symptoms, and daily stressors were measured at T1. Physical symptom reactivity to stressors (i.e., individual slope of physical symptoms as a function of daily stressor severity) was calculated using 8-day diary data. Physician-diagnosed CVD was captured at T1 and T2. Indirect pathways (A path: race-&gt;stressor physical reactivity, B path: race-&gt;CVD) were tested, adjusting for health and sociodemographic covariates. At T1, Black adults exhibited a higher risk of CVD compared to White individuals through higher physical symptom reactivity to stressors (A path: B=0.004, SE=0.0006, p&lt;.001; B path: B=-3.56, SE=1.32, p=.007; indirect effect=0.12, SE=0.03, 95% CI=[0.06, 0.18]). These indirect pathways were also supported when predicting the risk of CVD at T2 after controlling for T1 CVD (B path: B=-3.23, SE=1.56, p=.038; indirect effect=0.07, SE=0.04, 95% CI=[0.02, 0.16]). Findings newly suggest that racial differences in physical manifestations of stress may contribute to disproportionate development of CVD, the deadliest disease in America.
PSYCHOSOCIAL RISK, SUBCLINICAL CVD, AND BRAIN VOLUMES: EXAMINING SEX DISPARITIES IN DEMENTIA RISK
Authors: Wright Regina , Bygrave Desiree 
Published: December 2023

Abstract
The majority of the sex disparity in dementia remains unexplained. One potential risk factor for women’s higher incidence of dementia is subclinical cardiovascular disease (SCVD), including carotid atherosclerosis and arterial stiffness. To date, there is a significant gap in what is known about sex differences in the impact of psychosocial risk on pre-dementia risk factors both directly and via SCVD. Therefore, this study aimed to examine the mediating influence of SCVD on the relationship between psychosocial risk and brain volumes, as a proxy for pre-dementia risk, and whether the relationship is moderated by sex. The analysis included 136 older adults with a mean age of 68.04y who underwent neuropsychological, psychosocial, and vascular assessment (pulse wave velocity [PWV], carotid intima media thickness [IMT]), and 3T cranial magnetic resonance imaging. Moderated mediation analyses, adjusted for age and education, showed a mediating role of PWV in the relation of loneliness to total brain volumes (global measure of atrophy) was more pronounced among women (average causal mediation effect [ACME]=.44; p=.11). Unadjusted analyses trended toward moderated mediation, such that the mediating role of carotid IMT in the relation of anxiety to total WMLV (ACME=.001; p=.06) and total frontal WML volumes (ACME=.001; p=.05) was more pronounced among women than men. Findings suggest that in women, but not men, psychosocial risk factors may influence brain volumes via subclinical CVD. Additional research is needed to determine if these interrelations help to explain some of the sex disparity in dementia risk.
URBAN–RURAL DISPARITIES IN CHRONIC DISEASE PROGRESSION AMONG CHINESE OLDER ADULTS
Authors: Zhao Yuanchang , Kelley Jessica 
Published: December 2023

Abstract
Over the last thirty years, China has experienced rapid increases in the prevalence of hypertension and diabetes, across urban and rural areas. Studies do indicate that the prevalence rates both hypertension and diabetes are higher in urban areas than in rural areas, seeming to indicate higher chronic disease burden among urban older adults. Few studies, however, focus on the progression of hypertension and diabetes once diagnosed. Given the likelihood of under-diagnosis in rural areas, the aim of our study is to examine urban-rural disparities in the progression of hypertension and diabetes among older Chinese who have been diagnosed with either or both conditions. We utilize two waves of the CHARLS, examining adults over age 50 (n=5,067). Our findings confirm that rural older adults are less likely to be diagnosed with diabetes or hypertension than urban older adults, net of other risk factors. Among those with a diagnosis, and controlling for whether they received treatment, the nested logistic regression models indicate that rural older adults report 32% higher odds of worsening hypertension compared to their urban counterparts. Likewise, the odds of worsening diabetes are 52% higher in rural older adults than in urban older adults. Our findings indicate that although rural older adults are less likely to have a diagnosis of diabetes or hypertension, among those with a diagnosis, rural older adults tend to be sicker and worsen more quickly. We discuss the implications of rural-urban disparities in access to health care and treatment.
CHINESE AMERICAN FAMILY CAREGIVERS’ PERCEPTIONS OF HOME CARE AND FACILITY CARE FOR LOVED ONES WITH ADRD
Authors: Li Chien-Ching , Paun Olimpia , Gao Xiaojun , Lei Xiao Ying 
Published: December 2023

Abstract
Cognitive decline and impairment among older adults are significant public health concerns because they lead to increased disability, caregiver burden, and healthcare costs associated with the treatment of declining cognitive function. The Chinese American population, the largest Asian group in the US, is aging rapidly, and it is expected that older Chinese Americans and their caregivers will increasingly need ADRD care planning for home care and facility care. Therefore, the goal of this study is to examine the beliefs and attitudes of Chinese American family caregivers regarding home care and facility care for their loved ones with ADRD. In our study, N=17 Chinese American caregivers were recruited to participate in the study interview through a partnership with the Alzheimer’s Program at the Chinese American Service League. The mean age of the caregivers was 49.6 years, and the majority were female, married, had college degrees or higher, and reported being in good health. Results indicated that most ADRD patients needed medium or high levels of care and were cared for at home. Chinese American caregivers were reluctant to place their loved ones in facilities, such as nursing homes or memory care centers, due to high costs, poor quality of care, language barriers, and Chinese filial piety. Additionally, most Chinese caregivers lacked knowledge regarding the types of home care and facility care and the services provided. Therefore, future development of culturally and linguistically targeted interventions for ADRD care planning is necessary for Chinese American patients with ADRD and family caregivers.
DIFFERENTIAL MRI ATROPHY PROFILES IN OLDER ADULTS WITHOUT DEMENTIA FROM AGING STUDIES IN THE US AND CZECH REPUBLIC
Authors: Nelson Monica , Small Brent , Nedelska Zuzana , Lerch Ondrej , Vyhnalek Martin , Andel Ross , Hort Jakub 
Published: December 2023

Abstract
Alzheimer’s disease is a progressive neurodegenerative disorder with extensive neuropathological heterogeneity. We aimed to identify distinct latent subgroups of neuropathology and differentiate them using sociodemographic, contextual, and cognitive factors. Participants without dementia from the Alzheimer’s Disease Neuroimaging Initiative (ADNI; n=1703) and the Czech Brain Aging Study (CBAS; n=385) were included. Latent profile analysis was used to detect profiles using 10 volumetric structural magnetic resonance imaging regions of interest derived using Freesurfer algorithm (hippocampus, middle temporal, superior temporal, precuneus, anterior cingulate, medial orbitofrontal, pericalcarine, precentral, lingual, and caudate regions). Four profiles emerged in ADNI: Minimal Atrophy (n=192), Mild Atrophy (n=691), Moderate Atrophy (n=567), Severe Atrophy (n=253). Two profiles emerged in CBAS: Mild Atrophy (n=208) and Severe Atrophy (n=177). For all but the caudate region, there were significant pairwise differences in volumetry between each profile. Further, Minimal Atrophy was the youngest, had the highest proportion of participants with normal cognition, had the lowest progression to dementia, and the best cognition compared to all other groups – the remaining pairwise comparisons suggested that participants were older, more likely to have mild cognitive impairment, progress to dementia, and have poorer cognition, transitioning from Mild to Moderate to Severe Atrophy. Findings were consistent in CBAS. In ADNI, Minimal and Mild Atrophy had higher education and premorbid abilities compared to Moderate and Severe Atrophy. In CBAS, Mild Atrophy had better premorbid abilities compared to Severe Atrophy. Biological heterogeneity among older adults without dementia should be considered to understand who may be at risk of cognitive decline.
RELATIONSHIP-TYPE DIFFERENCES IN SUPPORT SEEKING AND MENTAL HEALTH FOR ADULT CHILDREN OF PARENTS WITH MEMORY LOSS
Authors: Gad Dustin , Monin Joan 
Published: December 2023

Abstract
Research shows that midlife children still rely on their parents for emotional and tangible support, which has implications for their mental health. Little is known about how these dynamics change when a parent enters the early stage of dementia or memory loss. One characteristic that may be important for these dynamics is the relationship-type (daughter-mother (n= 82), daughter-father (n= 29), son-mother (n=17), son-father (n= 14)). As part of a larger study, adult children 18 years of age and older (n= 142) completed self-report surveys including measures of emotional and tangible support seeking from their parent (Feeney, 2004), the 10-item CESD (Orme et al., 1986), the 12-item Zarit Burden Inventory (Bédard et al., 2001), and the PANAS (Watson et al., 1988). Results showed that tangible and emotional support seeking levels were low across all dyad-types, with no differences between groups. There was a trend for depressive symptoms (F= 2.559, p= .058) showing more in daughter-father than in son-mother dyads. Daughter-father dyads were the only group meeting the depression cut-off score. There were significant differences for burden (F= 3.377, *p= .020) with more burden in daughter-mother compared to son-father dyads. For the PANAS (F= 2.926, *p= .036), there was more negative affect in daughter-father compared to daughter-mother dyads. Results suggest that the relationship-type of the adult child and parent matters for mental health in the early stages of memory loss. This has implications for dyadic interventions helping adult children and their parents cope in the early stages of the dementia caregiving journey.
PAIN MEDICATION AND FALL RISKS AMONG COMMUNITY-DWELLING OLDER ADULTS WITH ARTHRITIS
Authors: Yoshikawa Aya , Fortinsky Richard 
Published: December 2023

Abstract
Pain medication is commonly used among older adults with arthritis. Research indicates an elevated fall risk among older adults with arthritis, yet this association among those who take medication for pain is not fully studied. This population-based study investigated the association of falls with pain medication use by arthritis status. A sample of community-dwelling Medicare beneficiaries in the 2015 National Health and Aging Trends Study, representing older adults who reported arthritis (n = 4,229) and no arthritis (n = 3,258), were analyzed using survey-weighted logistic regression analysis. Sensitivity analysis was performed to investigate differences in associations by the frequency of taking pain medication. All analyses were controlled for sociodemographic characteristics, living arrangements, balance problems, and chronic conditions. The majority of participants was 70 years or older (70.7%), female (55.3%), White (80.1%), had a high school or higher education (58.4%) and had two or more chronic conditions (53.6%). Significantly higher proportions of those with arthritis reported pain (67.9% vs. 32.1%) and pain medication use (63.1% vs. 36.9%) than those with no arthritis. Pain medication use (OR = 1.11, 95% CI: 1.03, 1.20) and balance problems (OR = 4.39, 95% CI 3.45, 5.59) were associated with falls among those with arthritis. Taking medication for pain every day a week (OR = 1.48, 95% CI: 1.05, 2.09) was associated with falls among those with arthritis. Findings suggest that the heavy use of pain medication may increase fall risk. Nonpharmacological pain management education is encouraged for supporting active living among older adults with arthritis.
CREATION OF A FAMILY CAREGIVER NEGOTIATION TRAINING PROGRAM USING ARTIFICIAL INTELLIGENCE
Authors: Murawski Alaine , Ramirez-Zohfeld Vanessa , Schierer Allie , Ramirez Ana , Mell Johnathan , Brett Jeanne , Lindquist Lee A 
Published: December 2023

Abstract
Family caregivers of people with dementia (PWD) experience conflicts as they navigate the healthcare system but do not have adequate training to resolve these disputes. We sought to develop and pilot test an artificial-intelligence negotiation training program, NegotiAge, for family caregivers. With NIH funding [R01AG068421], we convened a team of negotiation experts, geriatrician, social worker, and community-based family caregivers (Illinois/Florida/New York/California). Content matter experts created informational videos to teach negotiation skills. Family caregivers generated dialogue surrounding caregiver conflicts. Computer science experts input generated dialogue into the Interactive Arbitration Guide Online (IAGO) platform to develop avatar-based agents (e.g. sibling, older adult, physician) for caregivers to practice negotiating. Family caregivers review didactic material then access scenarios to negotiate (e.g. physician recommendations, sibling disagrees with care, PWD refusing support). Caregivers negotiate in real-time with avatars designed to act like humans, including emotional and irrational behaviors. Caregivers can use negotiation tactics until either mutual agreement occurs or time expires. Immediate feedback is generated from the responses chosen and tactics to assist with the negotiation skills training. Pilot testing was conducted with family caregivers of PWD (n=12) and showed that the negotiation and conflict resolution training program was feasible and usable for family caregivers. Subjects found the program to present real-world applicability. NegotiAge is an Artificial Intelligence-based Caregiver Negotiation Program, that is usable and feasible for family caregivers to become familiar with navigating conflicts seen in caring for PWD.
DEVELOPMENT OF AN ONLINE DISASTER PREPAREDNESS PROGRAM FOR CAREGIVERS OF PERSONS WITH DEMENTIA
Authors: Donohoe Maria , Ostrem Nicholas , Rudzianski Nicholas , Gay Jane , Smith Brigid , Wunderlich Tiffany , Ashida Sato 
Published: December 2023

Abstract
Individuals with medical conditions, including persons with dementia (PWD), are vulnerable in disaster situations. Disasters limit caregivers’ ability to continue with care due to stress, reduced resources and limited social support. We previously developed and tested a disaster preparedness program for older adults, Disaster PrepWise, and showed its impact on improving preparedness and personal emergency support networks. Through community engaged approaches, we adopted this program to specifically support family caregivers of PWD. Contents were revised based on the emergency management and dementia caregiving literature, and input from the stakeholder advisory board (SAB) consisting of caregivers, aging service providers, public health, and emergency management agencies. The SAB also provided guidance on implementation strategies from the lens of over-burdened caregivers. The new program includes a five-step process with an emphasis on the needs of caregivers and caregiving tasks, for example, developing emergency caregiving network to be activated during and after a disaster. The program also informs caregivers of tasks involved in the event of an emergency and provides various information such as how to navigate staying at public shelters with PWD, identify services during and after an emergency, and manage stress. Preliminary data shows high levels of acceptance and perceived usefulness of this caregiver-specific program. The program is perceived to fill a gap in current disaster management approaches that have limited ability to support vulnerable populations. Caregivers and service providers also praised this program’s ability to connect caregivers to community programs and resources. Additional pilot data will be presented.
IMPROVING REPLICABILITY THROUGH DATA STANDARDIZATION: REFINING TELE-STELLA FIDELITY PROCEDURES
Authors: Mooney Aimee , Lindauer Allison , Gothard Sarah , McKenzie Glenise , Tadesse Ruth , Bernard Hannah , Boardman Charles , Danschin Arlene 
Published: December 2023

Abstract
Tele-STELLA (Support via TEchnology: Living and Learning with Advancing Alzheimer’s disease and related dementias) is a prospective, non-randomized, mixed methods clinical trial of a multicomponent videoconference-based psychoeducational intervention for family care partners to facilitate effective management of behavioral symptoms of dementia. The intervention is delivered by nurse “Guides” over two 8-week sessions with the goal of reducing care partner burden, assessed before, during and after intervention. To ensure treatment adherence to this complex intervention protocol, Guides complete intervention checklists after each session. Fidelity monitoring early in study implementation revealed inconsistency in Guide adherence to the intervention protocol as evidenced by gaps and barriers with data collection platforms. To optimize fidelity of the protocol, an iterative process of refinement was applied to procedural operations and data capture practices. These refinements included standardization of protocol tasks (procedural fidelity), explicit definition of guide behaviors (theoretical fidelity) for the continuity of fidelity assessments, and implementation of a unified data capture platform, REDCap®, providing immediate visibility and reference for all team members. We found lower, non-significant Zarit Burden Scores after process revisions (pre=9.14, post=8.43, p=0.29). We also found improvement in data capture with a significantly reduced proportion of missingness for required fields (p=2.2e-16). These findings provide meaningful signaling of improved treatment fidelity, which is associated with those mechanisms of action hypothesized to impact study outcomes. These findings further indicate that a more formal architecture was needed to implement this curriculum and standardization of these processes are vital for long-term replicability and downstream adoption.
AGING AND THE LIVED EXPERIENCES OF TRANSGENDER AND GENDER NONCONFORMING OLDER ADULTS
Authors: Koller Jeanne , Urbanski Paul 
Published: December 2023

Abstract
Adults identifying as transgender and gender non-conforming (T/GNC) in the United States may experience adversity, victimization, and discrimination across the life span (McDowell, et al., 2019). T/GNC older adults have higher rates of poverty, homelessness, social isolation, depression, and violence compared to older adults in the general population and compared with lesbian, gay, and bisexual (LGB) older adults (Sloan & Benson, 2022). This descriptive phenomenological study utilized a purposive and snowball sampling strategy and sought to increase understanding of this diverse group. Twenty participants aged 50 and older were interviewed. Themes included fear and/or actual loss of relationships after “coming out” as transgender; concerns and complexity of healthcare and anticipated changes in healthcare if faced with needing long-term care; navigating gendered space; living as their authentic self; “passing” as cisgender; finding acceptance within the LGB community; desire but struggles to have intimate relationships; conflict between internal and external sense of self; and histories of depression, and suicidality. Protective factors included having an internal source of strength; support within the T/GNC community; being in committed relationships; and receiving support from others. Age at time of transitioning, sex assigned at birth, and identifying as GNB but not transgender influenced lived experiences. McDowell, M.J., Hughto, J.M.W., & Resiner, S.L. (2019). Risk and protective factors for mental health morbidity in a community sample of female-to- male trans-masculine adults. BMC Psychiatry, 19(16), 1-12. https://doi.org/10.1186/s12888-018-2008-0 Sloan, S., & Benson, J. J. (2022). Toward a conceptual model for successful transgender aging. Qualitative Social Work, 21(2), 455-471. https://doi.org/10.1177/1473325021994666
SOCIAL SUPPORT, MENTAL HEALTH, AND SEXUAL ORIENTATION: A STUDY OF THREE TIME POINTS IN THE CLSA
Authors: Grady Alexandra , Stinchcombe Arne 
Published: December 2023

Abstract
Lesbian, gay, and bisexual (LGB) older adults exhibit mental health disparities stemming from a lifetime accumulation of minority stress experiences. Psychological resources like social support may buffer against these poor mental health outcomes. The purpose of this study was to examine indicators of depression and social support by sexual orientation over time in a sample of Canadian adults ages 45-85. We used data collected at three time points in the Canadian Longitudinal Study on Aging (CLSA; baseline, 2011-2015; follow-up 1, 2015-2018; and follow-up 2, 2018-2021). Depression was measured using the Center for Epidemiologic Studies Depression scale (CESD-10) and social support was measured using the Medical Outcomes Study Social Support Survey (MOS-SSS). For depression symptoms (n=38,244; 830 LGB), results indicated a significant effect of sexual orientation (F(2, 38242)=35.93, p&lt;.001) such that LGB participants had more depression symptoms than heterosexual participants. There was also a significant effect of time on depression symptoms (F(2, 38242)=26.07, p&lt;.001); mean depression scores decreased over time. For social support (n=35,795; 770 LGB), results indicated a significant effect of sexual orientation (F(2, 35794)=45.31, p&lt;.001) such that LGB participants reported lower levels of social support than heterosexual participants. There was also a significant effect of time (F(2, 35794)=5.98, p=.003); the mean scores for social support increased over time. The potential role of social support in moderating depression symptoms will be discussed. This study adds to our understanding of potential protective factors influencing the mental health of older LGB people.