bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEIGHBORHOOD ENVIRONMENT AND DEPRESSIVE SYMPTOMS OF OLDER ADULTS IN URBAN AND RURAL CHINA : A MODEL OF SOCIAL CAPITAL
Authors: Li Yuekang 
Published: December 2023

Abstract
Depression is a significant mental health issue among older adults worldwide. This study aimed to examine the mechanisms linking neighborhood environment to depressive symptoms among Chinese older adults and how other levels of social environment influence this relationship. Using data from the China Family Panel Studies, mediation and moderated mediation models were tested among 3,483 urban and 3,812 rural adults aged 60+ years. Results showed that community-level social capital (trust, reciprocity, belonging) partially mediated the association between built neighborhood environment and depressive symptoms in both urban and rural areas. The indirect pathway linking neighborhood environment to fewer depressive symptoms through community social capital was more evident when older adults reported less society social capital, suggesting a compensatory relationship between these two types of social capital. However, this relationship was significant only for urban older adults. The findings highlight the importance of distinguishing different levels of older adults’ social environment. Fostering community social capital through improving neighborhood walkability, safety, and amenities could benefit older adults’ mental health. Community development efforts may play a compensatory role for urban older adults lacking societal-level social resources.
NOVEL GENE VARIANTS ASSOCIATED WITH HBA1C CHANGES OVER TIME AMONG NONDIABETIC SUBJECTS IN THE LONG LIFE FAMILY STUDY
Authors: Wang Siyu , Thyagarajan Bharat , Lee Joseph , Zmuda Joseph , Christensen Kaare , Province Michael , An Ping 
Published: December 2023

Abstract
Longitudinal changes in HbA1c (ΔHbA1c) are associated with insulin resistance, aging, cognition, and mortality. To identify novel gene variants underlying ΔHbA1c, we conducted linkage-guided sequence analysis on 17p12 (LODs=3.59) in the Long Life Family Study, a study with familial clustering of exceptional longevity in the US and Denmark. Subjects with clinical diagnosis of diabetes or diabetes treatment and undiagnosed diabetes cases whose fasting glucose ≥ 126 mg/dl or HbA1c ≥ 6.5% were excluded. ΔHbA1c, collected from two exams 7 years apart, was derived using growth curve modeling, adjusting for age, sex, BMI, smoking, field centers and PCs, and was blom-transformed to approximate normality. We identified a significant variant under the linkage peak (ARHGAP44 rs56340929, p=1.77E-06, MAF=6%, accounting for linkage=26.5%). Taking advantage of our currently available RNAseq data, we found a significant association between quantification of ARHGAP44 RNA transcript and adjusted ΔHbA1c using 16 linkage enriched families (n=176, β = -0.24, SE=0.09, p=0.01). We also assessed currently available lipidomics data (188 metabolites, 13 compound classes) and found phosphatidylcholine (p=0.025) and lysophosphatidylcholine (p=0.02) were marginally associated with adjusted ΔHbA1c. ARHGAP44 is reportedly associated with glycemic traits and is mainly expressed in the brain. Further complete omics-data analyses in the LLFS and a replication study using the Framingham Offspring Study are underway.
OLDER ADULTS’ SAVORING ABILITY IS ASSOCIATED WITH LONGITUDINAL CHANGE IN WELL-BEING
Authors: Stephens Jacquelyn , Mertz Laurel , Smith Jennifer 
Published: December 2023

Abstract
Well-being in older adults is an important concern as the aging population grows, as is identifying modifiable factors that contribute to well-being over time. The ability to savor the moment (i.e., to notice and enhance one’s emotional response to positive events) has been shown to be associated with greater well-being, though few studies have examined these relationships longitudinally or in older adults. The current study examined whether savoring ability moderated the trajectory of older adults’ life satisfaction and depressive symptoms over time. A sample of 5777 older adults (Mage = 83.83, SD = 6.61; 66.6% female), recruited from Life Plan Communities, completed four consecutive annual surveys. Multilevel growth curve models revealed main effects of small but significant declines in well-being over time (life satisfaction: B = -.09, SE = .01, p &lt; .001; depressive symptoms: B = .13, SE = .01, p &lt; .001), after accounting for age, gender, education, life stress, and health. Interactions between time and savoring ability indicated that participants with greater savoring ability were better able to maintain their levels of well-being (i.e., smaller decline in life satisfaction [B = .05, SE = .01, p &lt; .01] and smaller increase in depressive symptoms [B = -.10, SE = .01, p &lt; .01]). In contrast, individuals lower in savoring ability experienced less favorable well-being trajectories. Savoring is a malleable emotion regulation ability that is associated with attenuated declines in well-being over time. Implications for savoring interventions in older adults will be discussed.
ON THE FRONTLINES: TRAINING A DEMENTIA CAREGIVING WORKFORCE IN CALIFORNIA
Authors: Pond Brittney , Eldridge Corinne , Neri Mel , Beld Matthew , Ross Leslie , Martinez Suzanna , Hollister Brooke , Yeh Jarmin 
Published: December 2023

Abstract
Direct care workers who provide in-home care – such as caregivers hired by consumers of California’s Medicaid-funded In-Home Supportive Services (IHSS) program – are well positioned to observe changes in their consumer’s cognition, health, or behaviors. This proximity to consumers better allows for reporting to healthcare partners, which may reduce risk of emergency department visits, hospitalizations, and other adverse outcomes that are disproportionately high among people living with Alzheimer’s disease and related dementias (ADRD). Despite their vital role in supporting people living with ADRD, IHSS caregivers receive minimal formal training for their unique position. To address this training gap, the IHSS+ ADRD Training Project is a five-year effort funded by the California Department of Public Health to train 720 IHSS caregivers in Alameda and Los Angeles counties, with classes in English, Spanish, Cantonese, and Mandarin. To date, 582 IHSS caregivers have been trained. Using a pre-posttest design, our preliminary findings indicate statistically significant increases in dementia knowledge and self-efficacy that could bolster caregiver’s skills. These results also reveal that IHSS caregivers value training opportunities to better support their consumers. Correlations between caregiver training outcomes and healthcare utilization patterns of their consumers were further examined by evaluating administrative data before and after the training. The results need to be further understood in the context of COVID-19 and the ADRD illness trajectory. Implications include expanding long-term funding for multi-week training programs, which aligns with the California Master Plan for Aging’s goal to support and create one million high-quality caregiving jobs by 2030.
ORPHANED ELEPHANTS EXHIBIT HIGHER THYROID HORMONE CONCENTRATIONS COMPARED TO CONTROLS
Authors: Chusyd Daniella , Brown Janine , Paris Steve , Dickinson Stephanie , Steiniche Tessa , Austad Steven , Allison David , Wasserman Michael 
Published: December 2023

Abstract
Wild elephant populations provide a natural experiment to study biological effects of early adverse events, such as being orphaned due to poaching. We compared fecal glucocorticoid metabolite (fGCM) and thyroid hormone (T3) concentrations, and body condition between rescued orphaned elephants and similarly age-matched, control wild elephants. In 2021, single fecal samples were collected during the early (n=20 orphans; n=58 controls) and late (n=20 orphans; n=22 controls) dry seasons. Age was known (+/- 3 months) for orphans and estimated by dung diameter (+/- 1 year) for controls. Sex was assigned based on morphology and unknown for some controls. Body condition scores (BCS: 1 to 9) were assigned at time of sample collection. Linear Mixed Models accounting for repeated measures were performed adjusted for age and season. There was no difference in fGCM between orphans (mean 101.48, SD 59.62ng/g) and controls (mean 93.86, SD 49.97ng/g) (p=0.213). Orphans (mean 271.75, SD 123.16ng/g) had higher T3 concentrations compared to controls (mean 98.65, SD 71.89ng/g) (p&lt; 0.001). There was no difference in BCS between groups (p=0.629). In orphans, fGCM was associated with age (beta=-0.499, p=0.011). In controls, T3 was correlated with fGCM (beta=0.287, p=0.011) and season was associated with fGCM (p=0.008) and BCS (p=0.044). Either because of living under human care or because of alterations in T3 secretion, seasonal factors do not seem to impact orphans’ health status to the same extent as in control elephants. The support of an adopted herd may attenuate the physiological stress associated with experiencing trauma in our study population.
PATIENT PORTAL USE IN FAMILY CAREGIVERS OF PATIENTS WITH DEMENTIA OR CANCER: THE NATIONAL STUDY OF CAREGIVING
Authors: Bratches Reed , Wall Jaclyn , Puga Frank , Pilonieta Giovanna , Bakitas Marie , Geldmacher David , Odom J Nicholas 
Published: December 2023

Abstract
Family caregivers are often inexperienced and require information from clinic visits to effectively provide care for patients. The patient portal is a common way for health systems to engage family caregivers, especially those of patients with dementia or cancer. The objective of our study was to analyze a large, nationally representative sample of family caregivers from the National Study of Caregiving (NSOC) to determine factors associated with patient portal use among family caregivers of persons with dementia and of persons with cancer. We conducted a secondary data analysis using data from the 2020 NSOC, a large nationally-representative survey of family caregivers. Weighted regression analysis was used to examine associations between family caregiver use of the patient portal and demographic variables including age, race/ethnicity, gender, employment status, caregiver health, education, and religiosity. A total of 462 participants (4,589,844 weighted) were analyzed. In the fully adjusted regression model for caregivers of persons living with dementia, Hispanic ethnicity was associated with a higher odds of patient portal use (OR: 2.81; 95%CI 1.05, 7.57; p=0.04) and having less than a college degree was associated with a lower odds of patient portal use (OR 0.36; 95%CI 0.18, 0.71; p=&lt; 0.001). In the fully adjusted regression model for caregivers of persons living with cancer, no variables were associated with patient portal use. As the patient portal is a common method of connecting caregivers with information from clinic visits, future research should focus on understanding how the portal is used by the groups we have identified, and why.
PEOPLE NEED PEOPLE: A MIXED METHODS STUDY OF COMPANION CAREGIVERS
Authors: McNamara Kelsey , Lang Samantha , Meadows Jill , Hackel Emily , Rudy Ellen 
Published: December 2023

Abstract
Researchers have found positive aspects of caregiving (PAC) for both formal and informal caregivers, including social connection and sense of purpose. However, few have explored the experience of a novel source of helping individuals age in place: companion caregivers (CC), that is someone who is paid for providing companionship and assistance with everyday tasks that are non-medical. We conducted a descriptive mixed methods study to understand the experience of being a CC. Sixteen CCs who completed 10+ caregiving visits participated in semi-structured interviews and related questionnaires in 2023. Quantitative and qualitative data on CC’s perceptions of the impact of caregiving on their own whole health domains (physical, mental, social, purpose) were analyzed. In addition we examined CC’s perceptions of care recipients’ (CR) unmet social needs, risks in the home, and barriers to CRs achieving improved health domains. Among the cohort, the average age was 53, 63% White, and 31% lived alone. Majority of CCs indicated that they always feel a sense of belonging when with their CRs (n=15) and felt better about themselves after interacting with CRs (n=16). Common PAC across whole health domains emerged, including increased physical activity, improved social connection, and helping others improve CCs’ lives. Common barriers to CRs’ improving their whole health included: decreased social connection, physical limitations, and transportation insecurity. These insights highlight potential benefits for those who might engage in companion caregiving arrangements. More research is needed as new models of caregiving are necessary to meet the demands of our aging population.
PERSON-FIRST LANGUAGE FOR OLDER ADULTS INCARCERATED IN PRISON: A RAPID EVIDENCE ASSESSMENT
Authors: Merss Kristin , Block Laura , Kwas Stephen 
Published: December 2023

Abstract
Language can influence a person’s sense of self, relationship with healthcare providers, healthcare utilization, or their own symptoms and behaviors. The person-first language movement began decades ago and has been widely adopted by multiple fields including nursing, medicine, gerontology, and social and health sciences more broadly. For research involving older adults, non-stigmatizing language has become the standard for researchers. Incarceration is widely considered a dehumanizing experience, with recent calls for attention to the language used by researchers when describing their incarcerated participants. Researchers are also identifying that individuals with multiple stigmatizing identities (e.g., incarcerated and disabled, older adult) warrant specific consideration. This study presents a secondary review of terminology from a Rapid Evidence Assessment (REA) investigating what is known about transitions of older adults in the incarceration system. The REA included PubMED, PscyhMED, and CINHAL. Nineteen articles met inclusion criteria (11 qualitative, 11 quantitative, 3 mixed methods). As a sub-analysis, articles were analyzed to consider the language that was used to describe the currently or formerly incarcerated older adults who were the subject of the studies. The majority of articles considered older adults who were no longer incarcerated. While person-first language (i.e., “formerly incarcerated person”, “reintegrating women”, “older adult on parole”) was common, stigmatizing language such as “prisoner”, “offender”, “homicide offender”, and “ex-convict” were used in the majority of the studies included in the review. Appreciation and adoption of person-first, non-stigmatizing language should transcend not only research literature surrounding older adults in the community, but also incarcerated older adults.
PHYSICAL ACTIVITY, SEDENTARY BEHAVIORS AND MYOSTEATOSIS IN AFRICAN CARIBBEANS
Authors: Bessette Lily , Cvejkus Ryan , Acevedo-Fontanez Adrianna , Kuipers Allison , Zmuda Joseph , Wheeler Victor , Miljkovic Iva 
Published: December 2023

Abstract
Skeletal muscle fat infiltration (myosteatosis) leads to poorer muscle quality and function with aging, and is emerging as a predictor of skeletal muscle strength, mobility, and metabolic disorders. Few studies investigated the association of physical activity (PA) and sedentary behavior (SB) with myosteatosis, especially in African Caribbeans, a vastly under-studied, rapidly growing population. We examined the associations of objectively measured PA and SB (Bodymedia SenseWear Armbands) worn over 7 days with calf muscle density (mg/cm3), a marker of intra-muscular fat (Stratec XCT-2000), in older adult African Caribbean men (N=355, mean age 62 years) and women (N=682, mean age 59 years) of the Tobago Health Study. Compared to men, women were younger with higher BMI, more SB, less light (LPA) and moderate to vigorous PA (MVPA), and lower muscle density (p&lt; 0.05, age-adjusted). Meeting MVPA guidelines (150 min MVPA/week) was associated with greater muscle density in obese men and women (p=0.03, p=0.09 respectively, age-adjusted). Adjusting for age, BMI, smoking, diabetes, hypertension, and lipid-lowering treatment, we assessed sex stratified partial spearman correlations between PA and SB and muscle density. MVPA was more strongly correlated with greater muscle density in men (r=0.15, p=0.01) than in women (r=0.07, p=0.09), while SB was associated with lower muscle density in women (r=-0.08, p=.044), but not significantly in men (r=-0.10, p=0.12). Our novel findings indicate that the association between PA and SB with myosteatosis may differ by sex. These findings may have important implications for sex specific activity guidelines related to skeletal muscle health in African Caribbeans.
PREDICTORS OF FINANCIAL BURDEN IN TWO SAMPLES OF ADULTS WITH ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Authors: Clayton Jordana , Iacob Eli , Aruscavage Nancy , Utz Rebecca , Supiano Katherine , Bybee Sara , Dassel Kara 
Published: December 2023

Abstract
Compared to other older adults with chronic illness, individuals diagnosed with Alzheimer’s disease and related dementias (ADRD) incur much higher care costs at the end of life. The financial strain created by these high costs is experienced unevenly, as individuals who are low-income and minorities may have difficulty meeting out-of-pocket costs of care. Our objective was to examine the relationship between reported concern about being a financial burden to others and socioeconomic and demographic variables. To accomplish this, we conducted a mixed-methods study of two samples of individuals diagnosed with ADRD aged 31-89 (mean 63, n = 44) and 50-89 (mean 66, n=38) using two ordinal logistic regression models and qualitative analysis. The ordinal regression models indicate that the probability of reporting higher financial burden increases with lower age, higher education, and being widowed. One model shows income and employment as significant predictors of financial burden, particularly for the “forgotten middle” who have a high enough income not to qualify for social support programs but low enough income to experience strain from high out-of-pocket costs. In the qualitative analysis, we categorized 309 free responses from the second sample using the Financial Hardship Typology into concerns of material conditions / ability to pay (n=40), psychological distress about being a financial burden (n=28), and coping behaviors / limiting care to reduce costs (n=20). These results point to ways that social programs need to be improved to better support individuals with ADRD who are experiencing financial strain during the end-of-life.
PRESSURED TOUCH FOOT CARE TO RELIEVE CHRONIC PAIN AND IMPROVE QUALITY OF LIFE
Authors: Clayton-Jones Mary 
Published: December 2023

Abstract

Background
Chronic pain affects many older adults and is a leading cause of disability. It is often treated pharmacologically, but evidence indicates touch therapy modalities are beneficial. Purpose: To implement a therapeutic touch program for adults enrolled in a Program of All-Inclusive Care for the Elderly (PACE) to help reduce chronic pain and improve quality of life for those patients enrolled in this project.

Method
Twelve participants in an assisted living facility with chronic foot pain were initially selected by the PACE Family Nurse Practitioner (FNP) for home visits with this Doctor of Nursing Practice (DNP) student for a foot care and pressured touch intervention to occur once a month for 3 months. The McGill Pain and Quality of Life Scores questionnaires were administered before each intervention.

Results
Four participants completed all three interventions. Every participant experienced a decrease in pain pre- and post-intervention and month-to-month of 15% or more. Three participants had experiences of complicated grief and had a decrease in quality-of-life scores over the 3 months. The participant without complicated grief had an improvement in the quality-of-life scores with pain reduction.

Conclusions
This small home intervention project for chronic foot pain demonstrated that foot care and pressured touch may be a cost-effective adjunct therapy for reducing pain. Chronic pain can be complicated by grief, which must be considered when looking to support elder wellness and quality of life. Keywords: Chronic pain, therapeutic touch
PROFILES OF DIGITAL LITERACY AMONG COMMUNITY-DWELLING KOREAN OLDER ADULTS: A LATENT PROFILE ANALYSIS
Authors: Shin Jiyoung , Kang Hun , Choi Seongmi , Choi JiYeon 
Published: December 2023

Abstract
Digital divide exists among not only between older and younger generations but also within the older adult population. Understanding digital literacy profiles among older adults is important to identifying strategies for reducing digital divide among this population. This study aimed to identify profiles of digital literacy among community-dwelling older adults and examine associated factors. Data were collected from a national survey of 1016 community-dwelling older adults in Korea (average age 68.0±6.5 years, 47.8% male). Digital literacy was evaluated across three domains: ’Information and Communication’ (9 items), ’Contents Creation and Management’ (4 items), and ’Safety and Security’ (9 items). Latent profile analysis and multinomial logistic regression yielded three digital literacy profiles: “Low-level” (35.7%, n=363), “Middle-level” (39.2%, n=398), and “High-level” (25.1%, n=255). Compared to the low-level group, a higher likelihood of belonging to the middle level group was associated with younger age, higher education level, higher dependence on instrumental activities of daily living, longer digital device use, and participating in offline social activities. Similarly, a higher likelihood of belonging to the high-level group was associated with younger age, higher education level, higher dependence on instrumental activities of daily living, longer digital device use, better physical well-being, doing daily physical exercise, and greater social support. These findings suggest characteristics associated with lower digital literacy, including older age, lower education level, and reduced functional independence. To promote digital literacy in older adults, potential strategies encompass tailored access and guidance for digital device use specifically tailored to older adults, alongside efforts to nurture social connectedness.
PSYCHOMETRIC PROPERTIES OF THE KOREAN VERSION HOSPITAL SURVEY ON PATIENT SAFETY CULTURE IN HOME HEALTHCARE
Authors: Lee Kayoung , Lee Soohee , Woo Seoyoon 
Published: December 2023

Abstract
Patient safety culture is essential for quality care in healthcare organizations. Instruments for patient safety have been developed and widely implemented in hospital settings. The revised hospital survey on patient safety culture (HSOPSC) is one of the representative instruments for evaluating patient safety culture. In 2021, the Korean version of the HSOPSC 2.0 (K-HSOPSC 2.0) was developed. However, there is a lack of evidence to examine the validity of the instrument in home healthcare settings. This study aimed to test the psychometric analysis of K-HSOPSC 2.0 in home healthcare settings in South Korea. We collected 215 certified advanced practice nurses (APNs) and nurse managers from 163 out of 175 home healthcare institutions in South Korea. We conducted the confirmation factor analysis (CFA) to examine the existing 10 dimensions of K-HSOPSC 2.0. Statistical analyses were performed with Stata 17.0, and the Satorra-Bentler (SB) method was used to adjust the standard error. The construct validity demonstrated an acceptable fit (RMSEA_SB=0.061, CFI_SB=0.912, TLI_SB=0.889). The K-HSOPSC 2.0 demonstrated high reliability (Cronbach’s α=0.90), except for teamwork (α=0.52) and staffing and work pace (α=0.39) among 10 dimensions. The validity of the measurement of patient safety culture was supported in home healthcare settings. However, further evaluation is needed for the two dimensions of ’teamwork’ and ’staffing and work pace’. In home healthcare settings, it is crucial to consider the role of patients and caregivers in teamwork and different home healthcare working environments in staffing that reflects unique home healthcare settings.