bluuebunny/crossref_metadata_2025_split huggingface dataset:
LGBTQ AGING PARADOX: NEEDING WHILE AVOIDING LONG-TERM SERVICES AND SUPPORTS
Authors: Moone Rajean 
Published: December 2023

Abstract
A growing body of literature recognizes the significant health disparities experienced by sexual and gender minority (SGM) older adults including higher rates of chronic conditions, mental illness, and disabilities in comparison to their peers. Simultaneously SGM older adults are more likely to age alone and not have a friend or family caregiver to provide support. At the same time SGM older adults express hesitation and fear in accessing formal long term services and supports (LTSS). One study of trans older adults noted that suicide was a preferred option to a nursing home. This paper will outline a complex paradox: Many SGM older adults (1) experience significant health disparities which may require additional support; (2) lack informal support thus needing to rely on formal LTSS; and (3) avoid formal services due in large part to fear of discrimination and poor treatment. Opportunities to mitigate the paradox through education and awareness as well as implications for policy and research will be discussed.
POLYPHARMACY AND THE SYMPTOM EXPERIENCE OF OLDER ADULTS WITH AND WITHOUT ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Authors: Coates Martha , McClure Leslie , Finley Margaret , Sefcik Justine , Gitlin Laura , DiMaria-Ghalili Rose Ann 
Published: December 2023

Abstract
Older adults, including those living with Alzheimer’s disease and related dementias (ADRD), experience polypharmacy (PPY) (&gt;5 medications daily) due to multiple chronic conditions. High symptom burden in older adults with ADRD and multimorbidity is well known. However, there is a gap in knowledge regarding symptoms experienced by older adults with and without ADRD who experience PPY. To address this gap, we conducted a longitudinal case-control observational study utilizing Rounds 6 to 9 (2016 to 2019) of the National Health and Aging Trends Study (NHATS) datasets. PPY was categorized by the number of medications from Round 6. We categorized individuals into four groups based on presence of ADRD and/or PPY (PPY and ADRD, PPY only, ADRD only, no PPY/ADRD) (N=2052). We identified symptoms associated with PPY (hopelessness, anxiety, general pain, stomach pain, breathing problems, weight loss, balance problems, fatigue, insomnia) in each group over each time point. Among those with ADRD (11.8%), over half experienced PPY (52.3%). Older adults with PPY and ADRD experienced a mean of 4.85 symptoms over all time points compared to 3.52 (ADRD only), 2.79 (no PPY/ADRD) and 3.93 (PPY only) (p=&lt;0.001). Symptom frequencies in the PPY and ADRD group remained higher than all other groups across all four time points. Understanding the impact of medications on older adult’s quality life is a goal of the 4Ms framework. Future research will examine the symptoms associated with PPY and ADRD, physical function and health outcomes to inform medication management for older adults with dementia.
DEMENTIA CAREGIVERS, BURDEN, AND EMERGENCIES
Authors: Crawford Nicole , Levin Bruce , Gum Amber , Tyson Dinorah Martinez , Masys Anthony , Huntington-Symons Makeba 
Published: December 2023

Abstract
Caregivers of people living with dementia face multiple barriers, including social isolation, mental health problems, limited time for themselves, and limited support services. Navigating emergencies, including hospitalization, financial loss, and natural disasters, can exacerbate the burden that dementia caregivers face. This study examined dementia caregivers’ perspectives on burden, emergencies, and emergency preparedness. Semi-structured interviews were conducted with a predominantly female sample of fourteen dementia caregivers living in Florida. Data were analyzed using thematic analysis methods to define codes and identify themes. Results showed all dementia caregivers identified the term burden as having a negative connotation about their experience and the person living with dementia. Dementia caregivers predominantly stated that they cared for their family members out of love and a sense of responsibility. Findings also showed individual and caregiving experiences (e.g., being a single mom or having a previous caregiving role) prepared dementia caregivers to define and encounter emergencies. Understanding caregivers’ perspectives of burden, emergencies, and emergency preparedness is essential to developing evidence-based interventions and support services that aim to mitigate the adverse effects of emergencies on caregivers. Implications of using preferred terminology and recommendations for providing person-centered emergency planning will be discussed.
FAMILY CAREGIVERS’ REFLECTIONS ON FAMILY SUPPORT AND PREPAREDNESS FOR END-OF-LIFE CAREGIVING
Authors: Fox Aimee , Fruhauf Christine , Sharp Julia 
Published: December 2023

Abstract
Family caregivers often report not having the knowledge or skills to provide care needed at their care receiver’s end of life (EoL), leaving them vulnerable to emotional, psychological, physical, and financial stress. These stressors may be due to increasingly complex caregiving responsibilities, difficult medical decisions, and anticipatory grief. Studies have also found a higher incidence of adverse effects among dementia caregivers. Few studies have examined how family support is associated with preparedness for EoL caregiving. Thus, the purpose of this study was to explore family caregivers’ feelings of preparedness and family-member support for EoL caregiving, comparing responses between dementia care providers with all other caregivers. A sample of family caregivers were recruited to complete an online, self-report survey. Open-ended questions were included to explore caregivers’ feelings of preparedness and family support. Of all participants, 206 family caregivers responded to the open-ended questions. Nearly 40% (n=79) of these caregivers were providing care to a family member with Alzheimer’s disease or related dementia. Qualitative methods were used to analyze data, develop a coding scheme, and identify themes. Findings suggest that most family caregivers are providing care without adequate help, support, or communication from other family members. This lack of support seems to leave dementia caregivers feeling less prepared and more frustrated than other caregivers. Our findings highlight the importance of family communication about advance care planning and caregiving responsibilities to promote family caregiver preparedness and well-being, and effective care and quality of life for an individual at the end of their life.
MENTAL HEALTH AND WELLBEING ACROSS THE COVID-19 PANDEMIC AMONG OLDER PEOPLE IN ENGLAND
Authors: Beach Brian , Zaninotto Paola 
Published: December 2023

Abstract
Numerous studies have identified declines in mental health and psychosocial wellbeing over the course of the COVID-19 pandemic across the world and in different age groups, including older people. A key question for researchers, health practitioners, and policymakers alike is whether the influence of the pandemic on these outcomes is temporary or more long-lasting. The lived experience of the pandemic, such as lockdowns, likely played a role in shaping mental health and wellbeing, but recovery is not always immediate following the removal of such negative stimuli. Our recent work using the English Longitudinal Study of Ageing (ELSA) identified that depression, anxiety, and quality of life demonstrated statistically significant worsening trajectories between ELSA Wave 9 (2018/19) and through two assessments during the pandemic, i.e. June/July and Nov/Dec 2020. Because depression and anxiety are also common neuropsychiatric symptoms among people with dementia or mild cognitive impairment, we also examined differences according to cognitive function, finding a convergence among cognitive function groups in the risk for poor mental health through the pandemic. This paper expands on this work to incorporate ELSA Wave 10, the first survey assessment after the easing of key pandemic-related restrictions and health crisis measures, to assess how older people are faring since the acute phase of the pandemic in terms of mental health and wellbeing. It highlights key subgroup dynamics, including cognitive function group, that are associated with patterns of recovery in mental health and wellbeing to pre-pandemic levels and those linked to more long-lasting adverse experiences.
DISPARITIES IN LONELINESS AMONG OLDER ADULTS IN THE UK: AN EVIDENCE OVERVIEW AND CRITICAL EVALUATION
Authors: Victor Christina 
Published: December 2023

Abstract
We propose that there are three elements to healthy ageing: physical, mental and social. As a concept social health is less well researched although there is a significant literature on specific aspects of this concept such as loneliness or isolation. Researchers in the USA and Europe focussing on inequality in later life health outcomes have predominantly emphasised inequalities in physical and/or mental health. It is only comparatively recently that attention has been given to addressing disparities in aspects of social health because of the wide-spread stereotype that ‘all older adults’ are lonely and isolated. UK studies consistently demonstrate that specific individual characteristics such as gender, marital status, household composition, physical/mental health, ethnicity and socio-economic status are associated with higher risk of loneliness. Interventions for loneliness are rarely effective. We critique this evidence base on three grounds. First analysis of loneliness disparities focuses on individual characteristics rather than considering an intersectional approach that addresses the complexity and multiplicity of characteristics and identities that each of us embody and how these are associated with loneliness and other social health outcomes. Second research evidence is predominantly cross-sectional with some longitudinal studies. We argue that to fully understand loneliness and other late life social health disparities we need to adopt a lifecourse approach. Thirdly analysis of disparities in loneliness emphasises individual characteristics rather than adopting an ecological perspective which incorporates these, the effects of time as well as macro-level factors such as cultural norms and meso neighbourhood type, urban design and community cohesion.
TESTING MULTICOMPONENT DIGITAL THERAPIES TO PROMOTE HEALTHIER LIFESTYLE BEHAVIORS IN OLDER ADULTS: A PILOT STUDY
Authors: Evangelista Lorraine , Reyes Andrew-Thomas , Tran Dieu-My , Serafica Reimund 
Published: December 2023

Abstract
Multicomponent digital interventions to encourage healthy diet and physical exercise in older persons at risk for cardiovascular disease are understudied. We compared the feasibility and effectiveness of Get FIT vs. Get FIT+, two digital-based therapies, to encourage healthier lifestyle behaviors in this high-risk population. Fifty-four older adults (66.6 ± 5.9 years, 61% females, 61% married, 50% Asians, 39% Whites) were randomized to Get FIT (n=24), which included a health app, an activity tracker, and one 45-minute behavioral counseling session on healthy eating and exercise, or Get Fit+ (n=30), which added three months of health coach-personalized text messaging. We assessed retention, engagement, satisfaction, diet, physical activity, weight, cardiometabolic risks, and psychological well-being pre-and post-intervention. At three months, both groups had a 100% retention rate. Get FIT+ participants expressed high satisfaction, with 92% reporting that they would recommend Get FIT+. Individuals in both groups increased their physical activity and reduced their caloric consumption from baseline to three months. However, these changes were significantly greater in the intervention group (p .0001). Get Fit+ participants averaged a three-pound weight loss, whereas their counterparts averaged a three-pound weight gain (p .0001). Get FIT+ individuals had significantly lower systolic and diastolic blood pressure, triglycerides, total cholesterol, and HgbAa1C than Get FIT participants from baseline to three months. Both groups showed similar psychological well-being over time. Our findings imply that the Get Fit+ intervention may be more effective in lowering cardiometabolic risk in this cohort, although longer-term trials are needed.
RESIDENTIAL SEGREGATION AND DEPRESSIVE SYMPTOMS IN OLDER CHINESE IMMIGRANTS: MEDIATING ROLE OF SOCIAL PROCESSES
Authors: Li Ke , Tang Fengyan , Jiang Yanping , Rosso Andrea 
Published: December 2023

Abstract
Older Chinese immigrants are particularly at risk for depression due to acculturative stress and language barriers. Residential segregation with respect to language use may play an important role in mental health of historically marginalized immigrant populations. Previous research provided mixed evidence about the segregation effect among older Latino and Asian immigrants. Guided by a model of social processes, we examined the direct and indirect effects of residential segregation on depressive symptoms via multiple mechanisms of acculturation, discrimination, social network, social support, social strain, and social engagement. Four waves of depressive symptoms were assessed in the Population Study of Chinese Elderly (2011-2019, N=1,970), and linked to the 2010-2014 American Community Survey estimates of neighborhood context. Residential segregation was measured by the Index of Concentrations at the Extremes that simultaneously assesses Chinese and English language use within a given census tract. Latent growth curve models with adjusted cluster robust standard errors were estimated after controlling for individual-level factors. Residents of segregated Chinese-speaking neighborhoods had fewer baseline depressive symptoms but a slower decline rate than those living in segregated toward English-only speaking neighborhoods. Racial discrimination, social strain, and social engagement partially mediated the association between segregation and initial level; social strain and social engagement also partially mediated the association with decline in depressive symptoms. This study demonstrates the importance of residential segregation and social processes in shaping mental well-being among older Chinese immigrants and suggests potential mechanisms to alleviate mental health risks.
SOCIAL SUPPORT, RESIDENTIAL SEGREGATION, AND HEALTH OF OLDER CHINESE AMERICANS
Authors: Ma Yiming , Jiang Yanping , Bergren Stephanie , Tang Fengyan 
Published: December 2023

Abstract
The limited but increasing body of research on residential segregation among U.S. older Asian Americans shows inconsistent findings on the health impact of residential segregation. These mixed findings suggest that the relationship between residential segregation and health may depend on some individual characteristics. This study aimed to investigate the moderating effect of perceived social support on the relationship between residential segregation and the two health outcomes: depressive symptoms and cognitive function among older Chinese Americans. Data were drawn from 3,097 older Chinese immigrants from the PINE Study in 2011-2013. Residential segregation was measured by the Index of Concentrations at the Extremes (ICE) at census tract level, which captured the concentration of Chinese-only speakers and English-only speakers at extreme. The social support measurement was the perceptions of social support provided by spouse, family, and friends. Depressive symptoms were measured by Patient Health Questionnaire (PHQ-9). Cognitive function was assessed by Mini-Mental State Examination, executive function, working memory, and episodic memory measures. Results showed a positive and significant moderating impact of social support on the relationship between ICE and depressive symptoms (β=0.086, p=0.034). Specifically, living in neighborhoods segregated towards Chinese-speaking was associated with fewer depressive symptoms at high, but not low levels of perceived social support. There were no moderation effects of perceived social support on the relationship between ICE and cognitive function. These results indicate the protective effect of living in neighborhoods segregated towards Chinese-speaking on depression, but only when older Chinese immigrants have high levels of perceived social support.
ASSOCIATIONS BETWEEN SHARED TIME AND MENTAL HEALTH IN MARRIED COUPLES
Authors: Karakose Selin , Ledermann Thomas , Sutin Angelina , Terracciano Antonio 
Published: December 2023

Abstract
Spending time with the partner has been found to be beneficial in many ways for both the relationship and the individuals. However, little is known about the associations between time spend together and the partner’s mental health. The present study examined the dyadic associations between time spent with spouse and mental health, particularly depressive symptoms, anxiety, and stress. Using data from 145 married couples from Turkey (M wives = 39.84 years, M husbands = 42.97), we investigated whether time spent with the spouse is associated with the mental health of both the individual and their spouse. Actor-Partner Interdependence Model (APIM) analyses indicated that both husbands’ and wives’ perception of time spent together was associated with lower stress. Additionally, for wives, time spent together was negatively associated with their own depression. These findings revealed that spending time together can help to cope with stress and have a positive effect on wives with elevated depressive scores.
ADAPTATION OF THE PPC APPROACH FOR HISPANIC OLDER ADULTS
Authors: Samper-Ternent Rafael , Perez Gilberto , Hladek Melissa deCardi , Fonseca Carolina 
Published: December 2023

Abstract
Older Hispanics have a high prevalence of MCC, contributing to a higher risk for dementia. As a result, there is a rapid increase in the number of young Hispanics assuming caregiver roles. The caregiver role is a cultural expectation among Hispanics and caregiving by the family is preferred over professional caregiving. There is limited information on how the unique context of Hispanics impacts the dyadic interactions between older adults and their care partners. There is a gap in the literature on how health values among Hispanics frame their healthcare goals and preferences and whether care partner involvement impacts the identification of these goals and preferences. There is also a limited number of evidence-based interventions that can help shift the current healthcare paradigm from clinical-guideline-based care to patient-centered care for underrepresented older adults. Thus, we used the Heuristic Framework to culturally adapt PPC for Hispanics with MCC and cognitive impairment living in Texas and embed it in two Geriatrics Clinics. We will describe the adaptation and implementation process and share findings from a pragmatic pilot study with 25 older Hispanics that participated in the PPC approach. We will share the outcomes from this pilot and the feedback received from patients, caregivers, and clinicians on the implementation of PPC at these clinics. We will conclude by sharing the current plans to expand the outreach of PPC for diverse older adult populations.
LONGITUDINAL FACTORS ASSOCIATED WITH LIVING WELL IN PEOPLE WITH MILD TO MODERATE DEMENTIA
Authors: Clare Linda , Gamble Laura , Martyr Anthony , Matthews Fiona 
Published: December 2023

Abstract
Understanding the factors associated with quality of life can help us become more effective in optimizing the potential for people with mild-to-moderate dementia to ‘live well’. Identifying individuals at risk of declining quality of life could help to target support more appropriately. We used longitudinal data from 1749 individuals with mild-to-moderate dementia participating in the IDEAL cohort. Assessments took place on entry and at 12, 24, 48, 72 and 96 months. Using mixed effects modelling we examined change in quality of life, as measured by QoL-AD, since time of diagnosis, and looked at time-invariant and time-varying measures and their association with decline in quality of life at 6 years. Mean quality of scores life were stable over our six year follow up period. However, we were able to identify some individuals whose quality of life declined by varying amounts over this period. A larger decline was associated with being male and older, and those with a decline in quality of life had worsening cognitive function and increasing depression in the years following diagnosis. Our results show that quality of life does not decline for most people following a diagnosis of dementia. However, for those that did decline we were able to identify key factors associated with this decline. This model allows us to investigate further factors that may influence living well in people with dementia, and identify, at diagnosis, those most ‘at risk’ of decline and identify potential remediating factors that could inform potential intervention to mitigate this decline.
FACILITATING GROWTH VIA INDEPENDENT LEARNING PLANS FOR PSYCHOLOGISTS TREATING OLDER VETERANS WITH CHRONIC ILLNESS
Authors: Gregg Jeffrey , Rodriguez Rachel , Mehta Priyanka , Kramer Josea , Gould Christine 
Published: December 2023

Abstract
The VA Geriatric Scholars Program-Psychology Track (GSP) is a national post-licensure geropsychology training program for VA psychologists caring for rural-dwelling older veterans with complex physical, cognitive, and psychological comorbidities. In 2019, GSP developed an advanced workshop model to invest in the continued growth its alumni. The workshop focused on enhancement of geropsychology competencies in treating older veterans with chronic mental and physical illnesses (e.g., PTSD, dementia, diabetes). To facilitate ongoing and individually tailored learning following the workshop, participants developed and executed Independent Learning Plans (ILPs) during a 6-month window with consultation from an experienced geropsychologist. Upon completion, participants submitted final reports and responded to three prompts assessing overall experience, usefulness, and future plans. We examined these qualitative data using a rapid analysis approach with summary templates. Fourteen of 19 participants (73.7%) submitted both final reports and responses to the prompts. All 14 respondents endorsed clinical and/or personal usefulness of the ILPs, with emerging themes including increased confidence, enhanced skills for use with patients with complex needs, and career advancement. Regarding overall experience, most participants noted positive outcomes, including feelings of fulfillment, and noting that ILPs were feasible and learning resources were accessible. A minority (35.7%) identified meaningful barriers most often associated with not having enough time. Future directions included plans to learn new assessment/treatment approaches, read relevant literature, and pursue additional career advancement (e.g., board certification in geropsychology). Overall, our findings suggest ILPs are a viable way to enhance psychologists’ experience and effectiveness in treating older veterans with complex needs.