bluuebunny/crossref_metadata_2025_split huggingface dataset:
HOME BUT HOMEBOUND AFTER TBI: PREVALENCE AND CORRELATES OF HOMEBOUNDNESS AFTER TBI
Authors: Kumar Raj , Ornstein Katherine , Juengst Shannon , Reckrey Jennifer , Wagner Amy , Dreer Laura , Lercher Kirk , Dams-O’Connor Kristen 
Published: December 2023

Abstract
Discharge home following post-acute care for traumatic brain injury (TBI) has historically been viewed as an unequivocally positive post-treatment outcome. Payors incentivize hospitals to discharge patients home and minimize readmissions. A historically overlooked topic in post-acute TBI care is homeboundness, which is the state where an individual rarely or never leaves home. Homeboundness is associated with premature mortality and poor physical and mental health. Our study investigates the prevalence and correlates of homeboundness among 6,595 non-institutionalized adults (mean age=42, range 16-99) who received inpatient rehabilitation for TBI in the TBI Model Systems National Database, a multicenter prospective cohort study. Our definition of homebound was based on self-reported number of days participants get out of the house in a typical week. We found that 14.2% of participants were completely homebound (never left the home) or partially homebound (left the home 1-2 times/week) 1-year after TBI. Using multivariable regression, we found the following variables were significantly associated with being completely/partially homebound at 1-year post-injury: older age, &lt; college degree, Medicaid insurance, living alone and rural settings, not driving independently, and having functional needs for walking, upper body dressing, bowel and bladder, problem solving, and social interactions. These variables together had an area-under-the-curve of 0.81 distinguishing homeboundness. Our study elucidates an invisible subgroup of non-institutionalized adults living with TBI in the community who require ongoing support services or other follow-up care to improve functional status and participation. Implications for community integration will be discussed.
PAIN INTENSITY AND INTERFERENCE PREDICT STAGE OF ENGAGEMENT IN SELF-MANAGEMENT IN OLDER AFRICAN AMERICAN ADULTS
Authors: Booker Staja , Horgas Ann , Wu Jianli 
Published: December 2023

Abstract
Osteoarthritis in African American older adults often causes a disproportionate burden of severe chronic joint pain that interferes with physical and emotional/cognitive activities. One tool commonly used in clinical research studies to evaluate patterns in pain intensity and pain interference is the Brief Pain Inventory-SF (BPI-SF). Confirmatory factor analysis validated a three-factor structure of the BPI-SF comprising pain intensity, activity-related pain interference, and affective pain interference. However, what is unclear and novel, is whether these three factors predict stage of readiness to engage in osteoarthritis self-management. Stage of readiness to engage (pre-contemplation, preparation, action) were assessed for seven recommended osteoarthritis self-management strategies: land-based exercise, water exercise, strength training/stretching, assistive devices, warm/cool compresses, medications, and self-management education. Using secondary data from 110 African American men and women (Mean Age 68.4, SD= 12.4), we performed ANOVA and ordinal logistic regression in SPSS. Pain intensity, activity-related pain interference, and affective pain interference were not significantly different between stages of engagement in pain self-management strategies except for medication use and assistive devices (p&lt;.05). After controlling for age and employment, higher pain intensity was significantly associated with 27% reduction in the odds of being in preparation phase for water exercise, and higher levels of activity interference was associated with a 42% increase in the odds of being in the action phase for assistive devices. These results help us understand the relationship between behaviors and pain, particularly the impact of pain intensity and interference with physical activities on which strategies African Americans select to manage pain.
TWO SIDES OF THE SAME COIN: OPIOIDS AND CANNABIS FOR PAIN MANAGEMENT IN AFRICAN AMERICAN OLDER ADULTS
Authors: Jackson Simone , Booker Staja 
Published: December 2023

Abstract
Approximately 50 million U.S. adults live with chronic pain. Example treatments for chronic pain include opioids and the re-emerging cannabinoid pain management (CPM). However, older African Americans (AAs) are more likely to use pain treatments that are considered safe, affordable, and socially acceptable. We examined the perception of opioid and cannabis use for pain management in AA older adults by conducting: (1) secondary data analyses from two studies to quantify patterns of opioid and cannabis use, (2) a concept analysis to delineate the concept of CPM, and (3) developing data-driven model cases for CPM. Study 1 was a cross-sectional survey with 110 AA adults (age 50 and older) in Louisiana, and study 2 was observational with 72 AA adults (age 55 and older) in Florida with self-reported osteoarthritis. Both samples were primarily women, 79-81% respectively. Only 33% and 1.3% reported using opioid analgesics, while less than 4% in both studies reported using medical or recreational cannabis. Using Walker and Avant’s concept analysis approach, the (A) attributes of CPM include lower side effect profile and social acceptability; (B) antecedents include chronic pain, motivation to seek alternative treatment, access to cannabis dispensaries, family and professional support, and health literacy; and (C) the consequences are pain relief, lower mortality, self-efficacy, reduced anxiety, and empowerment. Lastly, based on our quantitative and qualitative data, we developed two model cases demonstrating support for and against CPM. These results illuminate the need to further understand the barriers and facilitators to using opioids and CPM in older AAs.
ASSESSING FRAILTY USING THE FIT-FRAILTY APP IN A NONGERIATRIC PRACTICE: A FEASIBILITY STUDY
Authors: Kouroukis Alexa , Tariq Suleman , Adachi Jonathan , Ioannidis George , Kennedy Courtney , Leckie Carolyn , Papaioannou Alexandra , Rodrigues Isabel 
Published: December 2023

Abstract
Frailty is a common medical condition with a prevalence of 24% in adults ≥50 years when using the Frailty Index. Thus, assessing frailty is a priority. The Fit-Frailty Application (App) is a user-friendly and validated measure that incorporates disease-related, physical, cognitive, psychosocial, and functional aspects of frailty. The purpose of this study was to determine the feasibility of using the App in a non-geriatric clinic. We conducted a cross-sectional study in a rheumatology clinic in Hamilton, Ontario. We included participants ≥50 years with osteoporosis who understood English or attended with a caregiver. Our primary outcome was feasibility defined by recruitment rate (criteria for success 90%), length of time to complete the App by a non-healthcare professional (≤15 minutes), and safety/challenges of using the App. Our secondary outcome was to conduct an exploratory analysis between osteoporosis management (osteoporosis medication, vitamin D and calcium) and total Fit-Frailty score. Thirty participants were approached during a routine clinic visit and 25 agreed to participate (mean age 72.2±11.2; 88% female; 44% had higher education). The mean Fit-Frailty score was 0.24±0.14; scores ≥0.25 indicate frailty. Five chose not to participate citing other time commitments. The mean time to complete the App was 15.48±6.6 minutes with no adverse events. Challenges included the need for a private room and space to perform the gait assessment. We found no association between osteoporosis management and Fit-Frailty score (p&gt;0.05). Despite not meeting our feasibility criterion for recruitment, the App was a feasible tool to measure frailty in a non-geriatric clinic.
COMPAS: AN APP TO PROMOTE PERSON-CENTERED COMMUNICATION BETWEEN PEOPLE LIVING WITH DEMENTIA AND THEIR CAREGIVERS
Authors: Delacourt Barbara , le Masson-Trottier Michè , Dubuc Jade , Dubé Catherine , Ansaldo Ana Inés 
Published: December 2023

Abstract

Introduction
People living with dementia (PWD) experience communication deficits as soon as the early stages of the diseases, deficits which significantly increase over time. In the last stages, constant communication breakdowns lead to reduced exchanges with caregivers, resulting in the isolation of both communication partners. These difficulties have negative impacts on the quality of life of PWD and their caregivers, who themselves face increasing burden. While communication difficulties in PWD are a core issue in care, few interventions to address this issue have been developed. Aims: The present study focused on COMPAs, an app designed to sustain communication between PWD and their caregivers. COMPAS has been shown to trigger emotional communication during the short co-viewing of personalized audiovisual material. Method: This was a pre-post intervention study with COMPAs in 2 long-term care centers. Seventeen caregivers used COMPAs in the context of daily routines over eight weeks with seventeen PWD. Data collection included specific questionnaires and semi-structured interviews to measure effects on communication and caregiver burden. Data analyses combined quantitative and qualitative approaches.

Results
In caregivers, there was a significant improvement in personal achievement at work. Semi-structured interviews showed an improvement in communication in the dyad and a more empathetic approach to caregiving.

Discussion
These results indicate that the communication triggered by COMPAs breaks down communication barriers, by creating positive exchanges through personalized emotionally driven exchanges, while stimulating empathy and personalized interventions. Caregivers see COMPAs as an ecological tool to address communication barriers, while facilitating an empathetic caregiving relationship.
DATA ANALYTICS FOR HEALTH-RELEVANT EVENTS DETECTION BASED UPON LONGITUDINAL FITBIT HEART RATE DATA
Authors: Dharangutte Prathamesh , Gao Jie , Schoenfeld Elinor , Xie Zongxing , Hua Yindong , Ye Fan 
Published: December 2023

Abstract
The increasing prevalence of wearable devices enables low-cost, long-term collection of health relevant data such as heart rate, exercise, and sleep signals. Currently these data are used to monitor short term changes with limited interpretation of their relevance to health. These data provide an untapped resource to monitor daily and long-term activity patterns. Changes and trends identified from such data can provide insights and guidance to the management of many chronic conditions that change over time. In this study we conducted a machine learning based analysis of longitudinal heart rate data collected over multiple years from Fitbit devices. We built a multi-resolutional pipeline for time series analysis, using model-free clustering methods inspired by statistical conformal prediction framework. With this method, we were able to detect health relevant events, their interesting patterns (e.g., daily routines, seasonal differences, and anomalies), and correlations to acute and chronic changes in health conditions. We present the results, lessons, and insights learned, and how to address the challenge of lack of labels. The study confirms the value of long-term heart rate data for health monitoring and surveillance, as complementary to extensive yet intermittent examinations by health care providers.
FEASIBILITY AND VALIDITY OF WEARABLE TECHNOLOGY FOR ASSESSING MOBILITY AMONG HOSPITALIZED OLDER ADULTS
Authors: Nascimento Paulo Roberto Carvalho do , Kirkwood Renata , Duong Mylinh , Griffith Lauren , Beauchamp Marla 
Published: December 2023

Abstract
The need for strategies to promote mobility during acute care hospital stays among older adults is increasingly recognized. Wearable technologies show great potential for this purpose. The objective of this study was to determine the most accurate wearable sensor device and location for capturing in-hospital mobility in older patients. Twenty-five older adults (79.6±8.1 years) admitted to a hospital medical care unit volunteered to test the feasibility and concurrent validity of the ActiGraph wGT3X-BT, Mox1, MetaMotionC and Fitbit Versa. All 25 enrolled patients wore the devices simultaneously on the wrist, hip, and ankle while undertaking a mobility activity protocol consisting of supine lying, sitting, and standing tasks. Participants also performed the Timed Up and Go (TUG) and 10-meter walk test (10MWT) wearing the devices. A trained physiotherapist supervised the performance of the tasks. Most participants (58%) preferred to wear the device on the ankle. Overall, the ActiGraph and Mox1 were the easiest to set up and download. The ActiGraph was the most reliable device, retrieving 100% of the collected data. Regarding body posture, the thigh-worn ActiGraph algorithm accurately classified 78% of sitting and lying postures, as well as 84% of standing postures, indicating high overall accuracy. After implementing the recommended low-frequency filter extension for slower gait speeds, the ankle-worn ActiGraph showed the narrowest limits of agreement and observations closer to zero for step count during the TUG and the 10MWT. These findings lay the foundation for subsequent work to validate wearable devices for monitoring “free-living” mobility in this population.
DUAL SENSORY LOSS AND COGNITIVE TEST PERFORMANCE IN OLDER ADULTS IN INDIA
Authors: Wang Ethan , Deal Jennifer 
Published: December 2023

Abstract
Dementia is rising in the global population, especially in low- and middle-income countries like India. Hearing and vision loss are risk factors for cognitive decline/dementia, but studies have primarily been in high income countries. This study aims to investigate the association between dual sensory loss and cognitive function with specific domains among the older Indian population. Data was from the 2017-2019 Wave 1 of the population-based Longitudinal Aging Study in India. The analysis sample consists of 27,975 individuals aged 60 years and older in 35 states and union territories. Dual sensory loss was determined by respondents’ self-reported, perceived difficulty regarding hearing and vision function. Linear regression was used to model associations of dual sensory loss with global cognitive performance, summarized as a z-score, and in the domains of memory, orientation, arithmetic, and executive function, adjusted for demographics and health characteristics. Overall, 5.9% had hearing loss, 24.1% had vision loss, and 3.4% had both. In fully adjusted models, hearing loss only, vision loss only, and dual sensory loss were associated with a change of -0.08 (95%CI: -0.1, -0.04), -0.11 (95%CI: -0.12, -0.09), and -0.22 (95%CI: -0.27, -0.18) standard deviations, respectively. Associations were also observed for all domains. Poor hearing and/or vision loss is associated with lower cognitive performance across various cognitive domains in older adults in India. The association was strongest for those with dual sensory loss. Rehabilitative interventions for hearing and vision may be an additional resource in reducing dementia risk in India.
PREVALENCE OF DEMENTIA AND COGNITIVE IMPAIRMENT IN PUBLIC SENIOR HOUSINGS: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Park Soobin , Amano Takashi , Park Sojung , Kim BoRin 
Published: December 2023

Abstract
Older residents in public housing represent a particularly vulnerable population at risk for cognitive decline due to their disadvantaged socioeconomic and health-related characteristics which are well-known risk factors of dementia. This study aims to synthesize available evidence regarding the prevalence of dementia and cognitive impairment among public senior housing residents. We conducted a literature search for studies published in English in the following databases: PsychInfo, PubMed, MEDLINE, CINAHL, and The Cochrane Library. We focused on observational studies about residents of public senior housings that reported prevalence and/or incidence of dementia and/or cognitive impairment screened by assessment tools for detecting dementia equivalent cognitive impairment. A total of ten studies were included for a meta-analysis to estimate the overall prevalence of cognitive impairment and dementia. Seven of ten studies utilized screening tools to detect dementia equivalent cognitive impairment. Overall pooled prevalence of cognitive impairment or dementia was 20.4% (95%CI: 14.1-27.5). The subgroup analyses revealed the pooled prevalence of cognitive impairment among residents of public senior housing was 25.5% (95%CI: 22.0-29.1) and pooled prevalence of dementia was 13.5% (95%CI: 8.3-19.7). The subgroup findings suggest the prevalence of dementia may be higher among residents of public senior housing compared to their peers in non-public housing. Also, this population may be particularly susceptible to an unrecognized or delayed diagnosis of dementia due to the lack of formal detection strategies in public senior housing. More resources should be allocated for detection to ensure better support the residents.
FAMILY CAREGIVERS AT WORK: THE RELATIONSHIP BETWEEN WORK PRODUCTIVITY LOSS AND WORKPLACE SUPPORTIVE MEASURES
Authors: Milnamow Mary , Bakk Louanne 
Published: December 2023

Abstract

Background
Employment and economic security remain elusive for the majority of working family caregivers, especially for caregivers for older adults with complex health problems. Family paid leave remains unattainable in the United States requiring caregivers to work while providing critical support to older adults making them vulnerable for unemployment and financial hardships. While caregivers experience higher rates of absenteeism and presenteeism at work compared to their non-caregiving counterparts, research pertaining to the impact of supportive measures in the workplace is relatively unknown.

Methods
This exploratory, cross-sectional study examined 1) the relationship between supportive workplace measures (i.e., employment stability, flexible work schedules), and productivity loss, absenteeism and presenteeism; and 2) the relationship between caregiver characteristics (i.e., traditional versus non-traditional) and supportive workplace measures, productivity loss, absenteeism, and presenteeism. Data from 2017 (n=2,652) and 2020 (n=1,938) waves of the National Survey of Caregivers (NSOC) were analyzed using the validated WPAI-CG measure.

Results
Bivariate findings suggest an association between workplace flexibility and productivity loss (p&lt;.001), absenteeism (p&lt;.001), and presenteeism (p&lt;.001); caregivers with flexible hours had greater productivity loss, absenteeism, and presenteeism compared to caregivers without flexible hours. Additionally, caregivers in traditional dyads reported higher work productivity loss (p&lt;.001) and presenteeism (p&lt;.001) compared to non-traditional dyads.

Conclusions
Findings suggest flexible hours may not adequately address workplace issues experienced by family caregivers for older adults. As the number of older adults increases over the next decade, greater understanding of the best way to decrease work challenges for diverse caregivers is critical.
INFORMAL CAREGIVING EXPERIENCES: CHALLENGES AND OPPORTUNITIES FOR AN AGE-FRIENDLY UNIVERSITY
Authors: Cannon Melissa , Johnson C J , Winters Emily 
Published: December 2023

Abstract
The growing Age-Friendly University (AFU) global network has been helping its members assess their institutions and identify action items for increasing age-friendliness. This research investigates one of the issues identified through previous assessment of an AFU as a weakness and area of opportunity, which is the lack of resources and information for campus community members who identify as informal or unpaid family caregivers. Data from N = 70 campus members (26% faculty, 18% staff, 56% students; 84% female, 16% male) were collected in early 2023 through a campus-wide online survey and analyzed by a team of researchers using quantitative analysis for responses to Likert-type items and thematic analysis for open-ended responses. Issues around physical demands, time demands, financial stress, and social and emotional health while caregiving were assessed. Results indicated that respondents are experiencing different types of stress and need additional support and resources as caregivers, particularly related to respite care, mental health services, financial support, and assistance with physical tasks such as housework and transportation. The findings from this research will be used to develop and share resources around caregiving broadly across the university campus, and to ensure that resources are culturally inclusive, particularly as nearly 25% of the enrollment of undergraduate full-time equivalent students is composed of students from a Hispanic/Latinx background. Findings will also be used to establish community partnerships to harness resources from outside the university, and ultimately to help support the campus community moving forward and to achieve a piece of the university’s AFU vision.
THE ROLE OF TRUST FOR DEMOGRAPHIC VARIABILITY IN VACCINE HESITANCY AND BEHAVIORS AMONG OLDER ADULTS
Authors: Huseth-Zosel Andrea , Fuller Heather , Hajdar Melisa , Kinkade Emily , Carson Paul 
Published: December 2023

Abstract
Because of increased risks of infectious disease, understanding older adults’ decisions related to trust and reception of vaccines is important. This study examines the associations between demographic characteristics, vaccine hesitancy, compliance, and the potential mediating role of uncertainty of who to trust. Seven hundred and thirty-nine older adults in North Dakota, oversampled from rural and lower vaccinated regions, completed a mailed survey about vaccine beliefs and behaviors. Participants reported demographic characteristics (age, gender, years of education, rurality, political ideology, and self-perceived physical health) and answered a 7-item scale of vaccine hesitancy. Vaccination behaviors were measured with an assessment of overall vaccine compliance, as well as measures of uptake for influenza, shingles, pneumonia, and SARS-CoV-2 immunizations. Uncertainty who to trust was assessed with the single-item “I am not sure who to trust when it comes to information about vaccines”, which was rated from Strongly Agree (4) to Strongly Disagree (1) and used as a mediator. Bootstrapping analyses indicated uncertainty of who to trust partially or fully mediated associations of rurality, education level, and political leaning with vaccine hesitancy. Further, trust partially or fully mediated associations of education level, health, and political leaning with vaccine behaviors; however, trust did not account for the association between vaccine hesitancy and behaviors. Findings highlight demographic variations in older adults’ vaccine beliefs and behaviors that may be partially explained due to uncertainty who to trust, indicating that practitioners should implement education and trust-building interventions, especially with rural-dwelling, conservative-leaning, and lower-educated older adults.