bluuebunny/crossref_metadata_2025_split huggingface dataset:
DIFFERENT LEVELS OF LEISURE-TIME PHYSICAL ACTIVITY AND MENTAL HEALTH FOR OLDER ADULTS WITH DIABETES IN THE PANDEMIC
Authors: Lee Jungjoo , Kim Junhyoung , Han Sua 
Published: December 2022

Abstract
This study is an initial investigation of the association of different levels of LTPA engagement with mental health (e.g., loneliness, happiness, and positive and negative affect) among older adults with diabetes during the COVID-19 pandemic. The COVID-19 has led public health researchers to improve mental health among older adults with diabetes. Leisure-time physical activity (LTPA) has been emerged to cope with mental health difficulties in the pandemic. Total 301 respondents were extracted from the Health and Retirement Study (HRS) based on the following two criteria: over 50 years old and the onset of diabetes. Multiple questionnaire items were used to assess mental health (i.e., loneliness, happiness, and positive and negative affect) for older adults with diabetes. Multivariate Analysis of Variance was utilized to investigate the relationships between the fixed variable (i.e., LTPA) and outcome variables (i.e., mental health). We categorized LTPA participation into three groups (i.e., low, mid, high) and examined mental health following a different level of LTPA participation. LTPA participation showed a significant group mean differences for loneliness, happiness, and positive affect, but not for negative affect. High-LTPA respondents presented lower loneliness) and higher happiness than Low-LTPA respondents. High-LTPA and Mid-LTPA respondents indicated higher positive affect than Low-LTPA respondents. This study provides evidence of the benefits of LTPA on mental health for older adults with diabetes. Our study supports the evidence that high-LPTA involvement can be effective in promoting mental health among older adults with diabetes in the COVID-19 era.
HEALTHCARE DISPARITY IN THE ASSESSMENT OF DEMENTIA IN THE PRIMARY CARE SETTING
Authors: Gibson Regina , Kodali Maneetha , Priyambada Priya , Mendiratta Priya , Hasan Danish , Harris Melodee , Wei Jeanne , Azhar Gohar 
Published: December 2022

Abstract
Literature suggests racial implicit bias can significantly affect quality of care. Data demonstrates that older adult Blacks are twice as likely to have dementia as their White counterpart. Inappropriate cognitive screening by providers or diagnosing dementia just based on clinical impression could easily result in an over or under-estimation of the dementia. We reviewed the rate and method of cognitive screening in randomly selected patient records (n=75) at a primary care university clinic. Our results indicated that the cognitive screening rate for Black patients was lower compared to their White counterpart (43.4% Blacks vs 68.5% Whites, p &lt; 0.05). We designed a quality improvement project to identify any contributory causes and challenges involved in screening for dementia with the goal to reduce racial disparity in dementia diagnosis. We identified knowledge deficits in providers in their approach towards patients with dementia and a lack of experience in their use of appropriate instruments for cognitive screening. A multipronged educational program, with videos, case conferences, presentations and one-to-one training by dementia experts and a neuropsychologist was employed to reduce the bias and train the providers in appropriate screening methods. Post-educational intervention, screening rates greatly improved in n=75 randomly selected patients from both races. In Whites, the screening rate increased by 20.9% to 89.4% and in Blacks by 38.9% to 82.3% (p &lt; 0.05). Overall, the quality improvement driven educational intervention improved the self-efficacy of providers and improved the standardized dementia screening rates in Black patients to levels comparable to those of White patients.
BLACK GREEK LETTER ORGANIZATIONS: FACILITATING HEALTH PROMOTION FOR AFRICAN AMERICANS ACROSS THE LIFECOURSE
Authors: Mingo Chivon 
Published: December 2022

Abstract
African Americans remain underrepresented in accessing and utilizing evidenced-based health promotion interventions (EBIs). Challenges with dissemination and implementation of EBIs further corroborate existing racial/ethnic health/healthcare disparities. Therefore, there is a need to identify effective ways to increase the widespread adoption of health promotion behaviors among African Americans across the life course. It is plausible that engaging in non-traditional partnerships (i.e., community groups or organizations valued in the community with the capacity and infrastructure) could result in greater adoption and improved utilization of EBIs among African Americans. Although frequently overlooked as a study variable in empirically sound public health research, Black Greek Letter Organizations (BGLO) could be an innovative and practical approach to advancing health in the African American community. It is necessary to gain preliminary evidence of feasibility (e.g., motivation, target population reach, acceptability, ). Therefore, the purpose of this study was to conduct a content analysis to identify the intentions and communication trends of BGLOs as it pertains to public health and the African American community and assess population reach and perceptions by evaluating responses to communication specific to health promotion.We assessed health promotion patterns of four BGLOs in a ten-county metropolitan area. Coded content included communication via the organization’s webpage, Facebook, Twitter, YouTube, Instagram, and LinkedIn from a five-year time period. Findings confirm that BLGOs are invested in the health and well-being of the community, place emphasis on mitigating health inequities, and are uniquely positioned to serve as stakeholders for the translation of EBIs to end-users.
TOWARD EQUITABLE AND DESTIGMATIZING DEMENTIA: ALASKA NATIVE POPULATIONS AND CULTURALLY BASED INTERVENTIONS
Authors: Crouch Maria , Rosich Rosellen 
Published: December 2022

Abstract
Alaska Native (AN) people’s incidence and prevalence of Alzheimer’s Disease and Related Dementias (ADRD) are projected to disproportionately increase in contrast to the U.S. population. This is alarming given that AN peoples experience health disparities exacerbated by prejudice, stigma, and systemic and structural inequalities. Twelve semi-structured interviews with AN Elders assessed the culturally derived meanings of memory function, loss, decline, and disease. Qualitative analyses observed eight culturally grounded themes and five interrelated and nested subthemes elucidating both the resilience and the stigmas, racism, and barriers faced by AN peoples: (1) Historical Trauma; (2) Oppression; (3) Distrust of Western Medicine; (4) Social Justice; and (5) Walking in Two Worlds. En masse historical and contemporary oppression, particularly within Western medicine, both contextualizes the present and points to the ways in which the strengths, wisdoms, and balance inherent in AN culture are imperative to the holistic health and healing.
SEXUAL MOTIVES, SEXUAL FREQUENCY, AND SEXUAL SATISFACTION AMONG MIDDLE-AGED DIFFERENT-SEX AND SAME-SEX COUPLES
Authors: Chai Hye Won , Mernitz Sara , Umberson Debra 
Published: December 2022

Abstract
Reasons for having sex and frequency of sex are significant correlates of sexual satisfaction. However, the possible interplay between sexual motives and sexual frequency remains unexplored. Also, prior studies on sexual satisfaction largely focused on heterosexual couples and less is known about the experiences of same-sex couples. Using dyadic survey data collected from 838 middle-aged spouses in 419 gay, lesbian, and heterosexual marriages, this study examined whether the associations between sexual motives and sexual satisfaction differed by sexual frequency and whether these dynamics varied across gay, lesbian, and heterosexual couples. Results showed that intrinsic sexual motives (e.g., for enjoyment and pleasure) were associated with higher sexual satisfaction only in the context of more frequent sex, and this association did not differ for same- and different-sex couples. On the other hand, extrinsic sexual motives (e.g., to please spouse) were associated with lower levels of sexual satisfaction in the context of high-frequency sex only among men married to men and women married to men, wherein the association was stronger for heterosexual couples compared to same-sex couples. These associations were not significant with less frequent sex. Results suggest that while frequent engagement in sex with intrinsic sexual motives benefits middle-aged adults’ sexual satisfaction regardless of relationship type, the sexual satisfaction of individuals married to men is vulnerable to the negative consequences of engaging in sex due to external pressure. These findings highlight the importance of considering how sexual experiences of men and women in midlife same-sex marriages compare to those of different-sex marriages.
CHILDHOOD PHYSICAL ABUSE INCREASES THE RISK OF SUBJECTIVE MEMORY IMPAIRMENT
Authors: Roach Lauren , Bell Tyler , Pope Caitlin 
Published: December 2022

Abstract
Subjective memory impairment, defined as self-reported difficulties in recall and learning, doubles the risk of Alzheimer’s Disease and related dementia, despite being weakly related to objective memory decline. Because of its strong stability over time, it may be possible that subjective memory impairment reflects earlier life risk factors for dementia such as adverse childhood experiences. It is reported that over a fifth of older adults worldwide experienced physical abuse during childhood. Previous cross-sectional studies suggest physical abuse is associated with later cognitive impairment. Still unclear, are the longitudinal associations between childhood abuse and subjective memory impairment in later life. Using a sample of adults drawn from the Health and Retirement Study (n = 19,185, Mage = 67.05, SD = 11.33) we assessed associations between reported physical abuse by a parent before the age of 18 and subjective memory impairment (current memory problems and perceived memory decline) over periods of up to 18 years. Generalized linear mixed models examined longitudinal associations between childhood physical abuse and subjective memory impairment while controlling for depressive symptoms and other empirically relevant covariates. Experiencing childhood physical abuse was associated with increased likelihood of reporting more current memory problems (OR = 1.17, 95% CI 1.04, 1.33) and perceived memory decline in later life (OR = 1.27, 95% CI 1.13, 1.43). Findings suggest childhood physical abuse is associated with subjective memory impairment, a strong predictor of dementia. Understanding early life conditions, including adverse childhood experiences may help explain associations between subjective memory impairment and dementia risk.
PROGRESSIVELY LOWERED STRESS THRESHOLD FOR BEHAVIORAL SYMPTOMS OF DEMENTIA: A DYNAMIC STRUCTURAL EQUATION MODEL
Authors: Pickering Carolyn , Yefimova Maria , Wang Danny , Maxwell Christopher , Jablonski Rita 
Published: December 2022

Abstract
The progressively lowered stress threshold model suggests that due to impairments in coping, persons living with dementia have a reduced threshold for stress and respond with more behavioral symptoms of dementia as stress accumulates throughout the day. While the propositions of the model have not been evaluated, this model serves as the basis of non-pharmacological interventions for behavioral symptom management aimed at modifying the environment to reduce stressors. These interventions have mixed success, which may be due to traditional longitudinal measurement models that don’t account for the dynamic temporal nature of behavioral symptoms. This paper evaluates the progressively lowered stress threshold conceptual model as an explanation for behavioral symptoms of dementia and tests several of its hypothesized propositions using an intensive longitudinal design. A sample of N=165 family caregivers completed brief daily diary surveys for 21 days (n=2841) reporting on behavioral symptoms of their care recipients. Dynamic structural equation modeling was used as the analytic technique to examine the impact of caregiver and care recipient environmental stressors on the diversity of behavioral symptoms of dementia (number of different symptoms) to account for the nested data structure and autoregressive relationships. Results show direct relationships between environmental stressors and diversity of behavioral symptoms of dementia that same day and the following day. Findings provide support for the progressively lowered stress threshold model. Further, findings suggest an extension to the conceptual model is warranted given evidence of an exposure/recovery trajectory and the lagged effects of stress exposure on behavioral symptoms of dementia presentation.
MULTIMORBIDITY AND ITS ASSOCIATION OF WIDOWHOOD, RACE, AND ETHNICITY IN OLDER ADULTS
Authors: Karakida Maki , Song Qian , Stokes Jeffrey , Leveille Suzanne , Dugan Beth 
Published: December 2022

Abstract
Living with chronic disease is common in later life and over 60% of adults 65+ have two or more conditions. Spousal loss, also common in late adulthood, is linked to chronic diseases, like heart attacks, cardiovascular disease, and strokes. This study examines the associations between widowhood, race/ethnicity, and onset of multiple chronic conditions (i.e., cancer, diabetes, heart disease, stroke) among 4,187 Americans aged 60+. Using the RAND HRS Longitudinal File 2018, we analyzed how married/partnered adults without major chronic conditions in 2010 experienced widowhood and developed cancer, diabetes, and/or cardiovascular disease during the subsequent eight years. We used ordinal logistic regressions to examine the associations between marital status, race/ethnicity, and multimorbidity onset, controlling for age, gender, birthplace, living conditions, income, education, smoking habits, physical activities, self-reported BMI, and Medicaid enrollment. Among participants, 69.41% were non-Hispanic White, 13.04% were non-Hispanic Black, 14.19% were Hispanic (any race), and 3.37% were non-Hispanic other. The mean age was 70.33 years, more than half (54.79%) were female, and 83.85% were married or partnered in 2018. Older widowed group were more likely to be non-Hispanic White women without smoking habits nor multimorbidity. The onset of multimorbidity at follow-up was elevated among divorced or separated non-White/Hispanic participants (OR = 1.83, 95%, CI 0.896, 3.744) unlike widowed non-White individuals (OR = 0.71, 95%, CI 0.433, 1.152). Age, previous smoking behavior, BMI, and birth in the South were all significantly associated with increased multimorbidity risk (p&lt;0.017). The association of widowhood and health outcomes may vary by race and ethnicity.
SOCIAL DETERMINANTS OF HEALTH UNDERLIE RACIAL/ETHNIC DISPARITIES IN PSYCHOLOGICAL HEALTH AND WELL-BEING
Authors: Jester Dylan , Kohn Jordan , Tibirica Lize , Thomas Michael , Brown Lauren , Murphy James , Jeste Dilip 
Published: December 2022

Abstract
This study sought to determine the impact of selected social determinants of health on psychological health and well-being (defined as depression, cognition, self-rated health) among Black and Hispanic/Latinx adults relative to White adults aged 51 to 89. We measured disparities in depression, cognition, and self-rated health among 2,306 Non-Hispanic/Latinx Black, 1,593 Hispanic/Latinx, and 7,244 Non-Hispanic/Latinx White adults from the Health and Retirement Study (n=11,143). Blinder-Oaxaca decomposition was used to examine whether differences in selected social determinants of health explained a larger share of the disparities than age, sex, measures of health, health behaviors, and healthcare utilization. Selected social determinants included education, parents’ education, number of years worked, marital status, veteran status, geographic residence, nativity status, income, and insurance coverage. Black and Hispanic/Latinx adults reported worse depression, cognition, and self-rated health compared to White adults. Selected social determinants of health explained a larger proportion of the Black-White disparities in depression (51%), cognition (39%), and self-rated health (37%) than did age, sex, measures of health, health behaviors, and healthcare utilization. Social determinants of health explained a larger proportion of the Hispanic/Latinx-White disparity in cognition (76%) and self-rated health (75%), but age and functional status primarily drove the disparity in depression (28%). Education, parents’ education, years worked, income, and insurance parity were social determinants associated with the disparities.In conclusion, differences in social determinants of health underlie racial/ethnic disparities in depression, cognition, and self-rated health among older adults. Education, income, number of years worked, and insurance parity are key social determinants of health.
SOCIOECONOMIC CHARACTERISTICS AND HEALTH OF OLDER ADULTS IN RURAL CAMBODIA: ROLES OF SOCIAL AND WELFARE SUPPORT
Authors: Kuy Kakada 
Published: December 2022

Abstract
Considering differences in support systems and socioeconomic characteristics, findings from studies of high-income nations could be biased if generalized to population of low- and middle-income countries. Insights into roles of social support in socioeconomic characteristics and health relationships are valuable for health interventions targeting older adults in low-resource communities, such as rural Cambodia, but such knowledge remains unexplored. This study examined mediating roles of social and welfare support in associations between socioeconomic characteristics and health among older Cambodians. Data came from a 2019 survey of older Cambodians age 60 and older (N=220) living in three rural provinces. Dependent variables included health complaints and psychological well-being index. Independent variables were wealth index derived from household items and living conditions, and subjective socioeconomic characteristic derived from three self-perceived economic circumstances. Social support and welfare support were operationalized using Social Support and Social Network scale and status of welfare assistance, respectively. Mediation analysis using Structural Equation Modeling substantiated a full mediation effect of social support on the relationship between subjective socioeconomic characteristic and psychological health. A partial mediation of social support was also found in the subjective characteristic and physical health relationship. However, no mediation was found in relationships between wealth index and health. Welfare support did not mediate any relationship between socioeconomic characteristics and both health outcomes. Healthy aging interventions in low-resource settings could benefit from improving existing support system of family and friends, which may buffer the impact of economically negative self-image on one’s health and well-being in the community.
SOCIAL DETERMINANTS OF COGNITIVE HEALTH
Authors: Rusch Amber , Camp Janella , Patrick Julie Hicks 
Published: December 2022

Abstract
Social determinants of health (SDOH), such as age, race, sex/gender, socioeconomic status, and access to healthcare, influence wellbeing, and shape day-to-day life. To what degree SDOH influence cognitive decline is less well understood. Thus, we applied frameworks of SDOH to understand cognitive health better. We used data from the CDC's 2020 Behavioral Risk Factor Surveillance System, in which 61,770 adults (mean age = 64.7, SD = 10.4, range 24-80+ yrs.) supplied demographic information and answered questions about cognitive decline. We conducted a logistic regression and interpreted the Odds Ratios (ORs). A significant equation emerged, X2 (DF = 8) = 438.214, p &lt; 0.001. Each indicator of age, sex, race, and education uniquely contributed to the equation. Older adults, those with less education, and those identified as American Indian (OR = 1.25) were more likely to express cognitive decline. Using this equation, we correctly classified 0%, so we added a second step that included SDOH beyond demographic predictors: number of health conditions, access to health care, urban/rural status, and depression. The model retained its significance (X2 (DF=12) = 3400, p &lt; .001. The OR showed adults with depression were 3.8 times more likely to report cognitive decline. Thus, examining a range of SDOH beyond demographics increases our understanding of the context in which cognitive decline occurs.
EFFECTS OF CHANGES IN THE FREQUENCY OF SOCIAL OUTINGS ON DEPRESSION AND WELL-BEING DURING THE COVID-19 PANDEMIC
Authors: Abe Koji 
Published: December 2022

Abstract
In Japan, in order to reduce the risk of infection with COVID-19, a state of emergency was declared in areas the infection had spread to, and priority measures were issued in equivalent areas. As a result, many senior citizens who were not good at using the Internet lost the opportunity to communicate with others through interpersonal interaction. Previous studies have shown that reduced interpersonal interaction negatively affects the mental health of senior citizens. However, little research has been done on the effects of socially created restrictions on interpersonal interaction. The purpose of this study was to focus on the changes in the frequency of going out among senior citizens and to examine the effect on mental health. An internet survey of a nationwide sample of individuals was conducted in October 2021. In total, there were 1600 respondents (males, 47.8%; females, 52.2%; mean age, 70.39(SD=4.67) years). During the pandemic, 47.1% participants had decreased the frequency of going out, and 52.9% had either no change or a slight increase in the frequency of going out compared to the period before the pandemic. Multiple regression analysis showed that social capital and decreasing frequency of going out had a significant effect on depression. However, a decrease in the frequency of going out had no effect on subjective well-being, and only social capital had a significant effect. The results showed that a decrease in frequency of going out increased the depressive mood, but social capital had an even greater impact on depression and subjective well-being.
“A GLARING OMISSION”: BARRIERS TO INCLUDING LONG-TERM CARE RESIDENTS’ VOICES IN THE NEWS MEDIA
Authors: Allen Laura , Bradley Dana , Ayalon Liat 
Published: December 2022

Abstract
News media stories on residential long-term care (LTC) are mostly negative in tone, and the increase in news coverage of residential LTC during the COVID-19 pandemic intensified the pessimistic tone with panicked and accusatory reporting. Although there has been an increase in the amount of news coverage on residential LTC over the last two years, the perspectives of the residents themselves have been largely overlooked and excluded. The aim of this study is to identify and understand the barriers and embedded institutional logics in the news reporting process of LTC that prevent residents from being included and interviewed. Using a purposive sampling strategy, the researchers conducted 26 semi-structured interviews with LTC administrators (n=7), journalists on the topics of aging and LTC (n=7), and older residents living in LTC settings (n=12) in the United States. Thematic analysis is applied to the data to qualitatively extract the guiding logics frameworks of each stakeholder group. Findings are grouped into the following four themes: (1) residents are not considered "experts" by reporters and are therefore not a prioritized source of information; (2) facility administrators fear for the facility's public image & reputation and do not enthusiastically cooperate with inquiring reporters; (3) facilities were in physical lockdown for several months during the COVID-19 pandemic, and (4) residents feel forgotten and unheard. Implications of this study point to the social exclusion of older residents living in LTC and reductive reporting that fails to capture their nuanced and dynamic lived experiences.