bluuebunny/crossref_metadata_2025_split huggingface dataset:
SES DISPARITIES IN FUNCTIONAL IMPAIRMENT WITHIN OLDER ASIAN AMERICANS: COMPARISON OF FOUR RACIAL/ETHNIC GROUPS
Authors: Wang Katherine , Zhu Zheng , Qi Xiang 
Published: December 2023

Abstract
This study investigated to what extent socioeconomic status (SES) disparities associates with functional impairment within older Asians in comparison with other racial/ethnic groups. Data were from the National Health and Nutrition Examination Survey 2011-2018 that included 3,297 White, 1,755 Black, 1,708 Hispanic, and 730 Asians aged ≥60. Physical functioning was measured by activities of daily living (ADL) or instrumental activities of daily living (IADL). Memory was determined by CERAD-WL, and language fluency was measured by Animal Fluency Tests. We conducted multivariate logistic regressions to examine the association between SES and functioning impairment within racial/ethnic groups and performed seemingly unrelated regressions to compare the regression coefficients across subgroups. For the age- and sex-adjusted prevalence of functional impairment, Asians with ≤high school education had the highest prevalence of memory impairment among all races/ethnicities, and no difference was observed for all racial/ethnic groups with &gt;high school education. After adjustment for key covariates, Blacks and Hispanics had higher odds of ADL/IADL disabilities and cognitive impairment relative to Whites. The odds of ADL/IADL disabilities did not differ with Asians and Whites, whereas Asians were more likely to have language fluency impairment than Whites. Education disparity for ADL disability (OR, 3.42; 95% CI, 2.21-5.29) and memory impairment (OR, 16.87; 95% CI, 8.57-33.21) were largest among Asians compared to Whites, Blacks, and Hispanics. Income disparity for function impairment did not significantly differ across four racial/ethnic groups (all P &gt; 0.05). This study indicates that Asians fare worst in the burden of functional impairment due to education disparity.
FACTORS ASSOCIATED WITH DEPRESSIVE SYMPTOMS AMONG OLDER SOUTHEAST ASIAN AMERICANS
Authors: Wang Kaipeng , To My Ngoc , De Fries Carson , Wu Bei 
Published: December 2023

Abstract
Depressive symptoms are prevalent among older adults, particularly those from Southeast Asian American (SEAA) communities. Although SEAAs represent one of the fastest growing minority groups in the U.S, research has given little attention to understanding depression among older SEAAs. This study therefore aimed to examine the factors associated with depressive symptoms among older Southeast Asian Americans. We recruited a total of 251 adults aged 55 and above who identified as Vietnamese American, Filipino American, or Indonesian American via community organizations. Participants completed online or in-person questionnaires. Depressive symptoms were measured with the 10-item Center for Epidemiologic Studies Depression Scale. Items are rated on a 4-point Likert scale, with higher scores indicating more depressive symptoms. We used ordinary least squares (OLS) regression to examine the association between depressive symptoms and various health, psychological, social, demographic, and environmental factors. In general, Vietnamese Americans (mean=1.74, SD=0.65) had significantly more depressive symptoms than Indonesian (mean=1.56, SD=0.60) and Filipino (mean=1.47, SD=0.47) Americans. OLS regression results showed that resilience and age were negatively associated with depressive symptoms, while greater family conflict was significantly associated with more depressive symptoms. Participants who could not speak English fluently had significantly more depressive symptoms than those who could not. Those residing in urban or suburban areas had significantly more depressive symptoms than those living in rural areas. Results contribute to better understanding of the factors that contribute to depression among older SEAAs and inform the strategies for preventing and treating depression in this population.
ACCELEROMETER-DERIVED PHYSICAL ACTIVITY IN THE NATIONAL HEALTH AND AGING TRENDS STUDY
Authors: Schrack Jennifer , Zhang Talan , Wanigatunga Amal , Zipunnikov Vadim , Freedman Vicki 
Published: December 2023

Abstract
Physical activity (PA) is a modifiable risk factor for disability, chronic conditions, and functional outcomes with aging. Yet the amount of PA in which older adults engage is not well understood, as objective evidence is lacking, particularly among those aged ≥80 years. To address this gap, the National Health and Aging Trends Study (NHATS) implemented wrist-worn accelerometry (Actigraph Centrepoint Insight Watch) in a subset of Round 11 (2021) participants (N=747, 54% women, 40% aged≥80) using a seven-day 24-hour/day protocol. Mean daily PA (total activity counts/day) was examined in those with ≥3 valid wear days by health and demographic factors with analytic survey weights applied. Daily PA averaged 1.67M counts/day, was lower at older ages and varied widely across health and demographic factors, notably: women were more active than men (β=208K), married participants more active than unmarried (β=163K), those with impaired contrast vision were less active than those with normal vision (β=-231K), those with hearing loss were less active than those without hearing loss (β=-233K), and participants with possible or probable dementia were less active than those without dementia (β=-457K) (p&lt;.001 for all). With regards to care and accommodations, those who reported getting help with mobility were less active than those who did not (β=-459K) and those residing in the community were more active than those in (non-nursing home) residential care (β=394K). These data present unique insights into factors that may shape daily PA in older adults. Future work should examine longitudinal trends and potential interaction with the disablement process.
SENSORIMOTOR IMPAIRMENTS AND DEMENTIA: A CROSS-SECTIONAL ANALYSIS OF NATIONAL HEALTH AND AGING TRENDS STUDY
Authors: Davoudi Anis , Agrawal Yuri , Gross Alden , Wanigatunga Amal , Reed Nicholas , Ehrlich Joshua , Schrack Jennifer 
Published: December 2023

Abstract
Sensory impairments in vision and hearing are linked to dementia in older adults. However, this association has not been investigated in conjunction with motor function performance. We examined cross-sectional sensory and motor function and dementia status data from 1,765 participants in the National Health and Aging Trends Study (NHATS R11, 2021) (32.7% aged ≥80 years; 55% women) who completed objective physical function and sensory testing. Motor function was defined using grip strength (kg), gait speed (m/s), standing balance, and chair stand speed (stands/sec). Sensory function was defined using hearing (pure tone average for better ear (BPTA) (dB)) and vision (contrast sensitivity (logCS)). Dementia was categorized as possible or probable using NHATS dementia classification. Survey-weighted logistic regression models estimated the likelihood of dementia by impairment in sensory and motor function, adjusted for demographic and medical conditions. 185 (10.5%) participants had possible or probable dementia. In models incorporating both motor and sensory impairments, impaired standing balance (&lt;3 standing balance score in SPPB) and slow walking speed (&lt;0.8m/s) were associated with higher odds of dementia (OR=1.75; 95%CI 1.10-2.79; and 2.39 95%CI 1.37-4.15, respectively), while hearing impairment (BPTA&gt;25dB) and contrast sensitivity (&lt;1.55logCS) were not associated with higher prevalence of dementia. In this nationally representative sample of older US adults, results suggest motor function is more strongly associated with dementia relative to sensory function among participants able to complete physical function testing. Future research is needed to understand how the associations of sensory and motor function with dementia change from mid-to-late life.
MUSCLE STRENGTH AND INCIDENT DEMENTIA IN THE NATIONAL HEALTH AND AGING TRENDS STUDY (NHATS)
Authors: Wanigatunga Amal , Lu Yidan , Marino Francesca , Davoudi Anis , Dougherty Ryan , Schrack Jennifer 
Published: December 2023

Abstract
Slower gait speed is linked to dementia risk, but the role muscle strength plays in this relationship is unclear. We examined whether muscle strength measured in the hands and legs is related to dementia risk beyond usual gait speed. We included 3,212 NHATS participants (mean age 75 years, 54% women) followed from 2011-2019 without dementia at baseline. Muscle strength was measured by maximal grip strength (kg) and repeated chair stands (seconds). Incident dementia combined possible and probable dementia defined by a validated NHATS algorithm. Cox regression models were used to estimate longitudinal associations between each baseline muscle strength and incident dementia. Models were adjusted for demographics and medical conditions, and additionally for usual paced gait speed (m/s). Over an average of 5 (SD=3) years, there were 946 (30%) first-time dementia events. For 1 kg higher in grip strength, there was a 2% decrease in incident dementia (HR:0.98; 95%CI: 0.97-0.99;p&lt;0.001), which remained significant after adjustment for gait speed (p=0.005). More time to complete chair stands was positively associated with dementia incidence (HR:1.02; 95%CI:1.01-1.03;p&lt;0.001) but results were attenuated after adjusting for gait speed (p&gt;0.10). All results remained robust after removing events that occurred 1 year from baseline. These findings suggest that grip strength, after accounting for gait speed, is associated with dementia incidence. These results suggest the muscle morphology differences between the hands and legs capture different neuromuscular mechanisms linked to dementia. Replication of these findings and further investigation into potential biological mechanisms are needed.
TRANSCRANIAL DIRECT CURRENT STIMULATION MODULATES BRAIN ACTIVITY DURING DUAL-TASK STANDING IN OLDER ADULTS
Authors: Kahya Melike , Gouskova Natalia , Lo On-Yee , Zhou Junhong , Cappon Davide , Pascual-Leone Alvaro , Lipsitz Lewis , Manor Brad 
Published: December 2023

Abstract
In older adults, performing an attention-demanding cognitive task while standing comes with a ‘cost’ (i.e., decrement) to postural control. Transcranial direct current stimulation (tDCS) designed to facilitate the excitability of the left dorsal-lateral prefrontal cortex (L-DLPFC) and motor cortex (M1) mitigates this dual-task cost (DTC). The effects of tDCS on underlying brain activity measured by electroencephalography (EEG) during dual-tasking, however, is unknown. We hypothesized that tDCS would decrease the DTC of EEG-measured alpha and gamma power, as these frequencies have been linked to attentional processing and their attenuation is believed to reflect more efficient and/or effective postural control. Thirty participants received 20-minutes of tDCS targeting the L-DLPFC and M1, or sham (i.e., control) stimulation, in random order, on two separate visits. Before and immediately after each stimulation, EEG and postural sway area were recorded as participants completed trials of standing with and without verbalized serial subtractions. EEG alpha and gamma power were derived from channels corresponding to the L-DLPFC and M1 areas. The DTC (absolute change from single to dual-tasking) for both EEG and sway outcomes were calculated. tDCS, compared to sham, decreased the DTC to gamma power (p=0.04) and sway area (p=0.04). No pre-to-post stimulation changes were observed for alpha power (p=0.42). Participants who demonstrated a greater decrease in the DTC to gamma power after tDCS exhibited a greater reduction (improvement) in the DTC to sway area (r=0.66, p=0.002). The results suggest that the tDCS-induced changes in gamma-frequency activity were associated with improved dual-task standing balance in older adults.
PSYCHOMETRIC PROPERTIES OF THE CHANGING TALK ONLINE TRAINING PROGRAM EVALUATION SCALE FOR LONG-TERM CARE STAFF
Authors: Yang Frances , Coleman Carissa , Shaw Clarissa , Perkhounkova Yelena , Hein Maria , Williams Kristine 
Published: December 2023

Abstract
The Changing Talk (CHAT) intervention educates long-term care staff about elderspeak and person-centered communication strategies. The online version of CHAT training is a national trial to reduce behavioral symptoms in long-term care residents with Alzheimer’s Disease and other dementias. The development and validation of program evaluation scales are important for ensuring valid intervention evaluation. Using item response theory to assess the satisfaction of the CHATO program by staff, we tested for unidimensionality and local independence. Confirmatory factor analysis showed that there was redundancy between two items, based on the best fitting unidimensional model (Root Mean Square Error of Approximation=0.134, Comparative Fit Index=0.999). The IRT parameters showed that the highest discriminating item was the “The information in the course was clearly presented,” which also showed the highest range of difficulty parameters for the response choices. Other items in the scale were: “This course enhanced my knowledge of the subject matter,” “The information was a good refresher for me,” “I can use this training in my job,” “The resources listed in the course were useful for my job duties,” “The video clips were useful in helping me learn course materials,” “I would recommend this course to others,” “The learning activities were useful in helping me learn course materials,” and “I was satisfied with this course overall.” Differential item functioning due to race/ethnic, language, and educational achievement were examined to test for the presence of measurement noninvariance. This program evaluation scale may be utilized in other pragmatic trials as a valid measurement tool.
CANNABIS USE AMONG OLDER ADULT CANCER PATIENTS: PATTERNS OF USE AND PERCEIVED SYMPTOM MANAGEMENT
Authors: Fahey Margaret 
Published: December 2023

Abstract
Prevalence of cannabis use among U.S. older adults (&gt;65 years) is increasing and is common among cancer survivors of all ages. This National Cancer Institute-funded supplement supported administration of a cross-sectional survey in a state with illegal access to cannabis. This study descriptively examined weighted estimates of cannabis rates (lifetime, post-diagnosis, current) among older patients (&gt;65 years) (N=524; 51% of full sample) with a cancer diagnosis (&lt; two years). Of those endorsing post-diagnosis use, weighted estimates examined patterns of use (timing relative to cancer treatment, reasons for use, primary mode of use) and self-reported impact of cannabis on symptoms (since diagnosis; 5-point Likert scale for 9 symptoms). Almost half (46.0%) of older patients used cannabis in their lifetime, with 18.2% using post diagnosis and 9.8% currently using. Of patients who used cannabis following diagnosis (N=107), approximately half used during cancer treatment (7.0% had not yet started) and most common mode of use was smoking (e.g., joint) followed by edible use. Most common reasons were for pain (44.3%), sleep (43.4%) and recreationally (38.1%). Most common symptoms patients endorsed improved quite a bit, included pain (27.7%), difficulty sleeping (27.3%), and stress, anxiety, depression (23.5%). Overall, few believed cannabis worsened symptoms, with most indicating either improvement or no change. Findings indicate older oncology patients commonly use cannabis to alleviate medical or health symptoms. Oncology care teams require evidence-based recommendations and guidance to inform conversations and shared decision making about cannabis with their older patients, even within a state without a legal cannabis marketplace.
THE LTSS STATE SCORECARD AND THE ROLE OF STATE POLICY
Authors: Tewarson Hemi 
Published: December 2023

Abstract
States play a crucial role in long-term services and supports. State agencies and legislatures have the power to make LTSS and family caregiver supports more (or less) accessible, affordable, and high-quality for the residents they serve. In addition, much of the policymaking during and after the peak of the COVID-19 pandemic took place at the state level. State agencies had the authority to grant providers, consumers, and family caregivers new flexibilities and options as it relates to LTSS, and states have and continue to decide where much of the federal COVID-19 funds (e.g., American Rescue Plan HCBS funding) will ultimately go. This portion of the symposium will present an overview of where states are today with LTSS and how the Scorecard can help both identify and drive system change.
PREDICTING CLIENT RETURN TO ADULT PROTECTIVE SERVICES: A SECONDARY ANALYSIS OF RECURRENCE USING NATIONAL APS DATA
Authors: Gaeta Raphael , Gassoumis Zach , Lovegrove Peter 
Published: December 2023

Abstract
APS programs are provided by state and local governments across the U.S. to serve older adults and adults with disabilities facing abuse, neglect, or exploitation (“maltreatment”). The purpose of this analysis was to identify predictors of recurrence, which occurs when clients return to APS for investigation/services after their cases have been closed. The analysis combined several data sources, including the National Adult Maltreatment Reporting System (NAMRS), the first comprehensive, national data reporting system for APS programs. This analysis represents the first study of this kind to use NAMRS data. The main analyses used Bayesian logistic regression with client, case, and state-level APS system characteristics to predict 12-month recurrence in a multi-state model and in separate single-state models. The sample included data on 1,211,360 APS episodes that closed from 2015-2019 in 19 states. These episodes contained information on 946,477 unique APS clients. About one in five clients in this analysis experienced at least one episode of recurrence. Multivariate results revealed several significant predictors of recurrence (e.g., gender, maltreatment type, maltreatment disposition, episode length, case closure reason), with the largest being age (85+ vs. ≤59 AOR=0.876) and self-neglect (AOR=1.132). The findings may be helpful for APS programs to better recognize and serve clients at high risk of returning to APS after their cases close. The findings also highlight the ambiguity surrounding the concept of recurrence in the APS field and the need for further research to determine the circumstances in which recurrence may be considered a negative or a positive outcome.
BIRTHPLACE AND COGNITION AMONG US OLDER ADULTS: EVIDENCE FROM THE HARMONIZED COGNITIVE ASSESSMENT PROTOCOL (HCAP)
Authors: Lin Zhuoer , Chen Xi 
Published: December 2023

Abstract
Growing evidence shows that place of birth and related circumstances may impose lasting and multiplicative impacts on a host of late-life outcomes; yet how it affects various domains of cognitive function in late-life is less understood. In this paper, we exploit the comprehensive cognitive assessments in the Health and Retirement Study (HRS) Harmonized Cognitive Assessment Protocol (HCAP) and HRS geographic data at birth to determine to what extent birth location measured at the state level is associated with cognitive status in later life for a representative sample of Americans over age 50 (N=3,324). We found that state of birth significantly influenced various cognitive domains later in life (including episodic memory, executive function, attention, visuospatial function, language fluency and orientation); and the regional rankings tended to be highly consistent across the cognitive assessments in each domain. Regression analysis demonstrated that the geographic disparities in cognition across birth states could be partly explained by the late-life differences in socioeconomic statuses. Nevertheless, Shapley decompositions demonstrated that, after accounting for mid-life to late-life factors, state of birth still contributed 20%-30% of the explained variations in cognitive outcomes. Particularly, foreign-born individuals and those born in the southern states tended to score the lowest on average on each of the cognitive tests/domains and can account for most of the explained differences in cognition. These findings suggest that place of birth may have lasting impacts on disparities in cognition later in life. Public policy should play pivotal roles in leveling the playing field in early life.
SOCIAL DETERMINANTS OF COGNITIVE HEALTH: A SCOPING REVIEW
Authors: Zhang Lingling , Zhang Yao 
Published: December 2023

Abstract
Population aging has caused a substantial increase in neurodegenerative disorders, such as Alzheimer’s disease (AD), the fifth leading cause of death for people aged 65 and older. It has posed tremendous challenges to families and society. The existing research shows that postponing AD onset by 5 years would reduce the disease prevalence by half. Therefore, to better understand the modifiable risk factors, including social determinants of health (SDOH) for cognitive health, will be helpful for early prevention and resource allocation. SDOH are classified into five domains (healthcare access and quality, education access and quality, social and community context, economic stability, and neighborhood and built environment). There are studies examining the relationship between one or more domains of SDOH and cognitive health, however, to our knowledge, there is no comprehensive review has been done to synthesize the evidence from all domains of SDOH. This literature review aims to map the existing evidences on social determinants of cognitive health to inform future programs and policies. Twenty-nine studies were included in the review through a systematic search of relevant literature published on peer-reviewed journals from four electronic databases (Pubmed, PsychInfo, CINAHL, and MEDLINE) during 2012-2022. The review summarized a broad range of empirical research on how SDOH affect cognition, as well as revealed the racial disparities in cognitive function, which is worth noting. The favorable SDOH conditions such as better healthcare access, education, social engagement, etc. were proved protective factors for cognitive impairment. Race and racial segregation were found to be the opposite.
PSYCHOSOCIAL FACTORS AND EARLY MID-LIFE BLACK WOMEN’S SLEEP QUALITY: A CONSIDERATION OF INTERSECTIONAL MEASURES
Authors: Erving Christy 
Published: December 2023

Abstract
Beyond an individual behavior, scholars are progressively conceptualizing sleep as embedded in social factors. Extant research establishes that sleep is influenced by experiences based on status characteristics such as gender or race along with psychosocial stressors such as discrimination. Moreover, sleep is important in the context of gender and racial disparities, as Black women experience relatively poorer sleep quality compared to their Black male and White counterparts. Given their relatively poor sleep quality, this presentation will center Black women by examining how psychosocial factors influence their subjective sleep quality in early mid-life, an important life course stage characterized by significant role obligations in personal and professional life domains. This presentation also takes an intersectional approach, examining the sleep implications of two recently developed measures that capture the unique intersectional oppression of Black women: Superwoman Schema and gendered racial microaggressions. To assess the association between these intersectional psychosocial factors and subjective sleep quality, data are drawn from Mechanisms Underlying Stress and Emotions (MUSE) in African-American Women’s Health Study, a cohort of 422 Black women (ages 30-46) in Atlanta, GA, USA. Preliminary findings suggest that both Superwoman Schema endorsement (e.g., feeling obligated to help others) and reports of gendered racial microaggressions (e.g., feeling marginalized and silenced in professional settings) are related to poor subjective sleep quality. Moreover, these associations remain even after adjusting for various factors including, but not limited to, depressive symptoms, anxiety symptoms, and social support. Study implications and future research directions will be discussed.