bluuebunny/crossref_metadata_2025_split huggingface dataset:
RISK FACTORS OF DISABILITY AMONG COMMUNITY-DWELLING OLDER ADULTS WITH HYPERTENSION IN THAILAND: THE HART STUDY
Authors: Wongsin Utoomporn , Chen Tuo-Yu 
Published: December 2022

Abstract
About 60% of the older adults in Thailand experience hypertension, a condition that increases the risks of disability. However, little to no study has investigated modifiable risk factors to prevent disability in this segment of population in Thailand. Therefore, this study aims to investigate factors associated with disability among community-dwelling older adults aged 60 years or above with hypertension in Thailand. Longitudinal data (wave-1 [2015] and wave-2 [2017]) were from the Health, Aging, and Retirement in Thailand (HART) survey. Descriptive analysis and logistic regression analysis were employed to analyze the data. Outcome variables were difficulty with activity of daily living, hearing-related disability, vision-related disability, and pain-related disability in wave-2. Sociodemographic information, health behaviors/health status, mental illness, chronic diseases, and disability at baseline were independent variables. The results showed that older age significantly predicted difficulty with activity of daily living and hearing-related disability among community-dwelling older adults with hypertension in Thailand. Drinking alcohol significantly predicted vision-related disability. No factors were found to be a significant factor for pain-related disability. Our analysis provided useful information for the prevention of disability among older adults with hypertension in Thailand.
EVERYTHING HAS CHANGED FOR THE WORSE: EXPERIENCES OF ELDERS DISPLACED BY ARMED CONFLICT IN ETHIOPIA
Authors: Gebeyaw Getachew , Dessale Shambel , Kasseye Eyayu , Adamek Margaret 
Published: December 2022

Abstract
In November 2020 an outbreak of ethnically and politically motivated armed conflict started in Tigray, Ethiopia and expanded to the Amhara and Afar regions, bringing a devastating impact upon civilians and disadvantaged groups. Persons living in those areas, including elders, were forced to flee and seek refuge at internal displacement centers. The purpose of this study was to investigate the challenges faced by older individuals fleeing the war zone and settling in internal displacement centers during Ethiopia's armed conflict. A qualitative descriptive case study was used in this cross-sectional investigation. Purposive sampling was used to identify 13 displaced older adults. Data from the in-depth interviews with elders were supplemented with key informant interviews and observations. Narrative data was analyzed using thematic analysis. Findings revealed that the older adults faced a variety of challenges in the war zone while escaping their homes and in the displacement center, all of which negatively impacted their physical and psychosocial well-being. Elders fled on foot and walked for three days without food to reach the internal displacement center. In addition to food shortage, other themes included loss of significant others, family disintegration, and lack of care and support. The findings call attention to the need for practical access to social and economic integration of elders in the aftermath of war as well as ongoing psychosocial intervention. In Ethiopia and in other war-affected areas, displaced older people need tailored support.
LIFE ON THE STREETS IS HORRIBLE: OLDER RURAL-URBAN MIGRANTS COPE WITH HOMELESSNESS IN ETHIOPIA
Authors: Gebeyaw Getachew , Kotecho Messay , Adamek Margaret 
Published: December 2022

Abstract
The prevalence of homelessness among older adults in Ethiopia is growing. While prior studies examined the push factors and challenges of homeless elders, little is known about how older people in Sub Saharan Africa cope with homelessness. This study explored the coping strategies of homeless older people in Kobo Town, Ethiopia. Purposive sampling was used to identify 10 homeless older people and four key informants. Study participants were homeless for a year or longer. Thematic analysis was used to analyze the data collected through in-depth interviews. To cope with the challenges faced on the street, homeless older people used various strategies including begging, holy water, drying leftover food, using river water for hygiene and sanitation, sleeping in church compounds, and creating their own social networks. Despite their efforts, the coping strategies used by elders were not sufficient. In the absence of family and government support, study participants relied heavily on begging to meet their survival needs. The findings call attention to the need for a national income support program and other supportive services for older adults. Homelessness is the product of a failing support system. Despite Ethiopia having a Plan of Action for Older Persons and Social Protection Policy for Vulnerable Groups, these policies have not been effectively implemented leaving older adults with no safety net. This study calls for the development of new policies to empower older people in Ethiopia and prevent them from turning to begging as their only recourse.
MEASURING A GOOD DEATH: AN ASSESSMENT ACROSS FOUR COUNTRIES
Authors: Clem Sarah 
Published: December 2022

Abstract
A good death is often viewed as a common goal in end-of-life care, yet our understanding of what qualifies as a good death is still under development. Previous studies have attempted to conceptualize our understanding of a good death and have highlighted the need to improve our measurement of this construct. The present study examines a measure of a good death across four countries. Data for this study were derived from the Four-Country Survey on Aging and End-of-Life Medical Care (2017), in which participants were sampled using a random digit dial method. The study relies on a sample of 4,239 participants from the US, Italy, Japan, and Brazil. Confirmatory Factor Analysis (CFA) was employed to fit a measurement model to the full sample for a measure of the importance of a good death. Once model fit was deemed sufficient, a multi-group CFA was used to assess invariance across the four countries. Model fit was adequate at the configural and metric levels, highlighting that across the four countries importance of a good death was measured and understood the same. However, the model failed at the scalar level of invariance, implying that indicators for the importance of a good death are valued differently across the four countries. Further developing our understanding of a good death and how it is measured is essential for improving quality end-of-life care. This study identifies a quality measure of good death while simultaneously highlighting the limitations in using such a measure in a transnational context.
THINGS LEFT UNDONE: RELATION OF GRIEF TO SENSE OF PURPOSE IN BEREAVED OLDER ADULTS
Authors: Sharma Shubam , Mroz Emily , Bluck Susan 
Published: December 2022

Abstract
Sense of purpose is grounded in life experiences (Ko et al., 2019) and can be threatened by the loss of a loved one. The death of a spouse in late life can be particularly disruptive when the bereaved struggle with perceptions of unfinished business with the deceased. This mentality may also derail their sense of life purpose. This study examined the association between persistent grief symptomatology (Prigerson et al.,1995) and sense of purpose (Ryff, 1989) in conjugally-bereaved older adults (N = 53; Mage = 81.59). Unfinished business constructs (i.e., unfulfilled wishes, unresolved conflict; Holland et al., 2018) were tested as mediating grief-purpose relations. Older adults who reported greater grief symptomology also experienced lower sense of purpose (r = -.27, p &lt; 0.05). Extent of unfulfilled wishes fully mediated the relation between grief symptomology and sense of purpose (t = -2.26, p &lt; 0.05); unresolved conflict did not act as a mediator. Findings indicate that the association between experiencing pervasive grief symptomology and a disrupted sense of purpose may be due, in part, to ongoing rumination about unfulfilled wishes: missed opportunities to meaningfully engage with one’s spouse before death. Results are poignant given recent COVID-19 physical distancing requirements that separated older couples during spouses’ dying days, potentially prompting unfulfilled wishes across bereavement. Findings highlight the need for palliative care practices that facilitate optimization of relationships at end of life and grief support practices that re-ignite purpose after difficult spousal loss.
SOCIAL SUPPORT AND STRAIN AS PREDICTORS OF MULTIMORBIDITY FOLLOWING A MARITAL TRANSITION
Authors: Denning Emily , Newsom Jason , Botoseneanu Anda , Allore Heather , Nagel Corey , Dorr David , Quiñones Ana 
Published: December 2022

Abstract
Marital transitions (MTs; widowhood or divorce) are stressful events that impact the health of older adults. This study examined the impact of social support and social strain on multimorbidity trajectories using data from the Health and Retirement Study (HRS). Participants were 377 adults age 50+ with a single MT between years 2006 and 2016. We used piecewise growth curve modeling to investigate whether social support and strain from one’s spouse, children, family, or friends, measured prior to transition, predicted trajectories of chronic conditions (count of 8 conditions: hypertension, diabetes, cancer, lung disease, heart disease, stroke, arthritis, and cognitive impairment) following MT. Covariates included sex, age, education, race/ethnicity, and wealth. On average, chronic conditions were increasing before MT, B = .172, SE = .021, p &lt; .001, and after MT, B = .211, SE = .031, p &lt;.001. Participants had an average of 2.2 chronic conditions at MT. Spousal support prior to MT was associated with fewer chronic conditions at MT, B = -.863, SE = .427, p = .043, whereas support and social strain from friends were each associated with more chronic conditions at MT (support: B = .772, SE = .354, p = .025; strain: B = 1.288, SE = .387, p = .001). Support from children was positively associated with more chronic conditions following MT, B = .212, SE = .084, p = .011, which may reflect adult children providing support in response to parental health decline.
DOES DEPRESSION IMPROVE DURING RETIREMENT AMONG BINGE DRINKERS?
Authors: Diaz-Valdes Antonia , Sellers Christina , Ponce Julian 
Published: December 2022

Abstract
Data from the Health and Retirement Study (1992-2016) was used. All non-institutionalized respondents aged 50+ were included in our sample (n=12,618). Mixed models were conducted to study the association between transitioning to retirement and depressive symptoms (CESD) among retirees, and to test the mediation effect of alcohol use.
Results: Those retired for at least 6 years had increased probability of binge drinking. Additionally, binge drinking mediated the association between the retirement transition and depressive symptoms, making the effect stronger for those retired for 3 to 5 years (p&lt; 0.05), and weaker and no significant for those retired for 6+ years (p&gt;0.05). Thus, the decrease on depressive symptoms was higher for those retired between 3 to 5 years when being binge drinkers. Discussion and Implications: Addressing depressive symptoms and binge drinking among older adults is sorely needed. Binge drinking was associated with decreased depressive symptoms, consistent with the self-medication hypothesis. Treatment and screening for depression as well as binge drinking are especially important as both are associated with increased mortality. Treating depression would reduce the risk of increased alcohol use and its detrimental effects on health.
MOTIVATIONAL FACTORS AFFECTING THE INTENTION TO VOLUNTEER IN ELDER CARE AGENCIES: A PILOT STUDY
Authors: Fu Rong , Xu Qi 
Published: December 2022

Abstract
The rapid rise of the aging population and the “4-2-1” family structure in China calls for speeding up the construction of the elderly care service system. To facilitate this process, it is desirable to encourage voluntary participation in elder care agencies. This study aims to identify motivational factors that may affect the intention to volunteer in elder care agencies in China. Data were collected in a sample of 199 residents of Beijing, China. Our results revealed gender differences in the demographic and socioeconomic factors that affect the volunteer intention. For men, earning more than 12,000 Yuan (about $1900) significantly increased the intention to participate in voluntary services (p = .043). For women, those younger than 60 years of age were more willing to participate in voluntary services than their older counterparts (p = .014). Participants identified three key motivational factors for providing volunteer services in elder care agencies: (1) to show love and kindness to older adults; (2) to fulfill oneself and take social responsibilities; and (3) to gain more life experience. We also found that most participants prefer to provide spiritual comfort services (e.g., chatting, shopping) and life care services (e.g., cooking, house cleaning) than other types of services. Our study suggested that effective interventions should be designed and implemented to match volunteering resources to the needs of elder care agencies in China.
PURPOSE IN LIFE, STRESS REACTIVITY, AND COGNITIVE AGING: A LONGITUDINAL INVESTIGATION
Authors: Nelson Niccole , Bergeman Cindy 
Published: December 2022

Abstract
This study examined (1) the time-varying relationship between purpose in life and perceived stress reactivity, (2) the trajectory of perceived stress reactivity as it relates to both within- and between-person purpose in life, as well as (3) the predictive utility of perceived stress reactivity and its rate of change on cognitive ability and allostatic load. The sample comprised 933 participants from the Notre Dame Study of Health & Well-being, a 10-year study of annual questionnaire packets and biennial daily diary bursts. Analyses included three-level multilevel models from which random effects were extracted and used to predict allostatic load and cognitive ability. Results indicated that individuals were affectively reactive to perceived stress, and that perceived stress reactivity declined over time. Considering the effects of purpose in life on these processes, there were two cross-level interaction effects indicating (1) more purposeful individuals were less stress reactive than less purposeful individuals, and (2) more purposeful individuals declined less in negative affect over time than less purposeful individuals. There was also preliminary evidence for a within-person interaction effect between yearly purpose in life and daily affective reactivity such that when individuals felt particularly purposeful, they also tended to be less stress reactive. Finally, higher perceived stress reactivity, as well as less decline in this construct, was predictive of better cognitive ability. These findings indicate purpose in life buffers against environmental and maturational effects on negative affect, and that perceived stress reactivity may indicate a different, more adaptive process than affective reactivity to experienced stressors.
THE IMPACT OF BEHAVIORAL LIFESTYLE INTERVENTION ON INFLAMMATORY CYTOKINES IN OLDER ADULTS WITH TYPE 2 DIABETES
Authors: Jiwani Rozmin , Serra Monica , Espinoza Sara , Patel Darpan 
Published: December 2022

Abstract
Chronic inflammation, a hallmark of type 2 diabetes (T2D) and adiposity, increases the risk for age-related co-morbidities, including physical frailty. This study aimed to examine the effects of a mobile technology-enhanced behavioral lifestyle educational intervention on frailty and associated clinical, inflammatory, and laboratory outcomes in overweight older adults with T2D. Twenty participants (≥65 years, BMI ≥25 kg/m2) with T2D were recruited to complete a single-arm 6-month lifestyle intervention modified from the Action for Health in Diabetes (Look AHEAD) study, enhanced with technology for self-monitoring of diet and physical activity. Clinical assessments were collected at baseline and end of the study and analyzed with paired t-tests. Inflammatory cytokines (interleukin [IL]2, IL4, IL6, IL8, IL10, granulocyte-macrophage colony-stimulating-factor [GM-CSF], interferon [IFNγ], tumor necrosis factor [TNFα]) were quantified using a commercially available multiplex kit (Millipore Sigma, Burlington, MA, USA). Clinical lab analysis was performed by Quest Diagnostics (Dallas, TX, USA). Eighteen participants completed the study (71.5±5.3 years; 56% female; 50% Hispanic). At baseline, 13 participants were pre-frail, 4 were frail based on Fried frailty criteria. Inflammatory cytokines and liver enzymes values were within normal limits. At follow-up, the following outcomes significantly improved: frailty score -44% (p=0.01), BMI -3% (P&lt; 0.00), alanine transaminase -18% (p=0.03), aspartate aminotransferase -13% (p&lt; 0.00), IL2 -33% (p=0.01), IL4 -31% (p=0.05), IFNγ -36% (p=0.03), GM-CSF -43% (p=0.03). No other significant differences were observed. The results suggest the efficacy of a technology-enhanced lifestyle intervention on frailty and associated clinical, inflammatory, and laboratory outcomes in overweight older adults with T2D.
FACTORS RELATED TO MOBILE INTERNET USE AMONG MIDDLE-AGED AND OLDER ADULTS: A MODERATING EFFECT OF DISABILITY
Authors: Yang Eunjin , Lee Kyung Hee 
Published: December 2022

Abstract
Although mobile devices are preferred as internet access devices, and the number of older adults with and without disabilities is rapidly increasing, little is known about the disability moderating effect on mobile internet use among older adults. This study examined the moderating effect of disability on older adults' mobile internet usage. This study was a secondary data analysis using 2020 Digital Divide Survey in South Korea. A total of 3,629 participants aged 55 and above were included. With the complex sample design in mind, multiple regression analysis was conducted to identify factors related to mobile internet use and test the moderating effects of disability on mobile internet use. Older adults with disabilities used mobile internet less than older adults without disabilities. However, disability status had a moderating effect on the relationships between mobile internet use and (1) operational skills of mobile devices (B=0.31, P=.004), (2) skills of internet use (B=1.46, P&lt;.001), (3) motivation to use digital devices (B=0.46, P=.01), and (4) attitude towards new technology (B=0.50, P=.002). The results revealed that these positive relationships were stronger among older adults with disabilities than those without disabilities. Although older adults and people with disabilities are considered vulnerable populations for technology adoption, disability creates a stronger positive association between several factors and actual mobile internet use. Therefore, policymakers and practitioners should deliver tailored information and technological education for older adults with disabilities. Older adults with disabilities could be the primary beneficiaries of various mobile services.
UNDERSTANDING CULTURAL DIFFERENCES OF SOCIAL ISOLATION AND ITS EFFECTS ON COGNITIVE FUNCTION OF HISPANICS/LATINOS
Authors: Arroyo-Miranda Mirna , Ochoa-Lopez Andrea , Medina Luis 
Published: December 2022

Abstract
Social isolation negatively impacts cognitive health. Although the mechanism is not fully understood, cultural values such as familismo, may help partially explain this susceptibility. Our work sought to understand how cultural differences in objective and perceived social isolation affect cognitive performance of Hispanic/Latinos (H/L) compared to non- H/L Whites. In our first study, using the TARCC dataset, objective covariates of social isolation (i.e. marital status, number of children, number of siblings, living situation), significantly explained a higher percentage of the variance in composite cognitive scores of H/Ls, compared to non-H/L Whites. In our second study, using the HABS-HD dataset, personal and health characteristics influenced the effect of perceived social isolation on cognitive status among older adults. Furthermore, compared to non-H/L Whites, fewer factors accounted for greater variance in cognition of H/Ls. Results suggest enhancing social connectedness of H/L older adults could be a modifiable factor for prevention of cognitive decline.
SERIAL MEDIATION BY DIGITAL ASSISTANCE, INTERNET SELF-EFFICACY, DIGITAL CITIZENSHIP, AND UNMET NEEDS
Authors: Joo Susanna , Choi Bomi , Park Hayoung , Lee Changmin , Kim Yoon-Myung , Kim Hyoun K 
Published: December 2022

Abstract
Although many social services are getting digitalized with the rapidly growing digital technology, there is little information available on the specific process of meeting personal needs in digital aging contexts. The present study examined the serial mediation model from digital assistant to unmet needs via internet self-efficacy and digital citizenship. An online survey was used to collect data in December 2021, and the sample included 223 older Korean adults aged 65 and above (M=68.79, SD=4.18, range=65-84) who owned at least one digital device. Unmet needs, the dependent variable, was the number of problems (e.g., housing, physical functioning) that participants responded to as ‘unmet.’ The independent variable was digital assistance, meaning getting help from friends or others when having problems with the digital device. The first mediator was internet self-efficacy, and the second mediator was five subtypes of digital citizenship (internet political activism, technical skills, local/global awareness, critical perspective, and networking agency). Covariates were gender, age, education, and income. SPSS Process Macro was utilized for serial mediation analysis. The result showed that only a serial mediation path from digital assistance to unmet needs via internet self-efficacy and internet political activism was significant. Additionally, a simple mediation path from digital assistance to unmet needs via internet political activism was significant. Technical skills, local/global awareness, critical perspective, and networking agency did not reveal significant mediational paths. Findings imply providing digital assistance system may be useful to reduce unmet needs among older adults by enhancing self-efficacy and political participation in the current digitalized world.