bluuebunny/crossref_metadata_2025_split huggingface dataset:
USING COMMUNITY ENGAGEMENT TO DEVELOP, TEST, AND IMPLEMENT INTERVENTIONS FOR DEMENTIA CARE PARTNERS
Authors: Eaton Jacqueline 
Published: December 2023

Abstract
Interventions for caregivers to persons living with dementia are numerous and target a wide array of outcomes. One challenge limiting the dissemination of research-based interventions is the complexity of translating the intervention models for a variety of community environments and situations. Interventions that plan for future translation and scalability during the development stages have a better chance of quickly and efficiently being adopted by community partners. This symposium describes the methods used and the lessons learned from five research projects that used various forms of community engagement to develop, adapt, and assess feasibility of caregiver interventions, while simultaneously preparing for their translation and scalability: 1) Eaton et al., present the process and benefits gained from partnering with dementia caregivers to iteratively develop the Enhancing Active Caregiver Training (EnACT) intervention. 2) Utz et al., discuss ways to use the RE-AIM implementation framework to guide the development and pilot-testing of the Time for Living and Caring (TLC) respite intervention. 3) Dassel et al., explore the use of community-based participatory methods to adapt a paper-based advance care planning guide to an interactive web-based LEAD (Life-Planning in Early Alzheimer’s and other Dementias) intervention. 4) Cotton et al., report on the lessons learned from a formative analysis of their processes used to culturally adapt an intergenerational respite program for older adults within the Latine community. 5) Supiano et al., describe how they engaged and trained nursing home social workers to develop and implement the PreLoss Group Support intervention for dementia family care partners.
ESPO AND SOCIAL RESEARCH, POLICY, AND PRACTICE SECTION SYMPOSIUM: LAW AS A DETERMINANT OF HEALTH: A SOCIAL JUSTICE LENS TO IMPACTFUL POLICY ENGAGEMENT
Authors: Bybee Sara , Yu Kexin , Choula Rita 
Published: December 2023

Abstract
The phrase “social determinants of health” has become a buzzword in health-related research and practice. While the US has long recognized that social determinants such as housing conditions, access to medical care, and neighborhood safety contribute to health outcomes, there has been little attention on more upstream factors. Structural, or political determinants of health are the determinants of the determinants. Political determinants of health refer to laws and policies that can inequitably distribute resources which creates structural barriers to equity for population groups that lack power and privilege. Unfortunately, many current US laws and policies perpetuate health inequities as they were originally written to protect those in power and punish those without power and privilege. Structural stigma and discrimination disproportionately affect historically marginalized and minoritized populations. Laws that disproportionately affect historically marginalized groups need to be identified, systemically tracked and revised if we aim to address health equity. In this symposium, speakers will discuss their research into the health-harming effects of laws and policies that disproportionately affect people of color and older adults. Speaker one will review GSA-related policy and advocacy activities. Speaker two will describe how to use law to address racial disparities in geographic access. Speaker three will discuss housing related laws and policies that perpetuate health inequities for older adults and disproportionately affect people from marginalized groups. This session is intended to fill a gap in current programming by making policy-related discussions more accessible and understandable for individuals who may not have experience in this area.
A LIFE COURSE APPROACH TO IDENTIFYING EVICTION LAWS AFFECTING OLDER ADULTS AND HISTORICALLY MARGINALIZED GROUPS
Authors: Bybee Sara , Canham Sarah , Sharareh Nasser , Wilson Fernando , Player Nathanael , Wallace Andrea 
Published: December 2023

Abstract
Alongside population aging, more older adults are becoming at risk of homelessness. Eviction—a type of housing instability in which a landlord initiates legal forced expulsion from a rental property—is one of the main drivers of homelessness. Evictions and homelessness disproportionately affect older adults, individuals of color, women, sexual and gender minority populations, veterans, and those with disabilities. Evictions can have devastating short- and long-term effects on tenants, and these negative consequences may be especially pronounced for individuals with multiple minoritized identities such as older LGBTQ+ adults. Older LGBTQ+ individuals face higher baseline rates of poor mental health, smoking, and health risk behaviors. In this study, key informant interviews (N=5) were utilized to identify state eviction and landlord-tenant laws that disproportionately affect older adults and other historically marginalized groups. Using a life course approach to understanding health disparities as they accumulate across the lifespan, data from LawAtlas—an online database allowing the examination of specific laws across the US—was cross-referenced with data from key informants to identify the following laws which may disproportionately affect older adults and other historically marginalized populations: nuisance property ordinances, source of income discrimination, state fair housing protections, and minimum notice-to-vacate laws. This presentation will describe how intentionally or unintentionally, these laws disproportionately affect older adults and other historically marginalized populations and may lead to negative eviction outcomes, homelessness, and poor physical and mental health. Identifying how such discriminatory laws can contribute to health disparities across the lifespan is necessary to achieve health equity.
BEYOND REDLINING: LAW, PROPERTY VALUES, RACIAL INEQUITIES, AND LTSS
Authors: Smith Lindsey 
Published: December 2023

Abstract
This presentation will provide background regarding the social construction of property values and the interactive role that public and private institutions have played in creating racial disparities in property values. I will discuss known and proposed mechanisms through which this form of structural racism affects access to long-term services and supports (LTSS) and implications for the health of older adults and their care partners, presenting a specific example from my own research, which found that assisted living communities are located in 30% of communities in America. However, among communities with the highest percent Black population in their county, 31% of those located in counties with a low gap in Black-White economic mobility had access to assisted living, while less than 15% of those located within a county with a high Black-White gap in economic mobility had such access. I will describe how policymakers can use law to address racial disparities in geographic access by developing policies that 1) provide financial incentives for private investors to develop assisted living and other forms of LTSS in neighborhoods that otherwise wouldn’t see development due to low property values; 2) prioritize the location of new buildings in historically marginalized communities; 3) implement anti-displacement measures; 4) incorporate community input and engagement; and 5) ensure accessibility and affordability. Finally, I will describe how policymakers may consider the various actors and institutions that shape the housing market and how they interact with each other to produce outcomes that may reinforce or challenge structural racism.
NONCOMBAT AND COMBAT MILITARY SERVICE EXPERIENCES, HEARING DIFFICULTY, AND DIFFICULTY REMEMBERING/CONCENTRATING
Authors: London Andrew , Landes Scott , Wilmoth Janet 
Published: December 2023

Abstract
Hearing difficulty is widespread among U.S. veterans. Research documents a strong association between hearing difficulty and a range of cognitive outcomes. Most research that examines cognitive outcomes in older adults does not distinguish veterans from non-veterans or non-combat from combat veterans. We use data on Sample Adults aged 50+ from the 2021 National Health Interview Survey to examine: the associations between military service experiences (non-veteran, non-combat veteran, combat veteran) and difficulty remembering/concentrating (none, some, a lot/cannot do at all) net of sociodemographic controls; the extent to which observed associations are mediated by hearing difficulty (none, some, a lot/cannot do at all); whether military service experiences moderate the association between hearing loss and difficulty remembering and concentrating. This latter hypothesis is motivated by the notion that service-related hearing loss may occur earlier in the life course and therefore be more detrimental to cognitive outcomes. Analyses are weighted; standard errors are adjusted for the complex sampling design. Preliminary results from multivariable ordinal logistic regression models that include sociodemographic controls indicate that: non-combat and combat veterans have significantly more difficulty remembering/concentrating than non-veterans; the associations between non-combat and combat military service experiences and increased difficulty remembering/concentrating are reduced 20% when hearing difficulty is added to the model, but remain statistically significant; hearing difficulty is strongly associated with difficulty remembering/concentrating; and military service experiences moderate the associations between hearing difficulty and difficulty remembering/concentrating. For example, the highest level of hearing difficulty is more strongly associated with difficulty remembering/concentrating among combat veterans than non-combat veterans.
DIVERSE ENVIRONMENTAL CONTEXTS AND LINKS TO LATER-LIFE WELL-BEING
Authors: Webster Noah , Schafer Markus 
Published: December 2023

Abstract
The places older adults spend time have profound impacts on their well-being. As new sources of data and methods become available it is imperative to refine work in this area to guide development of interventions with the precision necessary to address persistent disparities in well-being. This symposium brings together four complementary papers that focus on diverse environmental contexts and well-being using multiple methodological approaches. Perzynski, Berg, and Dalton discuss the potential of Digital Twin Neighborhoods, i.e., digital replicas of real communities, to address health inequalities. They present findings from engagement sessions with community members about priorities, preferences, and concerns with regard to use of digital twins. Sol, Clarke and Zahodne link data from the Detroit-area Michigan Cognitive Aging Project with data from the National Neighborhood Data Archive to examine the association between neighborhood disadvantage and cognitive reserve. They show how this association differs between Black and White participants. Cho, Dunkle, and Smith use data from the Health and Retirement Study (HRS) to examine the association between later life relocation and contact frequency with adult children. They illustrate the importance of proximity and mode of contact in this association. Morris and colleagues also use HRS data to examine the extent to which stressors operating at multiple levels (interpersonal, community, and society) explain racial disparities in memory. They show these contexts together explain 11% of the racial disparity in baseline memory. These papers will be discussed by Markus Schafer who will provide an outlook for future research in this area.
ASSOCIATION BETWEEN NEIGHBORHOOD DISADVANTAGE AND COGNITIVE RESERVE IN RACIALLY DIVERSE OLDER ADULTS
Authors: Sol Ketlyne , Clarke Philippa , Zahodne Laura 
Published: December 2023

Abstract
Social determinants of health such as neighborhood disadvantage (NDis) are increasingly implicated in cognitive aging. More study is needed on the role of neighborhoods in cognitive reserve—better-than-expected cognitive function given brain health—and dementia disparities. This cross-sectional study included 98 non-Hispanic Black (NHB) and White (NHW) participants (mean age=62.7; 30% NHB) from the Michigan Cognitive Aging Project, a community-based study of adults transitioning to late life in the Detroit area. Participants’ current addresses were geocoded and linked to 2017 measures of NDis at the census tract level from the National Neighborhood Data Archive. NDis is a composite of four indicators of disadvantage for the 26 unique census tracts in the sample. Cognitive reserve was the residual of an episodic memory factor score after regressing out hippocampal volume, cortical thickness across nine Alzheimer’s disease signature regions, and education. Linear regression estimated the association between NDis and cognitive reserve, adjusting for age, sex/gender, and race. Analyses were repeated stratifying by race. In the entire sample, NDis was not associated with cognitive reserve (beta= -.08, p=.841), but stratified analyses indicated that more NDis was marginally associated with less cognitive reserve within NHB (beta= -.36, p=.057) but not NHW participants. NDis may contribute to cognitive reserve more strongly among NHB because of racially-patterned risk and resilience factors. Results highlight the need for more research into specific neighborhood factors that facilitate and deplete cognitive reserve in racially diverse older adults. Cognitive reserve may reflect contextual factors in addition to individual factors.
CONTACT FREQUENCY WITH CHILDREN FOLLOWING RELOCATION LATER IN LIFE: DO CONTACT MODES AND PROXIMITY TO A CHILD MATTER?
Authors: Cho Joonyoung , Dunkle Ruth , Smith Jacqui 
Published: December 2023

Abstract
Contact with children is an important source of support for older adults. It is not clear if relocation and proximity to a child affect in-person communication as well as telephone, email, and social media contact between older parents and children. Using data from the Health and Retirement Study (2014-2018: N=3,332) we examined changes in communication frequencies between parents who either stayed or relocated in the last 4 years and potentially changed their close proximity to a child. We found differential effects of relocation on contact frequency depending on contact modes and proximity. Regarding in-person contact, unadjusted and adjusted linear regressions revealed older adults were less likely to meet up with their children regardless of the distance moved when a child was not nearby. In contrast to stayers, movers with proximity to a child were more likely to meet up with their children (adj. β=0.50, p ≤0.001). We found the same trend for telephone and email contact frequency. Movers with proximity to a child were more likely to have telephone (adj. β=0.17,p=0.034) and email contact (adj. β=0.33, p=0.023). Unlike other types of contact modes, social media contact frequency was not influenced by relocation or child proximity. While older adults tend to constrict their relationships, this trend is not applicable to every older adult. In the social convey model, situational characteristics (e.g., relocation) is considered, and heterogeneity in social relations in later life can be explained.
INTERPERSONAL, COMMUNITY, AND SOCIETAL STRESSORS MEDIATE BLACK–WHITE MEMORY DISPARITIES
Authors: Morris Emily , Palms Jordan , Lee Ji Hyun , Sol Ketlyne , Scambray Kiana , Kobayashi Lindsay , Smith Jacqui , Zahodne Laura 
Published: December 2023

Abstract
Psychosocial factors may contribute to racial disparities in cognitive aging beyond socioeconomic status. Contextual stressors at multiple ecological levels, which may be related to structural racism, disproportionately affect Black older adults in the U.S. and may explain increased dementia risk. This study examined the extent to which interpersonal, community, and societal level stressors independently explained Black-White disparities in memory at baseline and over time. The sample included 16,890 older Black and White adults (Mage=67.98, 22% Black) from the US Health and Retirement Study who completed psychosocial questionnaires and a word list memory task. Interpersonal, community, and societal stressors were operationalized as self-reported everyday discrimination, neighborhood physical disorder, and subjective societal status, respectively. Latent growth curves modeled memory performance over six years. Stressors were modeled simultaneously and allowed to correlate. Covariates included age, sex, education, wealth, and questionnaire year. Compared to White older adults, Black older adults experienced higher discrimination (b = -.004, SE=.001, p&lt;.001), greater neighborhood physical disorder (b = -.012, SE=.002, p&lt;.001), and lower perceived societal status (b = -.003, SE=.001, p=.001), each of which independently mediated the association between Black race and worse initial memory. Together, these stressors explained 11% of the racial disparity in initial memory. There was no racial disparity in memory decline. Individual experiences of stressors across multiple contextual levels contribute to racial disparities in memory, providing evidence that structural racism negatively influences dementia risk among Black older adults. Future research should consider protective factors that buffer against negative impacts of structural racism on health.
WELFARE REGIME TYPE AND ITS INFLUENCE ON THE FINANCIAL SECURITY OF FEMALE CAREGIVERS IN LATER LIFE
Authors: Wang Mengya 
Published: December 2023

Abstract
Guided by life course theory, this paper examines the effect of early caregiving experience and later life-changing events on the financial security of older women using cross-national data from two panels (2004 and 2014) of the Survey of Health Aging and Retirement in Europe Analyses found that caregiving in midlife and subsequent life-changing events (being divorced or widowhood, changing employment status, and/or declining health) significantly affected women’s economic status in later life, Importantly, we found that early caregiving experience intensifies the effects of negative life events, and in turn further deteriorates women’s economic security in later life. Tests of welfare regime differences found that women who experienced a marital change (becoming divorced or widowed) in the dual breadwinner model were less likely to experience economic deprivation compared to the other two models. This finding is likely attributable to more gender equality in these countries which makes women more financially independent. Unfortunately, a significant association between welfare regime and caregiving was not found in this study. This study adds to the knowledge about the political, economic and cultural forces that shape the financial security of women in later life. Our findings suggest that public expenditures on long-term care and the healthcare system should continue and/or be augmented to prevent women economic deprivation, especially those who assume caregiving role in their early life. Moreover, the policies and conditions of dual-breadwinner role countries are informative in helping women achieve gender equality.
COGNITIVE FUNCTION, ACTIVITY MEANINGFULNESS, AND SOCIAL ENGAGEMENT AMONG OLDER ADULTS WITH DEMENTIA
Authors: Wu Shinyi , Tung Yi-Hsuan , Chi Iris 
Published: December 2023

Abstract
Hess’s selective engagement theory (SET) suggests that individuals facing aging-related decline tend to selectively allocate cognitive resources in activity engagement. This selectivity can be mediated or moderated by motivational factors (e.g., activity meaningfulness). Yet, empirical research on SET and older adults with dementia is limited. This study aims to examine how cognitive function and activity meaningfulness affect social engagement among this population. Data is from the 2016 National Health and Aging Trends Study (N= 1,585 participants aged 65+ with dementia). Engagement in four social activities including visiting family or friends (VF), attending religious activities (RA), participating in group activities (GA), and going out for enjoyment (OE) were analyzed in separate multivariate logistic regression models with cognitive function, the corresponding meaningfulness (a mediator and a moderator), and covariates (age, gender, race, living alone, self-rated health, ADL, IADL, and depressive symptoms). Results showed that, of the four social activities, cognitive function was only significantly associated with RA and GA engagement. RA meaningfulness moderates the association between cognitive function and RA engagement, in that high RA meaningfulness shows high RA engagement, while low RA meaningfulness shows low RA engagement and in a negative association with cognitive function. GA meaningfulness partially mediates the relationship between cognitive function and GA engagement. These findings support SET by showing cognitive resources-related selection effects on activity engagement and the roles of activity meaningfulness in selectivity effects. The implication highlights the importance of sustaining both cognitive function and motivational factors to promote social engagement among older adults with dementia.
VALIDATING THE IMPACT OF THE COMPREHENSIVE MOBILITY EVALUATION TOOL USED BY NURSES IN ACUTE CARE
Authors: Hook Mary 
Published: December 2023

Abstract
Existing nursing-based mobility tools were developed with clinical and reliability testing with small samples; none focused on predicting assistance needs. The Comprehensive Mobility Evaluation Tool (CMET) was designed using established testing procedures to support nurses to assess all phases of mobilization and predict level of assistance. A prospective descriptive research design was used to test reliability and validate CMET items, scoring, and ability to predict LOA. A randomly selected sample of decisional/English-speaking non-ventilated stable patients were enrolled from four medical/surgical and one critical care units at a large community hospital where CMET was used. Trained data collectors consented patients, completed bedside testing, and distributed patient surveys. Descriptive, inferential, and regression statistics were used for analysis. The representative sample (N=190) had an average age of 67.3 yrs (SD=16.2, 23-101), 50% male, with a robust range of mobility levels. Inter-rater reliability (n=27) yielded an average kappa of 0.94. Six of seven steps contributed significantly to predicting patient LOA with scores that correlated with nurse judgement [r (184) =0.86, p&lt; .0001]. Patients needed time and support to perform testing without assistance for optimal accuracy and benefit. Patients reported CMET was useful (88%) and easy (62%) and identified barriers that limit walking while hospitalized. Study limited by research at a single site. This study represents the initial validation, confirming reliability and benefits of the CMET, a skill-based tool to evaluate mobility status. Providing time and encouragement to perform CMET helps nurses and patients to identify deficits and tailor care to overcome mobility barriers.