bluuebunny/crossref_metadata_2025_split huggingface dataset:
PAIN, PLACE, AND POSITIONALITY: SYSTEMIC APPROACHES TO IMPROVING EQUITABLE HEALTH OUTCOMES FOR OLDER ADULTS
Authors: Robinson-Lane Sheria 
Published: December 2022

Abstract
Racism and other “isms” are systemic problems that operate across multiple domains and affect access to care and services, available treatments, and long-term health outcomes for older adults. As such, changing these systems requires diverse methodological approaches that can identify and examine the contextual factors that influence these outcomes, along with continued strong advocacy that will result in related policy change. This presentation will highlight challenges in care delivery and outcomes for Black older adults in pain management, COVID care, and long term care placement and examine how mixed methodological approaches and implementation of the Culturally and Linguistically Appropriate Services (CLAS) Standards as outlined by the U.S. Department of Health and Human Services can make a difference.
EXPERT CONSENSUS PANEL RECOMMENDATIONS FOR MEDICAL AND MENTAL HEALTH CARE IN ASSISTED LIVING
Authors: Zimmerman Sheryl , Sloane Philip , Wretman Christopher , Cao Kevin , Silbersack Johanna , Carder Paula , Thomas Kali , Meeks Suzanne 
Published: December 2022

Abstract
Assisted living (AL) is now the largest residential provider of long-term care in the U.S., and the acuity of AL residents has been rising. However, AL is not a health care setting, and concern has grown about the medical and mental health care needs of AL residents. Because there is no guidance to inform this care, a Delphi consensus panel of 19 experts was convened, and their recommendations were compared to actual practice. Panelists rated 200 discrete items, 43 of which met standard recommendation cut points (rated as important by at least 75% of panelists) and reflected four critical components of AL: the tenets of AL, the role AL plays in providing long-term care for persons with dementia, the need for pragmatism in response to the diversity of AL, and workforce needs. Next steps regarding implementation of the recommendations will be discussed.
THE FACE OF ELDER ABUSE IN AFRICA: THE NIGERIAN PERSPECTIVE
Authors: Cadmus Eniola 
Published: December 2022

Abstract
Elder abuse is increasingly recognized as a serious problem in many African societies, including Nigeria. Contributing factors include a high level of poverty, unemployment, diminished availability, willingness, and ability of primary caregivers to provide for their older persons. Traditionally, elder abuse is considered taboo, and high secrecy surrounding its occurrence further contributes to challenges reporting and addressing the problem. Additionally, the patriarchal nature of the Nigerian society accounts for the gender-based differences in forms of abuse experienced with increased vulnerability among older women. This paper presents case studies that typify the experience of abuse among male and female older persons. The prevalence rates of abuse are drawn from community surveys across the six geopolitical zones. Although the methodologies vary, the total prevalence of any form of abuse experienced ranged from 30-81.1%. However, most studies relied on self-reports with no attempts at verification or data and records for triangulation of information.
THE MANY VOICES OF CARE PARTNERS ACROSS THE CONTINUUM OF CARE
Authors: Fox Aimee , Latimer Abigail , Waldrop Deborah 
Published: December 2022

Abstract
Caregiving and care-sharing is a dynamic, stressful, and physically demanding responsibility, often leading to adverse psychological and physical outcomes. Caregiving for chronic illness and disease involves increasing complexity and scope of responsibilities and expectations. Utilizing strengths-based approaches and a variety of qualitative methods, this symposium highlights the many voices of care partners across the continuum of care; pre-, during and post-caregiving. First, Latimer and colleagues will present a case study of an older adult with multiple chronic illnesses, offering insight into anticipating care needs and coping with daily stressors of multi-morbidity in late life. Second, Morgan and colleagues will present findings from interviews with care partners on supporting the inner strength of those recently diagnosed with mild cognitive impairment. Third, Fox and colleagues share results from a dyadic, multi-modal intervention for pain management. Care partners who both experience persistent pain discuss changes in their relationship as a result of participating in the intervention together. Fourth, Wladkowski discusses caregiver’s perspectives on live discharge and re-enrollment into hospice care. Her findings demonstrate how the anticipated “end” isn’t always the end for ADRD caregivers. Fifth, Buck and colleagues will share caregivers’ responses to a psychotherapy intervention for the treatment of complicated grief post-death of the care partner. Discussant Deborah Waldrop will contextualize these findings and offer suggestions for future research and interventions to enhance care partners’ well-being across the continuum of chronic illness and care.
UNDERSTANDING CAREGIVER PERSPECTIVES ON LIVE DISCHARGE AND RE-ENROLLMENT ONTO HOSPICE CARE
Authors: Wladkowski Stephanie P 
Published: December 2022

Abstract
Hospice care improves end-of-life outcomes for adults with Alzheimer’s Disease and related dementias (ADRD), yet with eligibility limited to a six-month prognosis, the patient-caregiver dyad can experience a live discharge from hospice. In 2019, nearly 350,000 patients with an ADRD diagnosis received hospice services in the US, and 6.5% of hospice patients were discharged due to being ‘no longer terminally ill.’ Caregivers of adults with ADRD who experienced a live discharge (n=24) were interviewed and thematic analysis was conducted. More than half (58%) noted specific support in their caregiving roles while 46% cited feeling relief. Eleven participants were enrolled for one hospice episode, and six re-enrolled at least one time. While participants would consider re-enrolling, they are waiting for a health crisis (n=7) for eligibility, while others question the meaning of hospice for ADRD patients (n=10). Implications for policy, practice, and research to support the patient-caregiver dyad are discussed.
THE RAISE FAMILY CAREGIVER ADVISORY COUNCIL: STRATEGIES TO BOLSTER CAREGIVERS’ FINANCIAL SECURITY
Authors: Nadash Pamela 
Published: December 2022

Abstract
The RAISE Family Caregiving Advisory Council, created under the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act (2018) has been tasked to support the Secretary of Health and Human Services in developing a national family caregiving strategy. The Council began by (in 2021) identifying five key Goals critical to supporting family caregivers, which were reported to Congress in the Council’s Initial Report; the next step (in 2022) was to identify how these Goals are to be operationalized via specific actions, as well as the stakeholders that needed to be involved. This symposium discusses Goal 4, which states that “Family caregivers’ lifetime financial and employment security is protected and enhanced,” a goal incorporating diverse components, including federal legislation (expanding FMLA, for example), enhancing workplace security for working caregivers, and ways to pay family caregivers for providing supportive services. The first paper, by Salom Teshale, PhD, will provide an overview of the Council’s work and the strategies that have been chosen to support the overall national strategy. The second paper, by Eileen J. Tell, MPH, will describe strategies to improve the ability of caregivers to remain and thrive in the workplace. Pamela Nadash, PhD, will report on the research that identified the expansion of self-directed programs to incorporate payment for family caregivers as key, and the fourth paper by Rani Snyder will conclude by identifying the research needed to move these efforts forward. Greg Link of the Administration for Community Living will act as discussant.
A RESEARCH AGENDA TO ADVANCE FAMILY CAREGIVERS' FINANCIAL SECURITY
Authors: Snyder Rani , Tell Eileen 
Published: December 2022

Abstract
The research supporting the RAISE Family Caregiver Advisory Council engaged a broad range of stakeholders who were committed to supporting actions that make a difference to family caregivers’ financial security, with many focusing on actions that sustain continued employment; 103 different organizations participated, including employer representatives. Participants strongly agreed on the need for more data. On a broad level, there was agreement on federal-level coordination regarding data collection on elements specific to family caregivers across federal agencies. In addition, they called for better information on the return on investment of varying strategies for workplace supports for employers, the added value of caregiver employees, and evidence regarding best practices in supporting family caregivers, with a goal of making a business case for family caregiver workplace supports.
THE RAISE COUNCIL'S WORK IN DEVELOPING A NATIONAL FAMILY CAREGIVING STRATEGY
Authors: Teshale Salom 
Published: December 2022

Abstract
Since 2019, the RAISE Family Caregiver Advisory Council (FCAC) has met regularly to carry out its work of developing a national family caregiving strategy. This strategy incorporates five goals to support family caregivers, and key actions that a range of stakeholders can carry out centered around these goals. This overview will describe the RAISE FCAC’s work in developing the national family caregiving strategy, and highlight the development of recommendations and key actions to support the fourth goal, “Family caregivers’ lifetime financial and employment security is protected and enhanced.” This goal’s recommendations include supporting caregivers through flexible workplace policies; supporting affordable long-term services and supports; supporting financial education and planning; and reducing overall negative financial impacts of caregiving short and long-term.
DIRECTORS OF SOCIAL SERVICES: OVERLOOKED LEADERSHIP NEEDS AT SKILLED NURSING FACILITIES (SNFS)
Authors: Abenojar John Paul 
Published: December 2022

Abstract
Skilled Nursing Facilities (SNFs) provide ongoing care to the elderly and chronically ill. To maximize the quality of this care, SNF staff must be trained to respond to patient care crises and communicate across departments. Although researchers have studied the leadership styles, strategies, and interactions of facility administrators and nursing directors, little was known about the leadership styles and strategies employed by the directors of social services (DSSs). The aim of this phenomenological study was to explore how DSSs influenced leadership policies, prepared subordinates for crisis intervention and management, perceived that social workers influenced patient care decisions, and believed that communication amongst SNF staff about patient care could be improved. The conceptual framework was based on the multilevel leadership model construct, the situational leadership model construct, and the complex adaptive leadership model construct. Participants included a purposive sample of 10 DSSs working in a large, corporate SNFs in Virginia. Data were collected via in-person, semi structured interviews consisting of open-ended questions. Data were analyzed via Hycner's phenomenological approach. Findings from this investigation helped clarify roles and responsibilities of DSSs, thereby improving the leadership they provide to subordinate social workers. Findings may be used to improve communication across professionals within SNFs and their roles in patient care decisions.
MITOCHONDRIAL COMMUNICATION AND AGING
Authors: Lee Changhan 
Published: December 2022

Abstract
Mitochondria evidently originate from endosymbiotic bacteria that presumably provided several advantages for eukaryotic life. For the past 1–2 billion years, mitochondria co-evolved with the ancestral cell to coordinate various cellular functions. Coordination requires communication and mitochondrial signaling has been shown to be vital to cellular fitness and aging. In this symposium, the speakers will discuss the role of mitochondria as a signaling organelle and their impact on key cellular functions in the context of aging. Consistent with emerging evidence of the complexity and sophistication of mitochondrial communication mechanisms, some of the mitochondrial-to-nuclear communication modes, including nuclear transcriptional programs and cellular signaling networks, that regulate molecular and cellular processes to promote fitness will be discussed. Dr. Chen will discuss how a mitochondrial metabolic checkpoint can regulate stem cell quiescence and maintenance that is important to stem cell aging. Dr. Picard will discuss the impact of mitochondrial stress on increased energetic cost of living (i.e. hypermetabolism) and cellular lifespan. Finally, Dr. Lee will discuss how signaling peptides that are encoded withing the mitochondrial genome regulate cellular homeostasis, increase physiological resilience, and promote healthy aging.
MITOCHONDRIA: POWERHOUSE, SLAUGHTERHOUSE, AND SPEAKER OF THE HOUSE
Authors: Lee Changhan 
Published: December 2022

Abstract
The nuclear and mitochondrial genomes have co-evolved since the union forged 1-2 billion years ago between our ancestral cell and free-living bacteria. The bi-genomic system is coordinated by close communication between the two genome-possessing organelles. More recently, peptides that are encoded in the mitochondrial genome have been identified and shown to communicate mitochondrial messages. In this symposium, I will discuss MOTS-c as a mitochondrial-encoded communication factor in the context of aging. MOTS-c can translocate to the nucleus under metabolic stress to directly regulate adaptive nuclear gene expression. In humans, MOTS-c levels increase in skeletal muscle and in circulation upon exercise. In mice, MOTS-c treatment significantly reversed physical decline in aged mice (22 mo.), including doubling in treadmill running time. Studies from our lab and others point to a novel class of mitochondrial-encoded longevity genes that coordinate cellular homeostasis.
MITOCHONDRIAL METABOLIC CHECKPOINT, STEM CELL AGING AND REJUVENATION
Authors: Chen Danica 
Published: December 2022

Abstract
Cell cycle checkpoints are surveillance mechanisms in eukaryotic cells that monitor the condition of the cell, repair cellular damages, and allow the cell to progress through the various phases of the cell cycle when conditions become favorable. Recent advances in stem cell biology highlight a mitochondrial metabolic checkpoint that is essential for stem cells to return to the quiescent state. As quiescent stem cells enter the cell cycle, mitochondrial biogenesis is induced and mitochondrial stress is increased. Mitochondrial unfolded protein response and mitochondrial oxidative stress response are activated to alleviate stresses and allow stem cells to exit the cell cycle and return to quiescence. These processes are critically regulated by several sirtuin family members, which are NAD+-dependent deacetylases. Because loss of stem cell quiescence results in the depletion of the stem cell pool and compromised tissue regeneration, deciphering the molecular mechanisms that regulate the mitochondrial metabolic checkpoint in stem cells will increase our understanding of tissue homeostasis and how it becomes dysregulated under pathological conditions and during aging. More broadly, this knowledge is instrumental for understanding the maintenance of cells that convert between quiescence and proliferation to support their physiological functions.
IT WAS TERRIBLE, I DIDN'T SLEEP FOR TWO YEARS: A MIXED-METHODS EXPLORATION OF SLEEP AMONG HOSPICE FAMILY CAREGIVERS
Authors: Starr Lauren , Washington Karla , McPhillips Miranda , Demiris George , Oliver Debra Parker 
Published: December 2022

Abstract
Due to overnight caregiving demands and inadequate social support, over 1.2 million hospice family caregivers in the U.S. and millions more worldwide are at risk of poor sleep and resulting negative effects on health. Sleep problems are a modifiable source of global health inequities. The purpose of this study was to describe hospice family caregiver sleep experiences, efforts to improve sleep, and effects of sleep. Developed using the Symptom Management Model, this mixed methods study featured a concurrent nested design prioritizing qualitative reflexive thematic analysis. In 2021, 47 family caregivers of hospice care-recipients from two randomized clinical trials in the United States (NCT03712410, NCT02929108) were interviewed. Sleep-related questions from PHQ-9 and GAD-7, and self-rated health and energy were administered at baseline. Three themes emerged: quality of sleep, factors influencing sleep, and effects of sleep. Hospice family caregivers commonly experienced “interrupted” sleep with frequent night-waking due to “on-call” “vigilance” and anxiety overnight and, sometimes, in bereavement. Negative effects included exhaustion, mental and physical health decline, and reduced performance. 72.5% described sleep quality as “fair” or “poor.” At baseline, 35.5% of caregivers were bothered by trouble falling asleep, staying asleep, or sleeping too much at least “more than half the days” in a week. Caregivers were reluctant to take sleep medications. Over half quit jobs or reduced work hours to provide care; few reported adequate support. Hospice family caregivers commonly experience disordered sleep with negative effects. Clinicians must assess sleep, offer tailored sleep interventions, and provide more supports to hospice family caregivers.
HEARING LOSS AND SUBJECTIVE COGNITIVE DECLINE IN THE ARIC-NEUROCOGNITIVE STUDY
Authors: Deal Jennifer , Lenzen Natalie , Majid Marjan , Jiang Kening , Reed Nicholas 
Published: December 2022

Abstract
Subjective cognitive decline (SCD) impacts quality-of-life, healthcare utilization and predicts dementia. If hearing loss is associated with SCD is unknown. We estimated the cross-sectional association between hearing loss and SCD in 2,536 participants (79.3±4.4 years, 60% female, 20% Black) in the Atherosclerosis Risk in Communities Neurocognitive Study. SCD was defined as self-reported persistent decline in memory (yes/no) among adults with normal cognition. Hearing was measured using pure tone better-ear thresholds (0.5-4 kHz), speech-in-noise, and self-report. Using Poisson models with robust standard errors, after adjustment for demographic and clinical covariates, self-reported moderate or greater trouble hearing (vs. excellent/good) was associated with a 30% increase in the prevalence of SCD (95%CI:1.12,1.51). Audiometric hearing and speech-in-noise performance were not associated. Use of self-report to approximate audiometric hearing warrants caution, particularly when the outcome is also self-reported; our findings suggest the association between self-reported hearing and SCD may be due to correlated measurement error.
THE ECONOMIC CONSEQUENCES OF GRAY DIVORCE FOR WOMEN AND MEN
Authors: Lin I-Fen , Brown Susan 
Published: December 2022

Abstract
Surprisingly little is known about the consequences of gray divorce (after age 50) and how women and men fare economically during the aftermath. Using longitudinal data from the 2004-2014 Health and Retirement Study, we estimated hybrid fixed/random effects models comparing women’s and men’s economic well-being prior to, during, and following gray divorce and subsequent repartnering. Women experienced a 45% decline in their standard of living, whereas men’s dropped by just 21%. These declines persisted over time for men, and only reversed for women following repartnering, which essentially offset women’s losses associated with gray divorce. Both men and women experienced roughly a 50% drop in wealth. Although repartnering seems to reverse most of the economic costs of gray divorce for women, few form new co-residential unions after divorce. This study offers insight about the financial aftermath of gray divorce, which is likely to contribute to growing economic disadvantage among older adults.
CON/DISCORDANCE BETWEEN SUBJECTIVE AND OBJECTIVE SLEEP PARAMETERS AND THEIR ASSOCIATION WITH COGNITIVE FUNCTION
Authors: Calfee Kristin , Lee Soomi 
Published: December 2022

Abstract
Studies report that subjective and objective sleep parameters often do not agree with each other. This study examined if discordance between subjective and objective sleep measures are associated with cognition. Participants from the Midlife in the United States study (n=627) provided subjective (self-report) and objective (actigraphy) sleep duration and sleep quality. Discordance was assessed by absolute difference between subjective and objective z-scores in each sleep variable. Cognitive function was measured by the Brief Test of Adult Cognition by Telephone (BTACT). The correlations between subjective and objective sleep measures were weak-to-moderate (r=.43, .18 for duration and quality, respectively). Discordance scores in sleep duration and quality were each significantly associated with BTACT, such that greater discrepancy was associated with poorer cognitive function. These associations remained persistent after adjusting for sociodemographic differences. Results suggest that discordance between subjective and objective sleep parameters may relate to cognitive abilities needed to accurately monitor sleep characteristics.
ACUTE RELATIONSHIPS BETWEEN MENTAL HEALTH AND COGNITIVE FUNCTION AMONG AGING ADULTS DURING THE COVID-19 PANDEMIC
Authors: Kobayashi Lindsay , O'Shea Brendan , Joseph Carly , Finlay Jessica 
Published: December 2022

Abstract
The acute impacts of COVID-19-related mental health concerns on cognitive function among aging adults are unknown. We investigated whether between-person (BP) differences and within-person (WP) changes in loneliness, anxiety, and COVID-19 worry were related to cognitive function and abilities in the COVID-19 Coping Study over nine months from August/September 2020 through April/May 2021 (n=2,262). Marginal structural models accounting for depression as a time-varying confounder and incorporating attrition and sampling weights estimated the BP and WP relationships of loneliness, anxiety, and COVID-19 worry with PROMIS cognitive function and abilities scores over time. In any given month, experiencing a loneliness or anxiety score higher than the sample mean (BP difference) as well higher than one’s personal mean across the nine-month period (WP change) were negatively associated with cognitive function and abilities in that month. Future research should explore long-term impacts of loneliness and anxiety experienced during the pandemic for population cognitive aging.