bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 INFORMATION ELICITING STEREOTYPE THREAT CAN HARM OLDER ADULTS’ COGNITIVE FUNCTION
Authors: Pham Julie , Shumaker Morgan , Bowen Holly 
Published: December 2023

Abstract
During the COVID-19 pandemic, older adults were identified as an at-risk group for developing severe physical symptoms. In addition to physical presentations, evidence indicated COVID-19 related changes in cognitive and neurological function; specifically, increased risk of stroke, reduced attention, concentration, and memory problems. Given that older adults remain particularly vulnerable to severe symptoms, exposure to information about COVID-19 and the associated cognitive symptoms may have adverse effects on their cognitive performance. This phenomenon, known as stereotype threat, describes situations in which negative stereotypes about a particular group can impair functioning. The current study aims to examine how exposure to adverse age-related information about the pandemic may impact cognitive performance compared to more neutral age-related information. 484 older adults were recruited February through July 2023 via Amazon Mechanical Turk and Cloud Research Connect. Participants were randomly assigned to a neutral or threat condition and read a paragraph related to aging or COVID-19, respectively. Afterwards, participants completed a memory task followed by a series of questionnaires to assess demographics, mood, depression, and COVID-19 health history. A one-way ANCOVA was conducted to evaluate the effect of COVID-19 threat on memory performance while controlling for history of COVID diagnosis. Findings indicate a significant difference in scores such that individuals in the threat condition had worse memory performance, compared to those in the neutral condition. This suggests that just reading information about COVID-19 may pose a threat to older adults’ cognitive abilities and further demonstrates the far-reaching effect the pandemic has had on individuals.
CREATIVE ACTIVITIES AND COGNITION AMONG OLDER ADULTS: DOES EDUCATION MODERATE THE BENEFITS OF CREATIVE ACTIVITIES?
Authors: Fassi Janelle 
Published: December 2023

Abstract
Engagement in leisure activities has been shown to offset age-related cognitive losses. Although activity engagement has a compensatory effect on later life cognition among adults with low educational levels in early life, no studies have examined this effect with creative activity engagement. The aims of the present study were to (1) investigate whether older adults’ engagement in any creative leisure activities is related to cognitive functioning, (2) investigate whether the number of creative activities in which older adults engage is related to cognitive functioning, and (3) determine whether education moderates the relationship between creative engagement and cognitive functioning. This present study utilized a nationally representative sample of 2,462 adults aged 65 years and older from the Health and Retirement Study, who completed either the 2016 or 2018 waves of the Leave Behind Questionnaire and the 2015 wave of the Consumption and Activities Mail Survey. Results from linear regression models revealed that creative engagement was associated with better cognitive functioning scores (β=0.74, p&lt;.001). Additionally, more years of education were associated with better cognitive functioning scores (β=0.49, p&lt;.001). Engaging in four creative activities is also associated with better cognitive functioning compared to engaging in no activities (β=1.38, p&lt;.01). In sum, the results were in line with previous research that creative engagement and education are positively associated with cognitive functioning. Contrary to previous findings, creative engagement did not have a compensatory effect on cognitive functioning among individuals with fewer years of education.
DEFINING ‘OUTBREAK’: ADMINISTRATORS’ EXPERIENCES MANAGING COVID-19 AT US NURSING HOMES
Authors: Brazier Joan , Meehan Amy , Hawes Courtney , Shield Renee , Gabois Emily 
Published: December 2023

Abstract
The CDC defines a COVID-19 outbreak as starting with a single positive case of a staff member or resident in a facility and ending after there have been no new cases for 14 days. According to a report from the U.S. Government Accountability Office, 94% of nursing homes in the U.S. experienced multiple COVID-19 outbreaks, resulting in a reported 1.66 million residents and 1.64 million staff members with confirmed COVID-19 as of July 2023. Research has shown that COVID-19 outbreaks froze new admissions and caused significant financial strain. This qualitative study aimed to examine how COVID-19 outbreaks were managed in U.S. nursing homes. 156 interviews were conducted with nursing home administrators from 40 facilities across the U.S. between July 2020-December 2021. Two major themes emerged from thematic analysis: 1) the definition of “outbreak” as a single individual testing positive with COVID-19 was inconsistently communicated to nursing home administrators at the start of the pandemic; and 2) administrator self-reports of COVID-19 outbreaks at their facilities indicated that many endured multiple outbreaks which were long-lasting (greater than 1 month). As policy makers and industry experts review policies around managing nursing home viral outbreaks, they should consider the emerging infection control strategies from the pandemic which successfully prevented the spread of COVID-19 and update the response to an ‘outbreak’ such that infection control mitigation measures are effective without causing restrictions that are detrimental to resident well being or nursing home financial hardship.
DEMENTIA CARE IN ASIAN AND LATINO COMMUNITIES: PERSPECTIVES FROM FAMILY CAREGIVERS AND SERVICE PROFESSIONALS
Authors: Patano Arienne , Sun Fei , Ortiz Daniel Vélez , Liu Ethan 
Published: December 2023

Abstract
While community-based support and services are increasingly available to family caregivers (FCGs) of a person with dementia (PWD), those from ethnic minority groups tend to be underserved. This study aimed to identify unaddressed challenges to dementia care and uncover strategies to better assist FCGs within Asian and Latino communities in Michigan. Focus group and individual interviews were conducted with service professionals (SPs) and FCGs. Specifically, we ran two focus groups with SPs (n=11), and one with Asian FCGs (n=8). Four individual telephone interviews were conducted with Latino FCGs. Sessions were audiotaped and conducted in the participants’ preferred language, then transcribed and translated into English for analysis. Shared challenges to dementia care included: transportation to services; lack of translation services and language-concordant specialists, daycare/respite workers, and in-home care staff; and feelings of shame in needing support. Latino FCGs reported the emotional burden of witnessing the cognitive decline of their PWD, whereas Asian FCGs focused on challenges related to the behaviors of PWD. SPs and FCGs expressed the desire for more education for FCGs on dementia and self-management of stress. Limited technology literacy impacted their access to digital education. Culturally informed outreach and intervention strategies were recommended, such as partnering with community leaders and adapting cultural practices (e.g., providing family-oriented events, and using social media popular among specific ethnic groups). This study highlights the sociocultural challenges and practical outreach approaches for FCGs in Asian and Latino communities by integrating the perspectives of FCGs and SPs involved in dementia care.
DEMENTIA CARE PARTNER ACTIVATION PROGRAM FOR FILIPINO AMERICANS
Authors: Ramos Mary Dioise , Sakib Nazmus , Hasan Mehedi 
Published: December 2023

Abstract
This study aims to enhance the quality of life and health outcomes for individuals with Alzheimer’s Disease and Related Dementia (ADRD) and their care partners through a culturally tailored support program. Specifically focusing on the unique challenges Filipino and Filipino American (FA) caregivers face, we seek to address disparities in access to care and develop strategies for effective health system navigation. The research employs a multifaceted approach, combining surveys, focus groups, observational techniques, and interviews to assess the caregiving experience comprehensively. Our primary objectives include evaluating the impact of caregiving burden, socio-emotional support, and health literacy on emergency department visits and hospital admissions for ADRD patients. Preliminary results highlight the significance of culturally sensitive interventions. FA caregivers often encounter difficulties due to cultural beliefs, knowledge gaps about ADRD, and limited support networks. This study outlines the development and testing of a specialized program designed to empower FA caregivers with the skills needed for proficient care management and emergency response. By engaging these caregivers in participatory action research, the program aims to foster active involvement and enhance their caregiving capabilities. The study’s outcomes emphasize the potential for improved quality of life and health outcomes for individuals with ADRD and their caregivers. By addressing FA caregivers’ unique challenges in the context of disparity populations, our research contributes to enhancing health system navigation behaviors and promoting culturally attuned care practices. This initiative promises to reduce emergency department visits and hospital admissions, benefiting ADRD patients and their dedicated care partners.
DEMENTIA PREVENTION: THE COST-EFFECTIVENESS OF PREVENTION SERVICES IN JAPANESE LONG-TERM CARE SYSTEM
Authors: Hu Xujing , Wu Yunfan , Yamakawa Miyae , Kanaya Reiko 
Published: December 2023

Abstract

Objectives
To analyze the cost-effectiveness of prevention services (Named “Support” in Japanese official documents) in Japanese Long-Term Care Insurance system, which draws data from a large volume of 10-year database in Osaka Prefecture. Design: We design an approach to estimate cost-effective prices using aggregate data including costs of dementia in 10 years, time of dementia first diagnosed, changes of care levels, and quality of life. Measurements: The outcomes were average annual expenditure per unit of services.

Results
In higher risk groups of dementia, prevention services delaying cognitive decline and enhancing quality of life were cost effective at $206 per individual. However, this cost-effectiveness will wear off as symptoms worsen and the care levels increase.

Conclusion
Prevention services from Long-Term Care Insurance system are possibly to be cost-effective, but this cost benefit is not long-term .
RURAL-URBAN DIFFERENCES IN DIGITAL HEALTH USE OF MEDICARE BENEFICIARIES
Authors: Power Shannon , Yeo Hyesu 
Published: December 2023

Abstract
Growing reliance on digital healthcare appears to marginalize rural older adults with limited technology access and experience. Existing research explores telehealth uptake of Medicare beneficiaries but does not consider the role of locality in digital health use (DHU). Using the 2021 National Health and Aging Trends Study data, this study compares rural-urban Medicare beneficiaries’ DHU (weighted N=18,729,829). Informed by the Senior Technology Acceptance Model, multiple linear regressions were performed on rural and urban models separately, including DHU, social determinant, and technology readiness variables. Participants in this study were predominantly White, female, and in their 70s. In the final model, men were more likely to use DHU than women in both rural-urban samples (β=.13, β=.08, p&lt;.05, respectively). Tablet access was the only significant device for DHU among rural residents (β=.18, p&lt;.05), while computer access (β=.12, p&lt;.05) was the most significant among urban residents. Online grocery shopping was the most predictive prior technology experience of DHU for rural dwellers (β=.24, p&lt;.05), while online banking led for urban dwellers (β=.21, p&lt;.05). These unique differences between rural-urban samples can inform research on how to specifically design and implement digital interventions to increase rural older adult uptake. Healthcare workers can emphasize similarities between DHU and older adults’ prior technology experience to build perceived ease of use. Expanding opportunities for rural older adults to interact with technology in daily life builds experience which best predicts DHU. Policymakers should consider the impact of locality and involve aging community stakeholders to advance equitable DHU in the digital age.
DEPRESSION AND ROLE OVERLOAD IN FAMILY CAREGIVERS OF PEOPLE LIVING WITH AND WITHOUT DEMENTIA
Authors: McDonald Claire , Bravo Adrian 
Published: December 2023

Abstract
The present study examined the associations between caregiver assistance, role overload as a stressor, and depression symptoms among caregivers of adults age 65 and older living with and without probable dementia. Specifically, we hypothesized that more time spent caregiving would be associated with higher depressive symptoms via greater role overload and this indirect association would be stronger for those caregiving for an older adult with probable dementia versus no probable dementia. This study analyzed data from round 11 of the National Health and Aging Trends Study (NHATS) and the supplemental National Study of Caregiving (NSOC), which were collected from 2021 through early 2022. The majority of caregivers (207 probable dementia caregivers, 451 no probable dementia caregivers) identified as white (69%), female (70%), and reported an average age of 63.33. A moderated mediation model was tested using the PROCESS Macro (Hayes, 2013) in SPSS. Within our model, dementia classification was found to moderate the effect of the number of days spent caring on role overload (B = .048, SE = .019, t = 2.54, p = .011). Moreover, the overall moderated mediation model was supported with the index of moderated mediation = 0.0094 (95% CI = .0010, .0192). These results indicate that the more days a caregiver spent helping was associated with more symptoms of depression via higher caregiver overload, especially among those caregivers taking care of an older adult with probable dementia. These findings highlight the importance of making healthcare services available and accessible for caregivers.
DEVELOPING A PROTOCOL TO ASSESS EXPOSURE TO ENVIRONMENTAL POLLUTANTS AMONG OLDER ADULT WOMEN IN SOUTHEAST MICHIGAN
Authors: Baker Jillian , Park Sung Kyun , Richards-McCullough Kerry , Hoover Andrew , Karvonen-Gutierrez Carrie 
Published: December 2023

Abstract
Environmental pollutants, including PFAS, phthalates, and parabens, contribute to the development of age-related diseases like cancer, cardiometabolic disease, and neurodegenerative diseases. Unfortunately, these chemicals are common in everyday exposures, including drinking water, personal care products (PCPs), non-stick cookware, and food packaging. Exposures to these pollutants may be high in communities that have encountered structural disadvantages; neighborhood disinvestment and decaying infrastructure can make exposures to these pollutants more likely, thus increasing the burden of age-related disease in these communities. Interventions that reduce exposures to these chemicals may prevent or delay the onset of age-related disease, especially in groups experiencing poorer health outcomes because of structural racism and discrimination. To explore the feasibility of a behavior change intervention for older adults that reduces exposure to harmful chemicals in PCPs, a protocol was developed to: 1) Assess attitudes, knowledge, and behaviors related to environmental pollutants via questionnaire; 2) Characterize individual-level ‘exposomes’, the unique mixture of chemicals a person encounters in their everyday lives, by wearing a silicone wristband; 3) Measure environmental exposures in serum. Data collection will begin in September 2023 among older adult women who have participated in the Study of Women’s Health Across the Nation (SWAN) at the Michigan site. Older adults have accrued environmental exposures across their lifetimes, likely in a way that reflects patterns of structural disadvantage. While structural solutions are necessary to address issues of health equity, behavior change efforts can work in tandem to reduce harmful environmental exposures to improve the health of older adults.
DEVELOPMENT OF A PHYSICAL PERFORMANCE SUMMARY SCORE IN MIDDLE AGE: FINDINGS FROM THE CARDIA FUNCTION ANCILLARY STUDY
Authors: Burrows Brett , Sloane Richard , Pieper Carl , Lewis Cora , Gabriel Kelley Pettee , Jacobs David , Bowling C Barrett 
Published: December 2023

Abstract
Recent evidence suggests that ~20% of middle-aged adults report mobility limitations, supporting the need for assessment strategies to detect early-onset limitations, appropriate for this population. Coronary Artery Risk Development in Young Adults (CARDIA) enrolled 5,115 Black and White men and women ages 18-30 years from four sites (Birmingham, AL; Oakland, CA; Minneapolis, MN; and Chicago, IL) in 1985-86. The CARDIA Function Study added self-reported function (PROMIS SF20a) and 5 physical performance measures (gait speed, single-leg balance, lower extremity strength, grip strength, and 6-minute walk test) to the Year 35 in-person follow-up exam conducted in 2020-22. The CARDIA Physical Performance (CAPP) score was developed by calculating sex-specific quartiles separately for each performance measure, assigning points based on these quartiles (0 for not attempted, 1-4 for each quartile), and summing points across all 5 performance measures (range 0-20, higher scores = greater performance). Among 2,021 CARDIA Function participants [mean age: 60.1 (±3.6) years; 57% female; 45% Black] the mean CAPP score was 12.3 (±4.1; range 0-20). Mean CAPP scores differed by age &lt; 60 vs. ≥60 years old (12.7 vs.12.1, p&lt; 0.05) and self-reported function above vs. below the median SF20a score (14.0 vs. 10.6, p&lt; 0.001), but as expected, not sex (12.3 vs. 12.3, p=0.99). Among middle-aged adults, the newly developed CAPP score captured a wide range of physical performance. Lower CAPP score was associated with lower than median self-reported function suggesting that the CAPP score may be helpful assessment tool for detecting early-onset limitations to attenuate functional declines with aging.
DIFFERENCES IN FRAILTY BETWEEN TRADITIONAL MEDICARE AND MEDICARE ADVANTAGE BENEFICIARIES
Authors: Shi Sandra , Olivieri-Mui Brianne , McCarthy Ellen , Kim Dae Hyun 
Published: December 2023

Abstract
Medicare Advantage (MA) plans cover at a minimum the same services as fee-for-service Medicare (FFS), but may target patient populations that differ in health and frailty. Leveraging 2011 and 2015 National Health and Aging Trends Study (NHATS) linked to Medicare claims, we classified participants as FFS or MA beneficiaries based on 12 months of Medicare enrollment. We calculated a deficit accumulation-based frailty index (FI) and phenotypic frailty from the survey assessment. All analyses accounted for the complex sampling design and weighted to reflect national estimates. In 2011, MA beneficiaries were more likely to be female (MA vs FFS: 59.1% vs 55.6%), Black (9.6% vs 7.4%) or other race (9.8% vs 5.2%), and to have an estimated income &lt;$25,000 (44.5% vs 39.4%). Although the mean FI was similar between MA and FFS (MA vs FFS: 0.25 vs 0.25), MA beneficiaries were more likely to have mild frailty by FI (20.1% vs 18.6%) but less likely to have severe frailty by FI (10.0% vs 11.7%) or phenotypic frailty (13.5% vs 14.0%). MA beneficiaries had a higher prevalence of some comorbidities, such as hypertension (MA vs FFS: 64.9% vs 63.3%) and diabetes (24.4% vs 23.3%), but a lower mean number of ADL disability (0.32 vs 0.39). In 2015 the results were similar, although MA beneficiaries had a higher prevalence of pre-frailty (MA 46.0% vs 43.3%). In conclusion, MA beneficiaries seem to have a lower level of deficit-accumulation frailty and phenotypic frailty. This difference is driven by comorbidities, but not functional disability.
DIFFERENT PATTERNS OF VACCINE HESITANCY AMONG OLDER ADULTS BY RACE/ETHNICITY, INCOME, AND EDUCATION
Authors: Kim BoRin , Jeon Jehoon , Jeong Chung Hyeon 
Published: December 2023

Abstract
Despite significant efforts to increase COVID-19 vaccination rates, a substantial number of people exhibit vaccine hesitancy. Vaccine hesitancy is considered as one of the greatest threats to global health but also poses substantial risks to individuals. Moreover, vaccine hesitancy patterns may reflect and perpetuate existing health disparities. This study aims to investigate if specific patterns of vaccine hesitancy exist among older adults across racial/ethnic and socioeconomic groups. Our sample included 4,656 respondents aged 65+ who participated in the 2021 Health and Retirement Study Perspectives on the Pandemic that focuses on the first-year pandemic experiences. Latent class analysis and multinomial regression was used to identify vaccine hesitancy patterns and examine the associated factors, adjusting for age, gender, marital status, and self-rated health. Four vaccine hesitancy patterns were identified: no hesitancy (56.7%), mild hesitancy-uncertainty (19.4%), strong hesitancy-personal concerns (12.0%), and strong hesitancy-lack of trust/conspiracy (11.9%). White (RRR=1.659, p&lt;.01), higher income (RRR=1.005, p&lt;.05) and higher education (RRR=1.078, p&lt;.001) were positively associated with no hesitancy. Respondents with higher education (RRR=0.573, p&lt;.05) were less likely to be in the group of mild hesitancy with uncertainty. Hispanics (RRR=0.583, p&lt;.05) and higher education (RRR=0.332, p&lt;.001) were negatively associated with strong hesitancy with personal concerns. African Americans (RRR=2.426, p&lt;.001) and those with lower education (RRR=1.324, p&lt;.001) were more likely to be in the group of strong hesitancy with lack of trust/conspiracy. Our findings show that vaccine hesitancy is not random, which is closely related to social stratification impacting health disparities in this society.
DISRUPTED SOCIAL LIFE MEDIATES ASSOCIATION BETWEEN PANDEMIC WORRIES AND RISK OF ELDER ABUSE
Authors: To Louis , Leung Lok Man , Wan Debby , Tsui Ronald , Yan Elsie 
Published: December 2023

Abstract
Social isolation is an important risk factor for elder abuse. This study investigated the mediating effects of pandemic-related disruptions of social life between worry about the pandemic and risk of elder abuse. A total of 1078 community dwelling older persons participated in this community survey. They provided information on their demographics, worry about the pandemic, pandemic related disruptions of social life, and risk of elder abuse as measured by a 10-item scale derived from Dong et al. (2015). Participants age ranged from 60 to 100 (mean= 76.2, SD=7.9), majority of them were female (81.6%), single, divorced or widowed (52.8%). Prevalence of risk of abuse was high (21.5%), with the most prevalent type being family conflicts at home (16.6%), followed by feeling uncomfortable with someone in the family (8.1%). Participants who were not in a marital relationship, of larger household, reported feeling worried about the pandemic and felt their social life disrupted were at greater risk of abuse. Logistic regression results show that pandemic related disruptions of social life partially mediated the association between worry about the pandemic and risk of abuse. In the final model, participants who reported feeling worry about the pandemic and those who reported that the pandemic has caused disruptions in their social life were at greater odds of reporting risk of abuse (OR=1.14 and 1.13 respectively, p&lt;.05). The effects of the former diminished after the latter was entered into the model. This finding highlights the importance of social life in protecting older persons against abuse.