bluuebunny/crossref_metadata_2025_split huggingface dataset:
RESEARCH ON SUPPORT FOR ELDER CARE IN DIFFERENT CULTURES AND SETTINGS
Authors: Jiang Lin , Zhang Ning 
Published: December 2023

Abstract
This cross-culture symposium consists of four studies that examined the interventions, patterns, technology, and challenges for elder care across settings in the U.S., China, and other countries. The first two papers focus on caregivers for patients with Alzheimer’s disease and related dementia (ADRD). The paper from the U.S. fills that gap by examining the information and communications technology utilization in relation to mental health among Mexican American informal caregivers for persons with ADRD. The findings suggest a need to explore further different types of ICT and their effects on Mexican American informal caregivers’ mental health. To help t reduce social isolation and loneliness, we may consider choosing an appropriate ICT based on their situation and culture. The paper from China highlights ADRD informal caregivers’ needs and struggles, which were ignored by the Chinese public. Also, the paper examined a model for healthcare professionals at inpatient and outpatient clinics to provide support to caregivers medically and emotionally. The third paper is a systematic review summarizing the latest evidence regarding the importance of using technology among people with dementia and their caregivers as an intervention. The fourth paper broadens our horizon by using a multinational comparison perspective to analyze research on pattern recognition and innovation of home-based care under the change of family structure in China. After individual presentations are done, one discussant will summarize shared themes in these papers and provide critical feedback.
VOICES FROM THE INSIDE: MEDICAL TREATMENT FURLOUGH IN THE LARGEST STATE PENITENTIARY IN US: LESSONS LEARNED
Authors: Harris Jolie 
Published: December 2023

Abstract
As part of the criminal justice reform to reduce prison population, the State of Louisiana undertook an initiative to explore a medical treatment furlough project. The plan was to transition long-term inmates from the prison to long-term care (LTC)). Angola, the largest maximum security prison in the U.S, had over 1000 prisoners 60 years or older. Eighty percent of the prison population is serving a life sentence. Prisoners with significant health and mobility issues were to be considered to be released to off-site facilities with parole supervision. We present lessons learned from exploring all aspects of a possible partnership between a Louisiana long-term care company and the correction department including: conducting site visits at Angola and the long-term care facility; gathering best practice data; exploring a referral process and acuity classification tool; exploring the role of the parole officer; and examining the prison population against the regulations for long-term care facilities from the perspective of the prisoners and current residents. Additional considerations were the impact on the local community and on-going support for services provided, along with staffing, staff training, and security and safety of the facility. After multiple discussions with representative from the Louisiana Department of Health we found the obstacles were too great to implement the program. Exposure to the challenges facing the corrections department and examining how to implement the Act as written was a lesson in the value of viewing an issue from multiple perspectives.
STRATEGIES FOR OLDER ADULT AND INFORMAL CAREGIVER INVOLVEMENT IN HEALTH POLICY DEVELOPMENT: STAKEHOLDERS’ VIEWS
Authors: Kolade Opeyemi , Porat-Dahlerbruch Joshua , Perlman Saritte , van Achterberg Theo , Ellen Moriah , Kolade Opeyemi , Porat-Dahlerbruch Joshua , Perlman Saritte , van Achterberg Theo , Ellen Moriah 
Published: December 2023

Abstract
Older adults and informal caregivers’ involvement in policy-making processes can enhance the creation of responsive policies and the provision of better health and well-being services. However, current involvement literature is more focused on involvement in research and healthcare decision-making. This research aims to explore stakeholders’ perspectives on approaches for the involvement of older adults and informal caregivers in health policy development. A qualitative study using semi-structured interviews was conducted within the European TRANS-SENIOR consortium and included policymakers, researchers, and advocacy organizations in nine countries. Participants were included if they had experience with older adult/informal caregiver involvement in health policy development. A total of eighteen interviews were conducted with nine representatives from older adult/informal caregiver advocacy organizations, five policymakers, and four researchers. Identified themes were: 1) diversity of involvement approaches, 2) impact of involving older adults and informal caregivers in health policy development, and 3) facilitators and barriers of involvement. Findings indicated that older adult and informal caregiver involvement vary in nature and intensity and that the actual effect of older adult and informal caregiver involvement in health policy development is difficult to assess. There is no one-size-fits-all approach for involving older adults and informal caregivers in health policy development; stakeholders can focus on exploring and implementing context-specific tailored strategies. Our study findings provide evidence that can be useful to decision-makers to involve older adults and informal caregivers in health policy development.
THE URBAN AGING RESIDENT’S COALITION: A CASE STUDY IN LATE-ADULTHOOD COMMUNITY ACTIVISM
Authors: Wright Kathy , Shields Pamela , Moss Karen , White Katie , Tate Judith , Rose Karen 
Published: December 2023

Abstract
The COVID-19 global pandemic, police brutality, and threats to voting rights retraumatized African American older adults, who lived during civil rights, causing feelings of powerlessness. Older adults can be equipped to regain agency and control through community activism. We provide a case study of an older African American activist’s (Ms. P) journey to create the Urban Aging Resident’s Coalition (UARC)—an affiliation of the National African American Men’s Wellness Agency. UARC was founded in 2019 to improve mental and physical health for urban older adults. Post-pandemic, Ms. P along with teenage volunteers, held monthly educational sessions that included interactions with local police and voting rights education. To facilitate a non-confrontational experience, Ms. P had the police bring Golden Retriever therapy dogs and a community support person. To increase relatability for voter education, Ms. P formed a panel of retired legislators, the first African American state senator who developed the Ohio Office of Minority Health, a younger state representative, and the former CEO of the Urban league to hold an open forum on voting rights and redistricting. Nearly 60 older adults attended the monthly educational sessions. The community activist addressed those traumas experienced by older adults in a safe and encouraging social environment. Participants reported feeling more comfortable interacting with the police. Older adults increased their awareness of the importance of voting to elect leaders that represent them and their ideas. This model, to engage minoritized groups to regain agency and power, can be a template for other communities.
EPIDEMIOLOGY OF THE INVERSE COMORBIDITY OF DEMENTIA AND CANCER: THE CHALLENGE OF SELECTIVE SURVIVAL BIAS
Authors: Shardell Michelle , Rathbun Alan , Gruber-Baldini Ann , Guralnik Jack , Golden Justine , Kapogiannis Dimitrios , Simonsick Eleanor 
Published: December 2023

Abstract
Observational studies have consistently found dementia to be inversely related to cancer, where presence of cancer predicts lower dementia risk, and presence of dementia predicts lower cancer risk. This “inverse comorbidity” relationship is of interest as an avenue to potentially identify novel intervention targets to develop for both conditions. However, it is unknown whether inverse comorbidity reflects underlying physiological mechanisms or is explained by selective survival bias. Specifically, persons with cancer are more likely to die before dementia onset than otherwise similar persons without cancer. Thus, we aimed to assess the robustness of inverse comorbidity between dementia and cancer to statistical methods that vary in how they address selective survival bias. Four discrete-time modeling methods were applied to data from the Health, Aging and Body Composition Study (n=3075; age: 70-79 years; 41.7% black; 51.5% women): (1) generalized estimating equations (GEE) assuming all missingness to be completely at random; (2) weighted independence estimating equations partly conditioned on being alive that only weight data missing for non-mortality reasons; (3) multiply-weighted GEE weighting data for all sources of missingness; and (4) marginal structural models that additionally adjust for covariates using inverse propensity score weights. Covariates included: demographics, APOEε, lifestyle characteristics, and health conditions. Methods (1)-(3) produced almost identical results: (1) Risk Ratio(RR)=0.81, 95% Confidence Interval(CI)=0.69-0.95; (2) RR=0.81, 95%CI=0.69-0.94; and (3) RR=0.81, 95%CI=0.69-0.94. Results for method (4) were slightly attenuated: RR=0.85, 95%CI=0.72-0.99. Inverse comorbidity was consistently observed and robust to statistical handling of missing data/mortality. Future research aims to identify mechanisms of inverse comorbidity.
THE U-SHAPED RELATIONSHIP BETWEEN DAILY ENERGY INTAKE AND ALL-CAUSE MORTALITY IN US ADULTS
Authors: Farsijani Samaneh , Mao Ziling , Newman Anne 
Published: December 2023

Abstract
The association between low energy intake and longevity observed in non-human studies has not been confirmed in large-scale human investigations. Therefore, we determined the associations between daily energy intake and all-cause mortality in US adults. We included 33,094 US adults (age&gt;19 years) from the National Health and Nutrition Examination Survey (2003-2018). Total energy intake was obtained from 24-hour food recalls and mortality was determined through December 2019 using the National Death Index. Survey-weighted multivariable Cox proportional hazard models were used to calculate all-cause hazard ratios (HR) across categories of energy intake. HR models were stratified by age, sex, race, and BMI, while controlling for potential covariates. During a median follow-up of 96 months, 4,162 participants died. Low energy intake (&lt; 1,000 kcal/day) was associated with higher mortality (HR=1.53 [95% CI 1.26-1.86]) vs. the reference category (2,000-2,500 kcal/d) independent of age, sex, race, BMI, and income. Similarly, low energy intake was associated with higher mortality risk (P&lt; 0.05) in middle-aged (40-64y) and older (≥65y) adults, men, women, and Whites. We observed the same negative associations between energy intake and mortality in normal-weight (18.5-24.9 kg/m2), over-weight (25.0-29.9), and obese (≥30.0) individuals (P&lt; 0.05). The only exception was in Blacks, where lower energy intake was associated with lower mortality (HR=0.75 [0.57-0.99]). Higher energy intake (≥4,000 kcal/d) was also associated with higher mortality, though HRs were not significant, except in young (20-39y), women, and normal weight adults. Our result showed a U-shaped relationship between total energy intake and mortality, like the observed relationship between BMI and mortality.
ACTIGRAPHIC MEASURES OF SLEEP AND METABOLIC SYNDROME AMONG OLDER ADULTS
Authors: Chen Diefei , Yue Yiwei , Hossain Sharmin , Rabinowitz Jill , Wanigatunga Amal , Ferrucci Luigi , Simonsick Eleanor , Spira Adam 
Published: December 2023

Abstract
Self-reported sleep disturbances are associated with obesity and diabetes, but little is known about links between objectively measured sleep and metabolic syndrome (MetS) in later life. We investigated associations between actigraphic sleep parameters and MetS in 406 participants (53.5% women, 20.9% Black) aged 72.8±10.1 years at baseline (range: 50-96) in the Baltimore Longitudinal Study of Aging. Participants completed wrist actigraphy (6.6±1.0 nights) and were classified as having MetS if they had ≥3 of the following: waist circumference ≥102 cm for men, ≥89 cm for women; high-density lipoproteins &lt; 40 mg/dL in men, &lt; 50 mg/dL in women; triglycerides &gt;150 mg/dL; high blood pressure ≥130/85 mmHg; fasting blood glucose ≥100 mg/dL. Overall, 37 participants had MetS at baseline and 27 participants developed MetS over 2.3±2.2 years of follow-up. Cross-sectionally, compared to participants with total sleep time (TST) &lt; 6 hours, those with 6-8 hours TST had lower odds of MetS (OR=0.28, 95%CI 0.13,0.61); higher sleep efficiency (SE) was associated with lower odds of MetS (OR=0.65, 95%CI 0.48,0.89) and longer wake bout length (WBL) was associated with higher odds of MetS (OR=1.47, 95%CI 1.07,2.01). Excluding 37 participants with MetS at baseline, TST &gt;8 hours was associated with faster increases in the likelihood of developing MetS (OR=1.62, 95% CI 1.03, 2.55). Findings link intermediate TST and higher SE to lower odds of MetS, and longer WBL to higher odds of MetS in older adults cross-sectionally; TST &gt;8 hours was associated with higher odds of incident MetS. Further studies are needed to understand mediators of sleep-MetS associations.
OBSTRUCTIVE SLEEP APNEA RISK AND LONGITUDINAL TRAJECTORY OF FUNCTIONAL HEARING LOSS OVER EIGHT YEARS OF FOLLOW-UP
Authors: Jiang Kening , Spira Adam , Reed Nicholas , Lin Frank , Deal Jennifer 
Published: December 2023

Abstract
Hearing loss prevention is important for physical, cognitive and psychosocial health among older adults. Obstructive sleep apnea (OSA) might cause functional hearing loss through ischemic damages to the cochlea or central auditory processing, but there is a lack of longitudinal evidence. The National Health and Aging Trends Study (NHATS) is a longitudinal panel survey of Medicare beneficiaries aged 65+ years. STOP-Bang is a validated screening tool for OSA risk and a subsample of NHATS round 3 participants responded to a modified version (age&gt;50, male, high blood pressure, body mass index &gt;35 kg/m2, snore loudly, observed apnea, tiredness; range 0-7, elevated risk if ≥3). Functional hearing loss at follow-up (rounds 3-11) was defined as self-reported deafness, hearing aid use, or inability to hear well enough to use the telephone or have conversations in a room with the television or radio on. We used generalized estimating equations logistic regression with inverse probability attrition weighting, adjusting for demographics and comorbidities. Among 1,433 participants, elevated OSA (58%) was associated with higher odds of hearing loss at baseline (odds ratio:1.50, 95% confidence interval[CI]:1.08, 2.10). Both OSA groups had significant annual increases in odds of functional hearing loss (Low:1.07, 95% CI:1.01, 1.13; Elevated:1.12, 95% CI:1.07, 1.18) during the first 4 years. Afterwards, the low OSA risk group continued to have significant increase in odds of functional hearing loss but not the elevated OSA risk group. OSA might be a novel risk factor for hearing loss. Screening and treating OSA might be important for hearing loss prevention.
WHAT CAN WE LEARN FROM THE LINK BETWEEN SLEEP AND GAIT ON THE AGING PROCESS?
Authors: Agmon Maayan , Tzemah-Shahar Roy , Shochat Tamar 
Published: December 2023

Abstract
Falls are a major problem among older adults; and older adults with sleep complaints are at a four-fold risk of falls compared with those without sleep complaints. Recent studies demonstrate comorbidity between gait and sleep, which are two essential, modifiable, and age-sensitive functions. Yet, most studies were conducted on older adults, whereas studies on midlife adults are lacking. Such studies can open a window to better understanding of the aging process. We aim to explore the link between sleep quality and gait among community-dwelling midlife adults. We recruited 103 midlife adults (age 59.3±7). Gait was evaluated with the cognitive Dual-Task (DT) paradigm. Gait speed and variability were assessed with the APDM mobility lab. Sleep quality was evaluated objectively using one-week actigraphy and subjectively using the Pittsburg Sleep Quality Index (PSQI). We found that age was significantly associated with earlier bedtime (p=0.007), lower sleep efficiency (p=0.01) and increased wake after sleep onset (p=0.01). Sex differences were found for objective and subjective sleep duration (actigraphy and PSQI, p=0.002 and p&lt; 0.001, respectively), with women sleeping significantly more than men. No sex differences were found for sleep efficiency. A significant main effect was found for actigraphy-based sleep duration (short/intermediate/long) on gait speed, such that gait speed was slower in long compared to short and intermediate sleepers under DT only (p=0.018). To conclude, a negative association between sleep quality and gait speed under DT was found, showing adverse health outcomes for long versus short and intermediate sleepers in midlife.
DETERMINANTS OF INFORMAL CARE TRAJECTORIES IN ENGLAND
Authors: Gessa Giorgio Di , Deindl Christian 
Published: December 2023

Abstract
In the context of an ageing population, combined with long-standing challenges in the delivery of formal social care for older people, unpaid caregivers play a key role in promoting the quality of life of older people and their extended families and ensuring that needs for care and support are met. Although many studies have provided snapshots of informal care provision, few so far have examined longitudinal patterns of informal care provision among older people. This paper aims to describe caregiving trajectories in later life and to examine how socioeconomic, demographic, and health characteristics of older adults relate to these patterns (including needs and enabling factors). Using six waves of the English Longitudinal Study of Ageing, we conduct latent trajectory analysis to cluster people’s diverse trajectories into a finite number of groups. The intensity of informal care provision is also considered when identifying longitudinal trajectories. Preliminary results show five distinct trajectories of informal care provision (including those who never provide informal care, those who provide sporadic informal care, those with increasing and decreasing commitment to care provision, and those who care throughout). Gender, age, health, income, living arrangements, and family compositions all relate to long-term trajectories of informal care, with younger married women in good health more likely to provide informal care throughout. Support should be provided to this group of caregivers, given that engagement in long-term caregiving might be detrimental to mental health.
SUBJECTIVE AGE MODERATES THE RELATIONSHIP BETWEEN GLOBAL COGNITION AND SUSCEPTIBILITY TO SCAMS
Authors: Weissberger Gali , Lim Aaron , Mosqueda Laura , Nguyen Annie , Fenton Laura , Han Duke 
Published: December 2023

Abstract
Understanding factors that increase susceptibility to scams in old age is of critical importance. Cognitive functioning has been demonstrated to be an important factor in predicting financial exploitation and scam risk. There is also evidence that subjective age, or one’s perceived age relative to chronological age, may be associated with financial exploitation risk. This study examined the interactive effect of subjective age on the relationship between global cognition and susceptibility to scams. Sixty-five participants underwent an assessment of global cognition (Mini-Mental State Examination; MMSE), reported their subjective age, and responded to a self-report questionnaire on scam susceptibility. A main effect of global cognition on scam susceptibility was found (b = -0.029, ß = -0.280, p = 0.028); there was no main effect of subjective age on scam susceptibility (p = 0.819). An interaction between cognition and subjective age was found, such that the negative association between cognition and scam susceptibility increased as subjective age increased (b = -0.185, ß = -0.311, p = 0.016). Examination of conditional effects demonstrated that the relationship between cognition and scam susceptibility was not significant amongst those with subjective ages below one standard deviation (SD) of the mean, but was significant for those whose subjective ages fell around or above the mean (within 1SD, b = -0.03, SE = 0.01, p = 0.03; +1SD, b = -0.06, SE = 0.02, p = 0.001). Findings suggest that individuals with older subjective ages may be particularly vulnerable to the negative effects of lower cognition on scam susceptibility.
THE IMPACT OF COVID-19 ON RESIDENTS AND FAMILY/FRIEND CAREGIVERS IN ASSISTED LIVING HOMES
Authors: Hoben Matthias , Maxwell Colleen , Beeber Anna 
Published: December 2023

Abstract
Healthcare reforms have neglected assisted living (AL) and nursing homes (NHs) for decades, setting them up for the excessive rates of death and suffering during COVID-19. Research before and during the pandemic has primarily focused on NHs, largely overlooking AL. AL is rapidly expanding, caring for people with similar vulnerabilities as those in NHs, yet is less regulated, offers fewer services, has lower staffing/skill mix levels and requires significant family/friend involvement in care. This symposium presents a program of research (COVCARES, COVID-19 and the Care of Assisted living Residents), aiming to understand how the pandemic has impacted AL resident, family/friend, and facility outcomes, and how resident outcomes compare between NHs and AL. Our research started over a decade ago with the first population-based cohort study comparing AL and NHs in Canada. Our current research includes repeated surveys (10/2020–04/2021 and 07/2021–09/2021) with family/friend caregivers and AL facilities, and population-based clinical and health administrative data (2017-2021) from AL and NH residents in Western Canada. Five presentations will report on the design/methods/goals of COVCARES (#1), the impact of the pandemic on family/friend involvement in AL resident care (#2), impacted of the pandemic on psychotropic drug prescriptions in AL (#3), and the association of AL home preparedness for and response to the pandemic on resident pain (#4) and loneliness (#5). Our discussant (Anna Beeber) will highlight similarities and differences between AL and NHs, similarities and differences in both settings between the US and Canada, and how policymakers can account for these differences.