bluuebunny/crossref_metadata_2025_split huggingface dataset:
CAREGIVER SUBGROUP ANALYSES FROM AN EMBEDDED DEMENTIA CARE EFFECTIVENESS TRIAL
Authors: Fortinsky Richard , Wakefield Dorothy , Zhong Lily , Grady James , Piersol Catherine , Robison Julie , Gitlin Laura 
Published: December 2022

Abstract
Efficacious dementia care interventions for family/informal caregivers are increasingly being tested for effectiveness in “real world” service delivery settings. We conducted an effectiveness trial in which we embedded the Care of Persons with Dementia in their Environments (COPE) program into Connecticut’s publicly-funded Home and Community-Based Services program. COPE is designed to build dementia management skills in caregivers of people with dementia in the home setting. In published results from this trial with the full study cohort, caregivers who received COPE, compared to controls, experienced improved well-being due to the dementia management skills they learned (perceived well-being), but they did not experience reduced levels of distress due to dementia-related behavioral and psychological symptoms (distress). For this presentation, we determined COPE effects for selected caregiver subgroups on perceived well-being and distress. Regarding caregiver sex, we found that COPE effects were statistically significantly positive on both outcomes for females (both p&lt;.05) but on neither outcome for males. Controlling for sex, we also found positive COPE effects on both outcomes for daughters (both p=.03) but on neither outcome for spouses or sons. For perceived well-being, we found positive COPE effects for White (p&lt;.001) but not for Black caregivers. For distress, we found positive COPE effects for caregivers living apart (p=0.03) but not for those living together with people with dementia. Findings suggest that male, Black, and co-residing caregivers may need more support from COPE, and more broadly demonstrate the value of subgroup analyses in offering greater precision when embedding nonpharmacological interventions in effectiveness trials.
A METHODOLOGICAL APPROACH TO IDENTIFY EPISODES OF LUCIDITY AMONG PEOPLE WITH ALZHEIMER'S DISEASE
Authors: Kim Kyungmin , Frangiosa Theresa , Biggar Virginia , Finnie Dawne , Bangerter Lauren , Gaugler Joseph , Lapid Maria , Griffin Joan 
Published: December 2022

Abstract
People with late-stage Alzheimer’s disease and related dementias (ADRD) who are assumed to have lost coherent cognitive capacity may exhibit unexpected episodes of lucidity (EL). Given the transient nature and lack of scientific explanation of the phenomenon, EL is under-investigated and poorly understood. To better understand this phenomenon, we set out to develop an operational definition of EL. Based on survey data from former and current family caregivers participating in UsAgainstAlzheimer’s A-LIST® (N = 480), we defined four EL typologies. We then interviewed 25 caregiver respondents about their experiences and used analyzed qualitative data to refine the preliminary typologies. Finally, we conducted a Delphi consensus panel with clinicians, researchers, and health care providers with medical, pharmacological, and clinical expertise to describe potential explanations for EL to help further refine the typologies. Next we will test the validity of these typologies in a prospective, demographically diverse sample of current family caregivers.
DISRUPTED ACTIVITIES AND CAREGIVERS RESILIENCE: LONGITUDINAL PATTERNS AND ASSOCIATIONS
Authors: Lee Jeong Eun , Peterson Natasha 
Published: December 2022

Abstract
PurposeRelatives are often caregiving for patients with advanced cancer and carry a heavy burden. Self-care and resilience-building activities offer building blocks to enhance their wellbeing and burden-bearing capacity. This study assessed the longitudinal patterns of disrupted activities of caregivers and their association with resilience reported by caregivers. MethodsData came from the National Study of Caregiving, a nationally representative study of caregivers. We analyze outcomes for caregivers for three waves of NHAT (2011-2017), estimating associations of disrupted activities and positive appraisals on 1) caregiving burden 2) resilience. Caregivers reported positive appraisals and the number of activities that have been interrupted due to their caregiving responsibilities. ResultsMultilevel models with heterogeneous within-person variance were fit to test the hypotheses on associations between disrupted activities, positive appraisals, and fluctuations in resilience and caregiving burden. Our analysis confirmed increasing disrupted activities among caregivers over time. When interrupted activities were higher than average, caregivers reported lower levels of resilience and higher levels of caregiving burden, suggesting that disrupted activities can contribute to caregivers. The reverse pattern was found for positive appraisals. ConclusionMore positive appraisals and lower levels of disrupted activities were associated with lower caregiver burden and higher levels of caregiver resilience. This study points to the critical value that caregiver self-care and positive appraisals are essential to bolster caregiver resilience and counteract caregiver burden. Future studies should illuminate the causal relation. This study will broaden our understanding of caregivers' self-care needs and provide practical implications for supporting caregivers.
DIGITAL LEARNING AND ONLINE CHAIR YOGA FOR RURAL UNDERSERVED OLDER ADULTS AT RISK OF COGNITIVE DECLINE
Authors: Wiese Lisa , Park JuYoung 
Published: December 2022

Abstract
We conducted a randomized control trial to test the feasibility of an online chair yoga intervention among rural older adults at risk for cognitive decline in an underserved, racially/ethnically diverse community. Participants were randomly assigned to either chair yoga (n=15) or computer brain games (n=15). Prior to the 12-week intervention, a computer training program was provided to all participants by local high school students, who followed a previously tested curriculum, and mentored the older adults in attending sessions. Digital literacy and cognitive, physical, and psychosocial measures were collected at baseline, 3 weeks, and post-intervention, with 3 and 6-month follow-up. We assessed students’ attitudes toward older adults pre/post-intervention. Both student and resident samples were 98% minority (African American, Latino, and Afro-Caribbean), with residents’ average age of 67.5 (SD = 8.3), years lived rural 38 (M = 11.5), and initial digital literacy of 48.5%. Additional outcomes will be detailed in this presentation.
SELF-PERCEPTIONS OF AGING IN THE CONTEXT OF CHALLENGING EXPERIENCES: PATTERNS OF RISK AND RESILIENCE
Authors: Giasson Hannah , Koffer Rachel , Smith Jacqui 
Published: December 2022

Abstract
Self-perceptions of aging have important implications for health and well-being in later life. Early life experiences, cultural and societal notions about age, and one’s present health and situational context may contribute to one’s expectations and perceptions of their own aging (e.g., Levy, 2009; Diehl et al., 2014; 2021). However, self-perceptions of aging may also predict people's responses in the face of current or future challenges. This symposium takes a closer look at self-perceptions of aging in the context of different types of life challenges. Hu and Larkina discuss early life informal caregiving experiences as antecedents of negative self-perceptions of aging in later life. Koffer and Giasson discuss how ten-year longitudinal associations between subjective age and future loneliness differ among current caregivers and non-caregivers. Mejia and colleagues discuss the role of self-perceptions of aging in adaptation to life following a fall, highlighting potential protective effects of positive self-perceptions of aging and sense of control. Finally, Giasson and colleagues discuss positive self-perceptions of aging as predictors of preventive health behavior and resilience in the context of the COVID-19 pandemic. Dr. Jacqui Smith will conclude the session with an integration of common themes, practical implications, and future research directions that emerge from the four studies.
SUBJECTIVE AGE AND FUTURE LONELINESS: COMPARING CAREGIVERS AND NON-CAREGIVERS ACROSS TEN YEARS
Authors: Koffer Rachel , Giasson Hannah 
Published: December 2022

Abstract
Experiences that make age salient can shape how old or young a person feels relative to their chronological age. Caregiving for a loved one may contribute to subjective age as well as the linkages between subjective age and well-being. We examined longitudinal associations between subjective age and future loneliness ten years later among 2,557 caregivers and non-caregivers (Baseline Mage=55) in the Midlife in the United States Study (2004-2014). Linear regression results indicated an interaction between caregiver status and subjective age (β = 0.60, 95% CI=[0.14, 1.06]), such that among non-caregivers, older subjective age predicted greater future loneliness, but among caregivers, younger subjective age predicted greater future loneliness. Associations hold after controlling for age, baseline loneliness, and caregiver status at follow-up. Future subjective aging research should examine the unique context of caregiving to further understand the meaning of subjective age and how it predicts important well-being outcomes among caregivers.
IMPACT OF CALORIE RESTRICTION ON PLASMA ALZHEIMER’S DISEASE BIOMARKERS IN HEALTHY YOUNG AND MIDDLE-AGED ADULTS
Authors: Parker Daniel , Doraiswamy P Murali , Kraus William , Huffman Kim 
Published: December 2022

Abstract
Midlife cardiometabolic risk factors are associated with an increased risk of Alzheimer’s dementia (AD). Moderate calorie restriction (CR) in healthy, non-obese young and middle-aged adults improves cardiometabolic risk factors. Plasma concentrations of amyloid β oligomers (Aβ-42 and Aβ-40) and total tau are emerging biomarkers of AD pathology. Our objective was to determine the impact of two years of CR in healthy young and middle-aged adults on Aβ-42, Aβ-40, and total tau in the Comprehensive Assessment of Long term Effects of Reducing Intake of Energy (CALERIE) Study. Participants were randomized 2:1 to 24 months of CR (prescribed as 25% reduction in baseline calorie requirements) versus an ad libitum (AL) diet. We quantified plasma Aβ-42, Aβ-40, and total tau using the ultrasensitive single molecule array (SIMOA) technology at baseline and two years in a subset of CALERIE (N=133). We used linear regression to evaluate the impact of CR, including age, sex, and presence/absence of the APOE-ε4 risk allele as covariates. We hypothesized that there would be differential CR effects based on APOE-ε4 carrier status; to test this, we included an interaction term. As compared to AL, there was a trend towards decreased Aβ-40, controlling for age, baseline Aβ-40 concentrations, and APOE-ε4 carrier status (β=-12.59, 95% CI[-27.14, 1.96], p=0.093) with 12% (average achieved) CR. The CR*APOE-ε4 carrier status interaction term was significant at a pre-defined threshold of p&lt;0.10 (p=0.062). Stratified by APOE-ε4 carrier status, CR was associated with a decrease in plasma Aβ-40 (β=-33.72, 95% CI[-65.16,-2.09], p=0.041). In conclusion, moderate CR in healthy, non-obese young and middle-aged adults impacts plasma biomarkers of AD risk, primarily in APOE-ε4 carriers.
POTENTIAL BENEFITS OF THC AND CBD IN THE TREATMENT OF HOSPICE-ELIGIBLE DEMENTED AND AGITATED PATIENTS
Authors: Mintzer Jacobo` 
Published: December 2022

Abstract
Today, half of the patients suffering from Alzheimer’s disease (AD) will use hospice care in the last days of their life. Most of them will present with moderate to severe agitation. In the absence of evidence-based guidelines, Hospice care eligible patients with Agitation and Alzheimer’s disease (AD) or other types of Dementia (HAD) are treated with a combination of antipsychotics, benzodiazepines, and opiates, which generate a variety of side effects. Two cannabinoids, tetrahydrocannabinol (THC) and cannabidiol (CBD), appear to be promising therapies for agitation in HAD with minimal side effects. Specifically, we suggest that a combination of THC and CBD oils have enhanced synergistic effects while maintaining a low side effect profile that the combination may provide. The evidence for this hypothesis will be discussed during the symposium.
CONTEXTUAL FACTORS ASSOCIATED WITH DECREASED DAILY DEPRESSION AND ANXIETY AMONG DEMENTIA CAREGIVERS
Authors: Puga Frank , Poe Abigail , Rafford Meghan , Wang Danny , Pickering Carolyn 
Published: December 2022

Abstract
Family caregivers of individuals with dementia (IWDs) have an increased risk of developing depression and anxiety. Little is known about daily protective factors that mitigate this risk. The purpose of this study was to identify everyday coping strategies used by family caregivers that reduce the daily odds of experiencing depression and anxiety-related symptoms. Daily diaries were used to examine whether pleasant non-care activities with the IWD, social connection, and exercise were associated with a decrease in depression and anxiety-related symptoms. A national sample of ADRD caregivers (N=165) completed diaries over 21-days (n=2,841). Participants were asked about their daily experiences as caregivers, coping strategies, and mental health. Data were analyzed using mixed-level modeling. Depression and anxiety symptoms were endorsed by 141 (85.45%) and 155 (93.94%) participants, respectively. Social connection was associated with a decrease in the daily odds of depression (OR: 0.71, CI: 0.54 – 0.94, p=0.016) and anxiety symptoms (OR: 0.74, CI: 0.56 – 0.97, p=0.032). Caregivers were also less likely to endorse depression-related symptoms on days when engaging in a pleasant non-care activity with the IWD was reported (OR: 0.70, CI: 0.52 – 0.93, p=0.015). Finally, anxiety-related symptoms were less likely to be endorsed on days when caregivers reported engaging in exercise (OR: 0.65, CI: 0.49 – 0.86, p=0.003). The results from this study help elucidate coping strategies that may mitigate the risk of depression and anxiety associated with caregiving. These findings inform potential components for interventions to help support the health and well-being of family caregivers of IWDs.
SPIRITUAL DEVELOPMENT AND AGING HUMANITIES: READING HESSE'S STEPPENWOLF THROUGH MOODY'S FIVE STAGES OF THE SOUL
Authors: Fogle Stephen 
Published: December 2022

Abstract
This paper explores Herman Hesse’s Steppenwolf through Harry Moody’s Five Stages of the Soul. Steppenwolf speaks to gerontological education objectives as it deals squarely with humanizing old age though, “deeply lived spiritual events which [the main character] has attempted to express by giving them the form of tangible experiences.” (Hesse, 1963, 21) Five Stages of the Soul is a seminal conceptual model for understanding spiritual development across the life course: particularly in old age. It documents lived experiences in five stages: call, search, struggle, breakthrough, and return. This paper follows Steppenwolf’s main character, Harry Haller, though each of these five stages. In doing so, this paper positions aging and spiritual development center stage in a tale featuring themes of enduring struggle such as personal identities, war & violence, sex, magic, and technological advancement. The plot line of Steppenwolf matches Five Stages of the Soul with enlightening consistency. Originally published a century ago, Steppenwolf enjoyed resurgent popularity among the baby boom cohort of older adults in the United States and globally during the 1960s. Today, Steppenwolf retains relevancy for understanding aging and spiritual development in lived contexts of social chaos and uncertainty. Steppenwolf is a classic and engaging piece of literature for contemporary readers of all ages. This paper helps students and teachers of gerontology apply a conceptual model of aging to a relevant case study. The paper contributes to incorporating literary masterpieces into gerontological curricula. Finally, this paper sheds light on the humanity of older adults engaged in spiritual development.
COGNITIVE AGING ACROSS NATIONAL CONTEXTS: EVIDENCE FROM THE HARMONIZED COGNITIVE ASSESSMENT PROTOCOLS
Authors: Kobayashi Lindsay , Gross Alden , Langa Kenneth 
Published: December 2022

Abstract
The global burden of dementia is rapidly rising and shifting to low- and middle-income countries. The triangulation of evidence across country contexts is essential for unlocking the causes of dementia and reducing its global burden. The Harmonized Cognitive Assessment Protocol (HCAP) is a recent innovation administered in the US Health and Retirement Study and several of its International Partner Studies. For the very first time, these HCAPs provide high-quality data for cross-national comparisons of later-life cognitive function that are sensitive to linguistic, cultural, and educational differences across diverse country contexts. However, despite the common HCAP protocols, human cognitive function does not lend itself to direct comparison across diverse populations without careful consideration of necessary test adaptations. This symposium presents results from analyses of the HCAP data in the US, England, Mexico, South Africa, China, and India, highlighting cross-national differences in later-life cognition identified using the HCAP data, and presenting key methodological concerns for cross-national comparisons of cognitive aging. First, Zhang will present findings comparing education gradients in later-life cognitive function across countries. Next, Cho will present longitudinal data comparing the relationships between short-term changes in household wealth in later-life and subsequent cognitive function across countries. Third, Avila-Rieger will present findings comparing sex/gender disparities in later-life cognitive function in the US and India and how they differ by education. Finally, Nichols will conclude the session by discussing differences in the measurement of cognition for the assessment of dementia across countries and implications for data interpretation and the design of future instruments.
EDUCATION GRADIENTS IN LATER-LIFE COGNITIVE FUNCTION ACROSS LOW-, MIDDLE-, AND HIGH-INCOME COUNTRIES
Authors: Zhang Yuan , O'Shea Brendan , Yu Xuexin , Cho Tsai-Chin , Langa Kenneth , Gross Alden , Kobayashi Lindsay 
Published: December 2022

Abstract
Education is positively related to cognitive function. However, educational gradients in cognitive function may vary across older populations with different educational compositions and physical and social environments. We conducted one of the first cross-national comparative studies on educational differences in later-life cognitive function using harmonized data. Multivariable linear regressions were employed to estimate the association between education according to International Standard Classification of Education (ISCED) categories and cognitive function for adults ages 60+ from the United States, England, Mexico, South Africa, India, and China. Cross-country differences were tested using fully interacted models. Controlling for demographics and parental education, we found significant educational gradients in cognitive function in low- and middle-income countries; however, in high-income countries, only those with upper secondary education and above had a consistent cognitive advantage over those with primary education. This study suggests substantial country-level differences in cognitive benefits of educational attainment.
SHORT-TERM WEALTH CHANGES AND SUBSEQUENT COGNITIVE HEALTH AMONG OLDER ADULTS IN CHINA, ENGLAND, MEXICO, AND THE US
Authors: Cho Tsai-Chin , Yu Xuexin , Gross Alden , Zhang Yuan , Kobayashi Lindsay 
Published: December 2022

Abstract
Household wealth is positively associated with later-life cognitive health, but little is known about the effects of changes in wealth over time and whether they differ across populations. In this study, we evaluated the within- and between-country relationships between short-term changes in household wealth and subsequent cognitive function among adults aged ≥65 years in China, England, Mexico, and the US. We used sampling-weighted, multivariable-adjusted linear models to estimate the relationships between household wealth change over 3- to 4-year periods and subsequent harmonized general cognitive performance factor scores using HCAP measures. We found that short-term decreases in household wealth were associated with poor subsequent cognitive health in the US and China, but not in England or Mexico. The observed associations were weaker in Mexico than in the US. In summary, macro-level social and economic structures may modify the association between wealth changes and cognitive health, although further investigation is needed.
POSITIVE APPRAISALS OF CAREGIVING SUPPORT DEMENTIA CAREGIVERS' PHYSICAL ACTIVITY GOAL PURSUIT
Authors: Turner Shelbie , Hooker Karen 
Published: December 2022

Abstract
Middle-age daughters caring for parents with dementia have multiple roles and often neglect their own health. In addition to reporting negative appraisals of caregiving dementia caregivers also report positive appraisals, which may support their health behavior. In this study we examine how positive and negative caregiving appraisals interacted to predict physical activity goal pursuit among 27 daughters of parents with dementia who participated in the ACHIEVE Study, an NIH-funded 30-day study on caregiving (Noccasions=622). On days when caregivers had more positive appraisals than their own average, they had higher physical activity goal pursuit, even after controlling for that day’s negative appraisals (β=0.31, SE=0.09, p=0.001). Moreover, the association between positive appraisals and goal pursuit was not dependent on that day’s negative appraisals (p=0.42). Supporting adult-daughter caregivers to feel positively about their role as a caregiver on a day-to-day basis may support them to stay on track with their physical activity goals.
FALL RISK, FEAR OF FALLING, PHYSICAL ACTIVITY, AND SELF-PERCEPTIONS IN ETHNICALLY DIVERSE LOW-INCOME OLDER ADULTS
Authors: Thiamwong Ladda , Xie Rui , Lighthall Nichole , Park Joon-Hyuk , Loerzel Victoria , Stout Jeffrey 
Published: December 2022

Abstract
Falls and fear of falling (FOF) are the leading cause of disability, and hospitalization in ethnically diverse low-income older adults. The present study included an ethnically diverse sample of low-income older adults (N=121) to examine ethnic and income-based group differences in risk factors for falls (high FOF, depression, avoidance of physical activity) and the role of negative self-perceptions of aging in driving these risk factors. Results revealed the highest levels of fall risk among Hispanics and Asian Americans, FOF among African Americans, and depression among Hispanics. Accelerometer-based physical activity measures confirmed that low-income older adults had lower levels of moderate to vigorous physical activity (MVPA) compared with their high-income counterparts (p=0.04). Further, financial difficulty was related to MVPA (p&lt;0.001), depression, anxiety, and fall risk (p=0.01). Critically, we also found a strong relationship between negative self-perceptions of aging and FOF (p = 0.002) across groups.