bluuebunny/crossref_metadata_2025_split huggingface dataset:
MEASURING COGNITIVE FUNCTION IN OLDER ADULTS WITH SENSORY LOSS
Authors: Deal Jennifer , Nichols Emma , Gross Alden , Swenor Bonnielin 
Published: December 2023

Abstract
Neurocognitive batteries are administered orally or on paper, requiring participants to hear and see to participate; yet 55% of Americans aged 60+ years have hearing or vision loss. We will review 3 studies investigating whether sensory loss could bias cognitive testing. First, we used item response theory to test whether cognitive testing is more difficult (biased) for individuals with vs. without sensory loss, controlling for underlying cognitive function using Atherosclerosis Risk in Communities (ARIC) Study and Baltimore Longitudinal Study on Aging data. Although differential item functioning exists for some tests, it is not salient (&gt;1 standard error difference), suggesting that sensory loss may not have a strong impact on measuring cognitive function in well-designed and conducted research studies. Second, we described how audiometric hearing loss impacts completion of neurocognitive testing, and how missing test scores affect estimates of the hearing loss-cognitive test performance association in a cross-sectional analysis of 3,678 adults (72-94 years) in ARIC. Hearing loss was associated with greater missingness on two auditory-only tests (Logical Memory, Digits Backwards) and two written tests (Boston Naming, Trail Making B). Ignoring this missing data underestimated the hearing-cognition association. Finally, we identified cohort studies measuring cognition in older adults through systematic review, and surveyed investigators for how sensory health was addressed in their studies. We found variation in methods used to assess sensory loss, with implications for resource allocation. Using these studies, we will discuss how to best measure cognition in adults with sensory loss, with a focus on inclusion and equity.
HEARING LOSS AMONG OLDER ADULTS IN THE NATIONAL HEALTH AGING TRENDS STUDY
Authors: Reed Nicholas 
Published: December 2023

Abstract
Hearing loss is an important condition that affects healthy aging. However, nationally representative estimates of hearing loss among older adults are limited due to differences in measures and categorization of hearing as well as limited sampling of older adults. The aims of this presentation are to review the meaning of different hearing measures and categorization and to estimate the prevalence of hearing loss by age and demographic covariates of adults over 70 years. The National Health and Aging Trends Study (NHATS) is a large nationally representative panel study of Medicare beneficiaries aged 65 and older with robust oversampling of the oldest old adults that added pure-tone audiometry, the current gold standard for quantifying hearing loss to the 2021 NHATS round 11 protocol. Cross-sectional (n=2620) weighted prevalence estimates by age, sex, race/ethnicity, education, and income were applied to corresponding United States Census Bureau estimates. Using traditional definitions of hearing loss, an estimated 67.9% (22.4 million) of adults over 70 years have at least some degree of hearing loss (37.4% mild, 25.8% moderate, and 4.6% severe). Prevalence is higher among White, male, lower-income, and lower education attainment subpopulations and increases with age such that 97.6% of adults 90 years and older have hearing loss. Application of new World Health Organization categories of hearing loss resulted in an increase in prevalence from 67.9% to 82.7% of adults over 70 years. The near ubiquitous nature of hearing loss in this population raises questions about identifying actionable cut points in future research.
NEW MEASURES AND POPULATION PREVALENCE OF VISION IMPAIRMENT IN NHATS
Authors: Nagarajan Niranjani , Ehrlich Joshua 
Published: December 2023

Abstract
The National Health and Aging Trends Study (NHATS) is a nationally representative panel study of older U.S. adults that in 2021 (Round 11) added to its annual protocol a suite of objective visual function measures consisting of distance visual acuity, near visual acuity, and contrast sensitivity tests. These measures were developed to approximate clinical gold-standard tests, while allowing for administration on a tablet in participants’ homes. The tests were found to have good agreement with clinical gold-standards based on their limits of agreement, correlations, and lack of systematic bias between tests. In the initial 2021 fielding of the NHATS visual function measures, 27.8% (25.5%-30.1%) of U.S. adults over age 70 had one or more visual impairment (VI) (distance VI: 10.3% [8.9%-11.7%]; near VI: 22.3% [20.3%-24.3%]; contrast sensitivity impairment: 10.0% [8.5%-11.4%]), and the prevalence was highest among those who were older, had less education, lower income, and were of Hispanic ethnicity and non-White race. Additionally, the adjusted prevalence ratio for dementia was significantly higher among those with each type of VI compared to those with normal vision (moderate/severe distance VI=1.72 [1.26-2.35]; any near VI=1.40 [1.16-1.69]-; contrast sensitivity impairment =1.31 [1.04-1.66]). Since few other national studies of older adults include objective visual function measures, NHATS now serves as a vital resource for the study of vision epidemiology and the impact of VI and blindness on later-life health outcomes and trajectories.
EXPERIENCES OF STAFF MEMBERS RELOCATING FROM A NURSING HOME TO AN INNOVATIVE LIVING ARRANGEMENT FOR OLDER ADULTS
Authors: Brouwers Mara , Boer Bram , Groen Wim , Verbeek Hilde 
Published: December 2023

Abstract
More innovative living arrangements are developed within long-term care, leading to an increase in relocations. Relocating within long-term care is a long pending and intensive undertaking, especially for staff members. The combination of relocating and achieving a successful culture change might be a daunting task for staff members. Given the increase in the number of relocations and the fast development of innovative living arrangements, it is key to expand our knowledge concerning the impact such an undertaking has. The research question is therefore: ‘How is the relocation from a regular to an innovative living arrangement experienced by staff members?’ To answer this research question, 41 semi-structured interviews with staff members of several nursing homes undergoing a relocation were conducted. These nursing homes had to undergo a relocation to an innovative living arrangement. Findings indicate that a relocation process within long-term care is an intensive and stressful undertaking. Staff members often describe the relocation process as ‘stressful’, ‘chaotic’, and ‘intense’. Furthermore, although staff members are mostly positive about the new physical environment, they experience an array of barriers when trying to implement a new way of working. They define two key elements for successfully relocating and implementing a new way of working. First, clear communication and receiving sufficient information throughout the relocation process. Second, proper preparation for implementing a new way of working and coaching on the job. It is evident that relocating to an innovative living arrangement is a large undertaking that requires careful planning.
EVALUATING WAYFINDING INFRASTRUCTURES FOR PEOPLE LIVING WITH DEMENTIA—THE 360 DEGREE MAPS STUDY DENHB
Authors: Altona Janissa , Wiegelmann Henrik , Mena Emily , Misonow Julia , Schuez Benjamin , Wolf-Ostermann Karin 
Published: December 2023

Abstract
Recent studies point to the importance of the built environment for the cognitive and social health of community-dwelling people living with dementia. One key aspect is wayfinding infrastructure, especially in urban areas. However, currently there are no clear indicators of wayfaring infrastructure and no standardized assessment instruments. Here, we provide such an instrument with the potential for online digital assessment as the result of the German DenHB-study. Based on an umbrella review and further research, we first developed a questionnaire to evaluate local wayfinding structures which are sectioned in different thematic blocks like general streetscape, signage, public transportation, buildings etc. Second, we conducted a cross-sectional validation study in the urban area of Bremen, Germany using Apple Maps Street View (2022) with a 360-degree viewing angle at more than 3,000 randomly selected geo coordinates within urban districts with a high proportion of older residents (&gt;65 years). The results document supportive as well as inhibiting wayfinding structures from the perspective of people living with dementia and can also form a basis for a later automated digital evaluation of wayfinding structures. Hence, providing easy to obtain new insights helps to support the development of actions to promote the dementia-friendliness of urban living structures.
CULTURAL INFLUENCES ON AMERICAN INDIAN AND ALASKA NATIVE DEMENTIA CAREGIVERS
Authors: Kim Steffi , Jackson Lexie 
Published: December 2023

Abstract
Associated with aging, Alzheimer’s disease and related dementias (ADRD) are likely having a disproportionate effect on North American Indigenous communities due to longer life expectancies and high rates of chronic diseases. Despite missing prevalence data on ADRD in for Native Elders, it is known that one in five American Indians and Alaska Natives experience subjective cognitive decline and one in four adults are currently caregivers. Similarly, Native Hawaiians and Pacific Islanders (NHPI) are twice as likely to have dementia compared to non-Hispanic Whites. Yet, little is known about the journey of dementia caregivers within American and Alaska Native, Native Hawaiians and Pacific Islanders (NHPI) and how their unique cultural influences shape their caregiving experiences within their communities. We will present the voices from the transcripts of three 3 different qualitative data sets that include 93 American Indians and Alaska Natives, and six Native Hawaiian/Pacific Islander caregivers and elders about their personal experiences with taking care of family or community members with dementia and approaches to care. in their communities. The presentation focuses on the influences on cultural values on the caregiving experience, caregiver access to resources, and generative moments throughout caregiving. Results identify similarities among these groups but also distinct variations, which emphasize the importance of linguistic and culturally tailored research, interventions, and policies. Based on our findings, we outline culturally specific recommendations to improve the caregiving experience for each of these Indigenous groups.
THE HEALTHY BRAIN INITIATIVE ROAD MAP CATALYZES ACTION AMONG STATE, LOCAL, AND NATIONAL PARTNERS
Authors: Fadel Meghan , Holtgrave Peter , Beaty Carissa , Roberts Shelby 
Published: December 2023

Abstract
The Healthy Brain Initiative Road Map Series (Road Map) has achieved measurable success in spurring action in health departments across the country. Evaluation data from the Alzheimer’s Association shows all 50 states have implemented actions from the 2018-2023 Road Map and the majority of states completed at least one action in each of the four domains of the Road Map. The Healthy Brain initiative has also sponsored initiatives to accelerate the implementation of Road Map actions. The projects described are separate from the CDC’s BOLD Program Awards for state and local health departments. The Road Map Strategist Initiative supports local health departments and tribal organizations. It has funded 16 agencies over the past two years to implement Road Map actions in their communities. A coordinated campaign to increase implementation and utilization of the BRFSS caregiving and subjective cognitive decline modules has near nationwide uptake, and, in 2023, a new project, Data for Action, launched in four states to support the use and dissemination of BRFSS and other data. Together, these projects improve assessment, planning and measurement of community health outcomes related to brain health. The 4th edition of the HBI Road Map has an accompanying evaluation tool offering common measures for state and local health departments to track their success as they implement the new actions. This session will explore the past impact of Road Map actions and opportunities for future measurement.
MULTISECTOR COLLABORATION DRIVES THE DEVELOPMENT OF THE FOURTH HEALTHY BRAIN INITIATIVE ROAD MAP
Authors: Clifford Kristen , Appleby James , Sands Talyah , Rodriguez Juan , Shean John 
Published: December 2023

Abstract
Partnerships and collaboration across sectors played a critical role in the development of the fourth edition of the Healthy Brain Initiative Road Map (Road Map). The public health community, leaders in related fields, and people living with dementia contributed to the development and review. The Alzheimer’s Association and CDC invited 20 national leaders from public health, aging, academia, health care and health systems to guide the development of the fourth HBI Road Map as a part of the Leadership Committee. Their contributions included reviewing data, setting the overall direction of the review and leading five workgroups, composed of 68 subject-matter experts, who recommended actions on Risk Reduction of Cognitive Decline; Timely Detection, Diagnosis and Management of Cognitive Impairment; Dementia Caregiving; Health Equity; and Community Linkages. Health departments offered input through facilitated listening sessions and an open input period. Their feedback emphasized the importance increased information on health equity and partnerships in the Road Map. The Leadership Committee also advised continued partner engagement through the review process. This translated to review by the Alzheimer’s Association, CDC subject matter experts, external health equity experts, the Leadership Committee, workgroup members, the Healthy Brain Initiative Collaborative, the Alzheimer’s Association Early Stage Advisory Group and ultimately CDC leadership. This presentation will explore important themes that emerged throughout this process that shaped the design and evolution of the HBI Road Map series to its most recent iteration, as a guiding document with health equity and multi-sector collaboration action at its core.
RACIAL/ETHNIC COGNITIVE HEALTH DISPARITIES: THE ROLE OF OCCUPATIONAL COMPLEXITY AND OCCUPATIONAL STATUS
Authors: Sheftel Mara , Goldman Noreen , Pebley Anne , Pratt Borianna , Park Sung 
Published: December 2023

Abstract
High levels of labor market segregation mean that Black and Latino workers may not have the same exposure to jobs involving complex work as their White counterparts, an aspect of work that appears to be protective of older adult cognition. The association between cognitive disparities and variation in exposure to occupational complexity by race/ethnicity remains understudied. Using work histories constructed from the Health and Retirement Study (HRS) life history data we analyze the role of occupational complexity in the development of dementia at older ages and address a conjecture that complexity reflects occupational status. Findings highlight that: (1) occupations involving complex work with data during working ages may be protective against dementia at older ages, potentially contributing to the differentials in dementia prevalence by race/ethnicity, and (2) occupational complexity reflects occupational status. This research increases understanding of the implications of labor market segregation for cognitive health disparities by race/ethnicity.
LOW-INCOME, MARGINALIZED OLDER WORKERS: FINANCIAL STRAIN, HEALTH, AND MENTAL HEALTH
Authors: Matz Christina , Coley Rebekah Levine , Teixeira Samantha , Lai Patrick 
Published: December 2023

Abstract
Social inequalities over the life course shape later life opportunities and outcomes in important ways. Research on paid work in later life has not always captured (and has sometimes mischaracterized) the variety and complexity of lived experiences in later life—in particular for low-income workers, workers of color, women, and others marginalized due to their social position. Marginalized older workers often face greater financial instability, limited interpersonal power, and reduced access to benefits like health insurance and paid leave, all of which can lead to increased risk of early retirement, poor health/well-being, and early mortality. Trend statistics and other aggregated data often obscure how the most marginalized older adults are faring in the aging and work literature and there is a need for more research that centers these voices to inform social change, particularly in the wake of the COVID-19 pandemic. The current study aims to fill this gap by drawing on data collected in 2022/2023 among residents of a large public housing development in New England who are age 40 and older (current N=166; expected N=250). Analyses explore relationships between social resources, financial strain, health, and well-being by work status and age. Preliminary analyses suggest that certain forms of social support can buffer the negative effect of financial strain on mental health (but not physical health) among older adults living in poverty and in poor housing conditions. Implications for interventions aimed toward older marginalized adults who are working or looking for work will be discussed.
PHYSICAL CAPACITY AS MARKER FOR RATE OF AGING IN MID LIFE
Authors: Tzemah-Shahar Roy , Agmon Maayan 
Published: December 2023

Abstract
Biological age captures the heterogeneity of aging by providing an estimation for rate of aging. As an alternative to the widely investigated laboratory biomarkers of aging, behavioral functional markers of physical capacity may offer a feasible alternative for identifying individuals at risk for negative aging trajectory. We aimed to examine the associations of different functional tests both together and as a composite score of physical capacity with rate of aging. We conducted a cross-sectional study, with midlife adults (age ~45) reporting being able to perform leisure physical exercise. Biological age was estimated using the Klemera-Doubal method and a set of physiological biomarkers; rate of aging, ∆Age, was defined as the difference between age and estimated biological age. Physical capacity was measured using a testing battery of 15 functional tests linked with six physical capacity domains. 116 participants completed the testing battery. For women, better results in terms of strength, flexibility, cardiorespiratory fitness, and balance tests were negatively correlated with ∆Age (r=0.38-0.29, p&lt;0.05); for men, beyond these tests, agility was also negatively correlated with ∆Age (r=0.27-0.59, p&lt;0.05). A sex-standardized composite score of physical capacity was negatively associated with ∆Age after controlling for chronological age, smoking, and education (r=-0.437, p=0.007; r=-0.491, p&lt;0.001 for women and men respectively). The suggested physical capacity battery offers a functional assessment for ∆Age. Higher physical capacity metrics correlate with smaller ∆Age, corresponding with younger biological age. Measuring physical capacity may help to assess aging trajectory and offer a suitable behavioral intervention goal.
PARTICIPATION IN DIVERSE SOCIAL ACTIVITIES IS ASSOCIATED WITH LOW MORTALITY RISK
Authors: Jeon Sangha , Turiano Nicholas , Charles Susan 
Published: December 2023

Abstract
Social activity is often associated with better physical health outcomes. Yet, less is known about specific qualities of social activity beyond its frequency, such as whether engagement in diverse social activities (social activity variety) is important for health. The current study assessed whether social activity variety, which was calculated as the number of different types of social activity, relates to mortality risk beyond non-social activity variety and how its relationship varies depending on age groups. Using data from the Health and Retirement Study (HRS), we included 5,559 adults who completed a questionnaire on social activity participation in 2008 and whose mortality status was recorded in 2019. We also examined whether age was related to the relationship between social activity variety and mortality risk. Cox proportional hazard model analyses revealed that those with higher social activity variety were more likely to survive over the following 11 year than those with low social activity variety. This result remains robust when adjusting for health status and non-social activity variety. The association of social activity variety with mortality risk is significant across all age, but it is stronger in older adults compared to young adults. Findings suggest that social activity variety is beneficial for longevity beyond non-social activities and health status across adulthood.
WORKING LIFE EXPECTANCY AND UNPAID CAREGIVING: HOW WORKING LIVES DIFFER ACROSS CAREGIVER GROUPS
Authors: Sacco Lawrence , Beach Brian 
Published: December 2023

Abstract
Informal or unpaid caregiving (i.e. unpaid and untrained help and support to an ill relative or acquaintance) is becoming more prevalent as a result of population ageing and policies promoting ageing in place. Informal or unpaid caregiving is most common in mid-to-later life and can generate conflict with individuals’ participation in paid work at a time when working lives are being extended in several countries. Few studies have examined the impact of unpaid caregiving on working life as a whole. The current study examines how unpaid caregiving affects working life expectancy (WLE) among people aged 50 or older. Measuring paid work through WLE allows engagement in paid work in later life to be examined accounting for the fact that retirement transitions have become more complex due to the diversity of retirement pathways (e.g. un-retirement, phased retirement). Furthermore, using longitudinal data to measure WLE in the context of unpaid caregiving over several years enables us to differentiate among frequent caregivers and sporadic spells of caregiving. Data from the English Longitudinal Study of Ageing (ELSA) and the Swedish Longitudinal Occupation Survey of Health (SLOSH) were used to evaluate how WLEs are affected among individuals who provided unpaid care. We highlight the impact of different trajectories in unpaid caregiving on WLE, distinguishing caregivers according to intensity (hours and frequency per week) as well as provision of care over time.
THE EFFECTS OF ICT USE ON PERSONAL MASTERY: RETIREMENT STATUS MATTERS
Authors: Ho Alvin , Li Daisy , Yeung Dannii 
Published: December 2023

Abstract
Internet and technology use have provided middle-aged or older adults with a new arena to regain control over their personal and social lives (McMellon & Schiffman, 2002) and improve their well-being (e.g., Sala et al., 2020; Shufford et al., 2021; Yeung et al., 2022). Still, whether such effects depend on retirement status has not been thoroughly examined. A total of 2391 middle-aged and older participants provided their retirement status (retired or not), and their use of information and communication technology (ICT) for different purposes (social, leisure, financial, and medical) and level of personal mastery were assessed. Four regression analyses were performed to test the moderating effect of retirement status on the relationship between each type of ICT use and personal mastery. Significant interaction was found between retirement and ICT use for leisure (β = .002, p = .046), financial (β = .003, p = .009), and, marginally, medical purposes (β = .002, p = .059), but not for social purpose (β = .000, p = .520). The beneficial effect of the use of ICT on personal mastery was shown to be either exclusive (for medical purpose) or significantly stronger (for leisure and financial purposes) for participants who were retired. This suggests that encouraging middle-aged and older adults to perform ICT-related activities may be particularly crucial when they are retired, presumably due to their capability to compensate for the loss of work-related control and identity.