bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE IMPACT OF CLOSING MEDICARE PART D COVERAGE GAP ON MENTAL HEALTH OF OLDER ADULTS
Authors: Gai Junjie , Arora Kanika 
Published: December 2023

Abstract
The ACA mandated the gradual elimination of the Medicare prescription drug coverage gap (also called the “Doughnut Hole”) beginning in 2011. This policy change can impact mental health through mechanisms such as reduction in out-of-pocket (OOP) expenses and increased access to prescription medication. However, no previous study has examined its impact on mental health outcomes of older adults on Medicare. Employing data from the Medical Expenditure Panel Survey (from 2006 to 2016), compare the mental health of Medicare beneficiaries (66-70 years; N=7,664) with that of non-Medicare beneficiaries (60-64 years; N=8,079) before versus after policy implementation. We find that the 2011 phasing out of Medicare drug coverage gap was associated with 0.86-point (p&lt; 0.05) improvement in the Mental Component score of the Short-Form 12 Health Survey among beneficiaries. Our analysis was robust to using alternate measures of mental health outcomes (Kessler Index and PHQ-2) as well as to an alternate construction of treatment and control groups (comparing individuals aged 60-70 years on Medicare and private insurance). We find no detectable differences in the mental health of Medicare beneficiaries who already receive subsidies for costs associated with the coverage gap through the Low Income Subsidy (LIS) program. Further, we find that elimination of the doughnut hole reduced OOP expenses by $32.65 among Medicare beneficiaries in our sample. Overall, our results for mental health and OOP expenses are mainly attributable to women. This evidence highlights indirect effects of drug coverage gap elimination on mental health outcomes among Medicare beneficiaries.
THE POTENTIAL BENEFITS OF COMPANION ROBOTIC PETS ON THE QUALITY OF LIFE AMONG COMMUNITY-DWELLING OLDER WOMEN
Authors: Kang Suk-Young , Kim Jeungkun , Poplawski Antonina 
Published: December 2023

Abstract
This project explores whether companion robotic pets improve mental well-being of community-dwelling older women with depression. Depression is a major mental health issue disproportionately impacting women due to lifelong experiences of sexism and limitations in education and employment. Aging exacerbates an already undervalued status, and feelings of powerlessness increase. Women thus experience double jeopardy from discrimination on both gender and age (Hooyman et al., 2017). This project will investigate the efficacy of companion robotic pets and will recommend plans to the local Office for Aging (OFA). Recruitment was done in collaboration with the local OFA, with mail-survey data collected from community-dwelling women over the age of 65. 38 participants were provided with a robotic pet after an initial screening. Following a one-group pretest posttest design, data from 31 participants were used to determine the impact of a robotic pet intervention on older women’s quality of life. Paired samples t-tests were used to compare means of the 15-item Geriatric Depression Scale (GDS), 10-item Geriatric Anxiety Scale (GAS), 6-item De Jong Loneliness Scale, and one physical health status question completed by 30 women. There was a significant average difference between before- and after-companion pet scores for depression (t29 = 6.597, p &lt; 0.001), anxiety (t29 = 6.728, p &lt; 0.001), loneliness (t29 = 6.462, p &lt; 0.001) and physical health (t29 = - 3.496, p = 0.002). Results confirmed companion robotic pets improve mental health in older women with depression and anxiety. Moreover, they are helpful in improving loneliness and physical health.
VOLUNTEERING, DISCRIMINATION, AND DEPRESSION IN OLD AGE: DOES THE FORM OF DISCRIMINATION PLAY A ROLE?
Authors: Shen Huei-wern 
Published: December 2023

Abstract
Older adults experiencing discrimination have an increased risk of poor mental health, such as depression. Discrimination could happen based on age, race, gender, sexual orientation, or other factors but the effects of experiencing different forms of discrimination on depression are unknown. Given the evidence that volunteering in old age promotes mental health, this study explores the relationship between volunteering and depressive symptoms among older adults who experience discrimination, and investigates whether such a relationship differs between those experiencing ageism and those experiencing other forms of discrimination. Using a subsample of respondents 65-96 years of age from the 2016 Health and Retirement Study, 1881 older adults who reported experiencing everyday discrimination were included. Discrimination was measured by the six-item Everyday Discrimination Scale. Among them, 955 respondents named age as the reason behind the discrimination experiences, and 926 named other forms (e.g. race). Controlling for health-related variables (e.g., ADLs/IADLs), SES (e.g., income), and sociodemographics (e.g., gender), findings from the weighted OLS regression models showed that volunteering (doing unpaid work for religious, educational, health-related, or other charitable organizations) related to lower depressive symptoms (8-item CES-D, P&lt;.05). When looking at the groups who experienced different forms of discrimination, volunteering continued to have a negative relationship with depressive symptoms for older adults who experienced ageism (p&lt;.01); however, such a relationship disappeared for the group experiencing other forms of discrimination. Discussions will target the importance of understanding the complicated relationships that may exist in volunteering, mental health, and the forms of discrimination that older adults experience.
A POLICY COMPARISON OF THE EVOLUTION OF COMMUNITY-BASED LONG-TERM CARE POLICY BETWEEN TAIWAN AND THE UNITED STATES
Authors: Peckham Allie , Liu Li-Chuan , Schmid Laura 
Published: December 2023

Abstract
Governments globally have been facing pressure to develop and implement effective policies to support population aging. This approach was historically rooted in a perception that as we age we become increasingly incapacitated. This research seeks to understand how policies in two countries valuing unpaid care differently, developed and implemented Long-term services and supports (LTSS). We compare the federal level efforts of implementing LTSS within the United States (U.S.) and Taiwan. Relying on a pre-established comparative framework developed by Richard Rose, we utilized a deductive analytical approach to assess the differences in policy options and timelines across Taiwan and the U.S.. After attending this session, participants will develop a deeper understanding of how Taiwan and the U.S. are working to offer home and community-based long-term care services. It wasn’t until the 1980s for the U.S. and late 1990s for Taiwan that LTSS were introduced with the intention of supporting people to live as independently as possible in their own homes for as long as possible (e.g., Department of Health and Human Services, 3-year Care Service Development Plan). It is likely that the delay in LTSS delivery between the two countries is rooted in the role that unpaid support is expected to play. There is increasing evidence that countries are shifting their policy efforts to focus less on aging as a social dependency and more on policies that encourage healthy longevity.
DEMENTIA-FOCUSED ADULT DAY CARE IN AN URBAN SETTING: PROGRAM STAKEHOLDERS’ VIEWS OF CRUCIAL COMPONENTS
Authors: Ernst Joy , Hopp Faith 
Published: December 2023

Abstract
Dementia focused adult day centers (ADCs) provide socialization, physical activity, and cognitive activities for participants, and respite for caregivers. This study reports findings from a process evaluation of an ADC serving a predominantly African American population in a large midwestern city. The evaluation examined whether the program was being implemented as intended, what was working/not working, and participant engagement. We conducted in-depth interviews of staff, volunteers, and student interns and surveyed caregivers (n=17). Thematic analysis of the interviews revealed themes such as “structured flexibility” in running the daily activities, an ethos of care that mixes encouragement of participation with respect for autonomy, ongoing and positive activity, and individualized attention to participants. Other findings revealed the value of consistent and experienced staff and reliance upon and benefits for students and volunteers. Quantitative and qualitative responses to caregiver surveys supported the interview themes. Caregivers valued the socialization and creative stimuli provided to participants. Guidance from program personnel included modeling communication strategies and being “in the moment” with the participants. The findings suggest that further work to inform the development of quality care and programming to improve the quality of life of older African Americans with dementia and their caregivers is needed. Specifically, there is a need to 1) identify essential components of ADCs; 2) document the ways that key ADC service philosophies are realized and communicated; and 3) explore the key role of volunteers and students in terms of their roles, activities, and motivations for working with older adults with dementia.
HELPING SENIORS AGING IN PLACE: ADULT GUARDIANSHIP AND ITS ROLE IN GERIATRIC SOCIAL WORK PRACTICE IN CHINA AND JAPAN
Authors: Yan Zi 
Published: December 2023

Abstract
As the most aging society in East Asia, a renewed adult guardianship system for the idea of respect for self-determination, practical use of remaining abilities, and re-socialization have been practiced in Japan for 20 years. While, compared with Japan, in lieu of a comprehensive adult guardianship regime, not until 2017, voluntary guardianship notarization has become the main alternative for supported decision-making and self-determination for incapacitated adults and a tool for mitigating the social risks of the frail elderly in China. Based on secondary data and semi-structured interviews, this study is the first attempt that demonstrates a comprehensive comparison of the recent developments and current forms of adult guardianship initiatives in mainland China and Japan. Besides highlighting the difficulties and challenges faced by these two countries, this article also outlined the types of guardians under their current legal framework, identified the social functions of guardians, the notary office in adult guardianship socialization, and the emerging geriatric social work initiatives adopted. The geriatric social work practices in China and Japan’s adult guardianship point in particular toward the potential provocativeness: adult guardianship in the eastern context—a context marked by a strict family system that emphasizes the virtues of filial piety and discourages outside intervention in family matters. As the number of people with dementia is projected to reach 82 million in 2030, China and Japan’s experience potentially holds wide significance for countries that lack substantial policies and programs for caring for the frail elderly.
PERSONS AGING WITH A PHYSICAL DISABILITY: EVALUATING PARTICIPATION CHANGE USING A TOOL FOR COMMUNITY CARE PROVIDERS
Authors: Putnam Michelle , Morgan Kerri , Hollingsworth Holly , Heeb Rachel , Chen Szu-Wei , Stark Susan L 
Published: December 2023

Abstract
Community participation measures for persons aging with disability were developed and evaluated to support community-based organizations (CBOs) with efficient assessment of change in participation and need for supports/services to facilitate participation. This study aimed to evaluate a set of 9 activity domain measures to broadly assess community participation and change in participation over time. A community-based sample (N=323) of persons ages 45-65 responded to a survey with repeated measures three times annually (T1, T2, T3) between 2019-2022. Nine activity domain measures were developed based on extant research and evaluated with assistance from community-based support service providers. Statistical analyses employed T-tests and Chi-square tests to assess change in participation over time, perceptions of participation satisfaction, and assistance needed to facilitate participation. Participants were asked if they thought changes were attributable to aging, the COVID pandemic, or other factors. Findings showed varying levels of participation across the 9 activity domains, with the lowest participation rate for employment and the highest participation rates for personal leisure and managing medications across T1, T2, and T3. Change in participation over the 3-year period was limited; most change was reported as activity reduction. In general, respondents indicated that reduction was due to their aging or the COVID-19 pandemic. Personal assistance, transportation, environmental modifications, and improved health were identified as factors needed to help increase participation levels. Conclusions were that activity domain measures demonstrated efficiency in identifying participation rates and change. CBOs may deem them useful for assessing support and service needs to facilitate participation.
A STUDY ON COOPERATION BETWEEN COMMUNITY COMPREHENSIVE SUPPORT CENTERS AND DV SUPPORT AGENCIES TO SOLVE ELDER ABUSE
Authors: Katsumata Asako , Tsukada Noriko 
Published: December 2023

Abstract
The purpose of this study was to examine current and future cooperation between Community Comprehensive Support Centers (CCSCs) and Domestic Violence (DV) support agencies in dealing with elder abuse cases among older couples in Japan. The data used in this study are from a nationwide survey from Certified Social Workers (CSWs) at CCSCs in November 2022. A structured questionnaire survey was provided to a randomly selected 3,563 out of 5400 CCSCs, and a total of 1,472 responses from CSWs were obtained (response rate of 41.3%). Preliminary analyses revealed about 70% of the respondents felt that the cooperation with DV support agencies was important (36.8% “important”, 32.6% “somewhat important“). Reasons for why respondents felt the cooperation was “not very important” (2.2%), “not important at all”(0.1%), or “neutral”(28.3%) included “have never cooperated with DV support agencies before” (62.1%), “CCSCs are supposed to deal with abuse cases with people aged more than 65“ (55%), “don’t know about roles of DV support agencies” (42.5%) , followed by “staff members at DV support agencies were not very helpful” (28.1%). Moreover, among 443 respondents (30.1%) who have dealt with elder abuse cases that have continued from their younger age, 25% of CSWs sought for cooperation with DV support agencies, got help and shared information to solve those cases. Findings suggest that professional staff members at both CCSCs and DV support agencies need to be trained to be aware of importance of exchanging their knowledge and resources regarding how to solve elder abuse cases effectively and efficiently.
DETECTING UNDUE HARM ARISING FROM ELDER ABUSE SCREENING: INNOVATIVE METHODS FROM THE EASI-LTC© PILOT STUDY
Authors: Ballard Stephanie , Wilchesky Machelle 
Published: December 2023

Abstract
Screening for elder abuse can cause victims to experience feelings of unpleasantness and/or relive painful memories which can be an ethical concern. Ensuring the safety of all participants/users, in our case long-term care (LTC) residents, is of the utmost importance. Drawing from approaches used in the intimate partner violence and clinical trials literature, we developed a novel typology of harm and a series of procedures to evaluate any negative consequences that might be incurred as a result of participating in the Piloting the Elder Abuse Suspicion Index-long term care©: A Mixed Methods Feasibility Study. Our typology includes subjective and objective reporting from a multitude of sources, including: 1) Interviews with LTC residents using a modified Consequences of Screening Tool, adapted from MacMillan et al, 2009; Opinions of the 2) Study social worker conducting validation assessments and 3) LTC residents and institutional stakeholders; 4) Feedback from study research assistants who administer the tool using a specialized Adverse Events Form; and 5) Chart reviews. Procedures include the creation of an independent interdisciplinary pilot study safety committee, chaired by a geriatric psychiatrist and convened to conduct interim evaluations after the first 5, 10, and 20 residents have participated, the liberation of social work teams, who are to be on standby and available to intervene as necessary, and the creation of participant resource cards displaying pertinent phone numbers for immediate assistance. To our knowledge, this is the first elder abuse study to conduct a thorough analysis of study-induced harm.
HIDING IN PLAIN SITE: LOW BACK PAIN RATES IN OLDER ADULTS WITH LUMBAR SPINAL STENOSIS
Authors: Hogans Beth , Siaton Bernadette , Goldman Stuart , Sorkin John 
Published: December 2023

Abstract

Introduction
Lumbar spinal stenosis (LSS) is highly prevalent in older adults, negatively impacting mobility and quality of life. Typically associated with progressive impairment of walking distance and pain which radiates into the legs, there is persistent controversy regarding the extent to which low back pain (LBP) is associated with LSS.

Objectives
To evaluate population-level evidence for and strength of an association of LBP with LSS in older adults. Data Source: Medicare Part B Carrier and Outpatient claims data, 5% standard analytical file for 2017.

Methods
Unadjusted and adjusted analysis of cross-sectional data, combined with condition process analysis

Results
Several hundred thousand older adults met criteria for inclusion in this study. Lumbar spinal stenosis was common in both older adult males and females, but slightly more commonly diagnosed in females. Low back pain was prevalent in older adults but more so in females. A majority of older adults with LSS were diagnosed with LBP. Unadjusted and adjusted analyses demonstrated that LBP was present at increased rates in older adults with LSS.

Conclusions
Low back pain is diagnosed in the majority of older adults diagnosed with lumbar spinal stenosis. It is important to recognize that the symptom profile of older adults with spinal stenosis includes low back pain and treatment should be adjusted to respond to this management need.
IMPACTS OF CHANGE FROM 27 TO 30 CHRONIC CONDITIONS ALGORITHM ON PREVALENCE OF DIABETES AND DEMENTIA
Authors: Kim Hyosin , Zafar Anum , Lin Haiqun , Setoguchi Soko , Jarrín Olga 
Published: December 2023

Abstract
The Centers for Medicare and Medicaid Services (CMS) Chronic Conditions Warehouse (CCW) algorithm used to identify the presence of chronic conditions recently changed. Not only was the number of chronic conditions changed, but also the diagnosis codes and look-back period. Accompanying documentation encourages researchers to empirically assess the change in algorithm for their studies. The purpose of this study is to highlight the impacts of switching to the 30 CCW Chronic Conditions file on the prevalence of selected chronic conditions (diabetes and dementia) in an end-of-life cohort of Medicare beneficiaries (n=2,182,092), with sub-analysis by insurance type. Data sources included the Master Beneficiary Summary File base file and chronic conditions segments (27 vs. 30). The study population was all U.S. Medicare beneficiaries over age 18 who died in 2019. This retrospective observational study summarizes the change in prevalence of diabetes, dementia, and stroke/transient ischemic attack resulting from the new chronic conditions algorithm (27 to 30), stratified by insurance type. Among Medicare beneficiaries who died in 2019, using the 30 vs. 27 Chronic Conditions algorithm decreased the prevalence of diabetes (45% vs. 32%) and dementia (41% vs. 31%). This change may pose challenges for longitudinal and end-of-life research. A decrease in the counting of dementia, diabetes, and stroke cases could lead to an underestimation of their burden on society and be misleading for policymakers and the public. This could result in inadequate policies and resources to address prevention and treatment, which could result in inadequate healthcare services for the affected population.
AGING WITH HIV: ASSOCIATION OF ART REGIMEN AND ADHERENCE TO VIRAL SUPPRESSION
Authors: Manalel Jasmine , Kaufman Jennifer , Fusaris Ethan , Correa Arlene , Ernst Jerome , Brennan-Ing Mark 
Published: December 2023

Abstract
Adherence to antiretroviral therapy (ART) is essential to effective management of HIV among an increasing population of older adults. Newer ART regimens are more “forgiving” of poor adherence allowing for viral suppression at lower adherence levels (i.e., &lt; 90%). This is especially promising for some older adults who may struggle with adherence due to high rates of multimorbidity and polypharmacy. We aimed to determine how ART forgiveness varies depending on ART type and adherence. Data came from 2017-2019 claims and clinical records of 1,044 HIV-positive members of a Medicaid managed care plan who were 50 to 65 years of age. Pharmacy fill data were examined on a quarterly basis to characterize ART medications using latent class analysis (LCA), which captures the complexity of real-world ART usage (i.e., multiple medications, ART switching). LCA yielded five distinct ART utilization patterns over three years, mostly characterized by recent medications and formulations of ART, though they varied in number of tablets and in medication class (e.g., boosted protease inhibitors). Logistic regression models adjusting for demographics and health-related covariates revealed that ART medication patterns did not consistently differ in odds of maintaining viral suppression across adherence levels (&lt; 50%, 50% to &lt; 80%, 80% to &lt; 85%, 85% to &lt; 90%, and &gt;=90%). In contrast, other factors, including nadir CD4 count and behavioral health conditions, were related to viral suppression across models. This highlights the importance of life-course illness trajectories when considering disease management and treatment strategies for older adults living with HIV, especially those with difficulty maintaining near-perfect adherence.
HOW PERSON-CENTERED SERVICE DELIVERY SUPPORT QUALITY OF LIFE: WHAT NCI-AD TELLS US
Authors: Giordano Stephanie , Plasencia Rosa 
Published: December 2023

Abstract
COVID-19 left a broad impact - for many older adults the pandemic led to changes in perceptions of person-centered services and experience with LTSS. Person-centered service delivery is widely accepted as a gold standard to supporting better outcomes, experience, and satisfaction; yet, there remains a gap in understanding person-centeredness from the perspective of people receiving the service. NCI-AD surveyors hear directly from older adults and people with physical disabilities on satisfaction with service delivery and quality of life. Using 2021-22 data, we’ll discuss the perception of responsiveness and person-centered service delivery among other important measures. For example, older adults who were satisfied with provider response were more likely than those who were not satisfied to have more positive outcomes related to access to the community, ability to maintain relationships, and fewer unmet service needs. This session will delve further into this relationship between person-centered service delivery and quality of life outcomes, addressing what this means for policy and practice. Data presented come from the 2021-2022 National Core Indicators® Aging and Disabilities (NCI-AD™) Adult Consumer Survey (ACS). The ACS includes two main survey sections. The Background Information provides key data about survey participants, including demographics, service-related characteristics, and clinical diagnoses, typically collected from administrative records about the person. The main survey section includes questions on a range of topics that address the quality of the service delivery system; including responsiveness of services and supports, availability of needed services, and quality of life outcomes.