bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gatekeepers: The Association of Caregiving Network Characteristics With Emergency Department Use by Persons Living With Dementia
Authors: Leggett Amanda N , Koo Hyun Jung , Strominger Julie , Maust Donovan T 
Published: December 2022

Abstract

Objectives
Caregivers are typically enmeshed in networks of family and friends who assist with care, yet this network is largely neglected in research. In light of the fact that caregivers are key medical decision makers and play a critical role in how persons living with dementia (PLwDs) interface with the health care system, this study explores how features of the caregiver network relate to PLwD emergency department (ED) use.

Methods
Using 2015 National Health and Aging Trends Study data linked with fee-for-service Medicare claims, we examine ED use in a nationally representative sample of community-dwelling persons aged 65 and older with dementia and at least 1 caregiver. We consider aspects of the caregiver network including membership (e.g., daughter in network), network size, hours of care received, and the presence of generalists and specialists (i.e., broad vs narrow functional assistance) as predictors of ED encounters among PLwD.

Results
PLwDs were 81.5 years old on average, 50% were female, and 33% were non-White. Care networks including nonimmediate family members involved in task sharing for mobility and self-care difficulties and those with more generalists had significantly higher odds of an ED visit. Networks that only consisted of specialist caregivers had significantly lower odds of an ED visit.

Discussion
Greater complexity of care networks increases risk of presenting to the ED for care. Better understanding how caregiving networks help PLwD interact with the health care system can inform intervention design and targeting in order to help care networks improve care coordination, management, and shared decision making.
ANTECEDENTS, OUTCOMES, AND CORRELATES OF METABOLIC HEALTH IN OLDER AGE: A MULTIDISCIPLINARY PERSPECTIVE
Authors: Drewelies Johanna , Steinhagen-Thiessen Elisabeth , Walston Jeremy 
Published: December 2022

Abstract
Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular disease associated with reduced physical fitness, higher disease burden, and impaired cognitive functions in late life. Thus investigating antecedents, outcomes and correlates of metabolic health is a priority in order to promote healthier lifestyles and successful aging. This symposium compiles four empirical interdisciplinary studies that examine the role of metabolic health/risk on different timescales. Employing advanced modeling approaches to data obtained in large-scale studies, these reports will shed light on potential antecedents, correlates, and consequences thereof. First, Kalyani and colleagues will report data from the SPRING (Study of Physical Resilience IN Geriatrics) study on the interrelation between metabolic syndrome, glucose intolerance, and physical resilience.Second, Buchmann and colleagues examine the association of the metabolic syndrome and Lipoprotein(a) finding that hormonal aspects and in particular menopausal alterations seem to moderate theassociation between MetS and Lp(a). Third, Demuth and colleagues show how metabolic health is related to specific DNA methylation age acceleration as derived from five different epigenetic clocks, namely PhenoAge, and GrimAge.Fourth, Duezel and colleagues examine the neural correlates of metabolic risk in a sample of older adults finding that lower metabolic risk is linked to greater GMI in the prefrontal cortex. Conjointly, findings demonstrate the multifaceted nature of metabolic risk across adulthood and across different timescales. Walston will critically discuss the contributions from an aging perspective and discuss implications for future research.
LP(A) AND METABOLIC SYNDROME IN OLDER PEOPLE
Authors: Buchmann Nikolaus , Schipf Sabine , Ittermann Till , Steinhagen-Thiessen Elisabeth , Demuth Ilja , Markus Marcello 
Published: December 2022

Abstract

Background
Although an inverse association between type II diabetes mellitus and Lipoprotein (a) [LP(a)] has already been well researched, there is sparse data on the association between metabolic syndrome (MetS) with Lp(a). MetS is highly prevalent in older people and insulin resistance in MetS might link Lp(a) with MetS. Thus, we analyzed the association between Lp(a) with MetS in two large cohorts the Berlin Aging Study II [BASE-II] and the Study of Health in Pomerania [SHIP-0]

Methods
Complete cross-sectional data was available for 5,743 BASE-II and SHIP-0 participants (48.7% men; age 58 [20-85] years). MetS was defined according to modified criteria of the AHA/NHLBI 2009 definition. The association between MetS with Lp(a) was examined by median regression adjusted for age, sex and study and models were stratified by gender and menopause.

Results
MetS was prevalent in 27.6% (n=1,573) participants. We found an inverse association between MetS with Lp(a) in the whole study sample (β=-11.9 [95% confidence interval (95% CI) -21.3 to -2.6]) as well as in men (β=-16.5 [95% CI -28.6 to -4.3]) and in postmenopausal women (β=-25.4 [95% CI -46.0 to -4.8]). In contrast to this, in premenopausal women a positive association between MetS and Lp(a) (β=39.2 [95% CI 12.3 to 65.9]) was evident.

Conclusion
Postmenopausal changes in hormone metabolism impact both MetS and Lp(a). With respect to the ongoing development of Lp(a)-lowering drugs, their use must be examined, particularly in old age and in subjects with MetS.
LONG-TERM ALCOHOL CONSUMPTION AND STABILITY OF DAILY WORKING MEMORY PERFORMANCE IN OLD AGE
Authors: Schilling Oliver , Gerstorf Denis , Lücke Anna Jori , Katzorreck Martin 
Published: December 2022

Abstract
Mixed evidence of associations of alcohol consumption with cognitive aging suggested that low to moderate alcohol consumption predicts more favorable cognitive outcomes than abstinence, whereas higher consumption operates as risk factor for cognitive decline. Daily short-term fluctuations of cognitive performance have also been established as risk factor for subsequent cognitive decline. Bringing these two lines of research together, our study analyzed associations of long-term trajectories of alcohol consumption with ambulatory assessments (7 days, 6 beeps per day) of working memory (WM) performance in participants (N = 155, aged 66-69 and 86-89) followed-up from a long-term (&gt;20 years) longitudinal aging study. Overall, the findings do not support the “risk-view”, because long-term alcohol consumption patterns were not found to be predictive of either individual levels or intra-individual momentary fluctuations of WM performance. Follow-up analyses will examine the combined effects of alcohol consumption with further risk factors, such as long-term declines in health.
DAILY ACTIVITY DIVERSITY AND DAILY WORKING MEMORY IN COMMUNITY-DWELLING OLDER ADULTS
Authors: Luo Minxia , Moulder Robert , Breitfelder Laura , Röcke Christina 
Published: December 2022

Abstract
Research has shown that diverse activity engagement has positive effects on cognitive functioning in older age. However, it is unknown whether the positive effect holds within persons across days and across people. We examined daily within-person association between activity diversity and working memory in older age and effects of potential moderators therein. We examined 16-day smartphone-based ambulatory assessment data from 150 older adults (aged 65+). Participants reported their present activities and completed working memory tasks seven times per day. Within persons, higher daily activity diversity was positively associated with higher daily working memory. Moreover, the prior day’s activity diversity led to that day’s higher working memory, but not vice versa. We did not find any moderating effects of age, education, or fluid and crystallized intelligence. Our results strengthen the evidence on the beneficial effect of activity diversity on cognitive performance. Results are discussed in the context of cognitive reserve theory.
CAREGIVER HEALTH LITERACY AS A MODIFIABLE TARGET TO PROMOTE OLDER ADULT HEALTH
Authors: O'Conor Rachel , Eifler Morgan , Opsasnick Lauren , Curtis Laura , Benavente Julia Yoshino , Lindquist Lee , Wolf Michael 
Published: December 2022

Abstract
Many older adults receive assistance in managing chronic conditions. Yet complicating the utility of caregiver support is whether caregivers have sufficient skills to aid in a patient’s self-care. Health literacy (HL) is as an important determinant of older adults’ health outcomes, but few studies have examined caregiver HL and patient outcomes. We interviewed 162 patient-caregiver dyads during an ongoing cognitive aging cohort study to examine associations between caregiver HL, measured using the Newest Vital Sign, and older adults’ health outcomes. Physical function and mental health symptoms were assessed using PROMIS short form assessments. Patients’ also self-reported emergency department (ED) visits and hospitalizations over the past 12 months. Chi-square and t-tests were performed, as appropriate. Patients were on average 73 years old and managing 4 comorbidities. The majority were female (70%), identified as Black (35%) or White (60%). Caregivers’ mean age was 64 years; half were female (56%) and had limited HL (48%). Limited caregiver HL was associated with poorer physical function (M=43.0 (8.5) vs. M=46.0 (9.1), p=0.05), greater comorbidities (M=4.0 (1.9) vs M=3.3 (1.8), p=0.02) and more ED visits in the past year (36.7% vs. 19.3%, p=0.01). No differences by caregiver HL were observed for patients’ mental health or hospitalization. Findings suggest that caregivers with limited HL are caring for medically complex patients, and further research should examine whether limited caregiver HL leads to poorer self-management of chronic conditions. The development of HL training for caregivers may better equip them to assist older adults and improve older adult health.
FACTOR STRUCTURE OF PRE-LOSS GRIEF-12 IN CAREGIVERS OF PEOPLE LIVING WITH DEMENTIA
Authors: Park JuYoung , Galvin James 
Published: December 2022

Abstract
While several studies on post-loss grief have been conducted, little research has examined assessment and treatment for pre-loss grief in family caregivers of persons living with dementia (PLWD). A total of 699 caregivers of PLWD were recruited through relevant dementia associations. The recruitment e-mail provided information about the study and instructions on how to participate by a link to the online survey. Confirmatory factor analysis (CFA) was performed to test the fit of the data from the caregivers and to assess the factor structure of the Prolonged Grief-12 (PG-12) to evaluate pre-loss grief accurately by identifying relevant items and eliminating items that are not appropriate for caregivers of PLWD to assess pre-loss grief accurately. CFA was conducted via the Full Information Maximum Likelihood estimation method to test the unidimensional model of the PG-12 in the study population. The initial model was modified to develop a better-fitting model and to detect misfitting parameters in the PG-12 by deleting irrelevant items for caregivers of PLWD. The adjusted dementia-specific 10-item version (PG-10-D) had significantly improved fit indices with RMSEA = .064, CFI = .972, and GFI = .963. An overall assessment of fit indicated that the model adequately approximated the data. Factor loadings ranged from 0.53 to 0.85. This study suggests that the dementia-specific, unidimensional PG-10-D, modifying the original PG-12, may be useful and parsimonious in assessing and quantifying pre-loss grief in caregivers. Further research is required to establish psychometric properties, including factorial validity and reliability, factorial invariance analysis and further factor analysis.
COGNITION IN CONTEXT: INVESTIGATING THE ROLE OF BUILT, SOCIAL, AND NATURAL ENVIRONMENTS IN COGNITIVE AGING
Authors: Finlay Jessica , Clarke Philippa , Besser Lilah 
Published: December 2022

Abstract
While a growing body of evidence points to potentially modifiable individual risk factors for Alzheimer’s Disease and Related Dementias (ADRD), the contexts in which people develop and navigate cognitive decline are largely overlooked. Geographic variation in ADRD rates suggest that environmental risk and protective factors may be important in cognitive aging and dementia caregiving. Community hazards are often heavily concentrated in underserved and underrepresented neighborhoods. This symposium aims to identify specific built, social, and natural environmental features associated with cognitive aging outcomes. The papers provide much-needed evidence on the role of neighborhoods and community networks for cognitive health and well-being among diverse older adults. First, Godina finds significant associations between neighborhood greenspace and microstructural indicators of brain health. Second, Westrick investigates the role of neighborhood disadvantage on long-term memory aging of older adults with and without a cancer diagnosis in later-life. Third, Finlay presents a new concept of Cognability to demonstrate which constellation of positive and negative neighborhood features may contribute most to healthy cognitive aging. Fourth, Nkimbeng identifies community networks and resources needed to inform dementia education and support care among African immigrants. Fifth, expert discussant Besser will share how these findings may inform upstream health promotion and reduce ADRD risk. She will discuss critical future research directions and methods to investigate environments of cognition. The symposium advances research assessing contexts of aging, and may inform public health and policy efforts to ameliorate community barriers and create more equitable opportunities to promote healthy aging in place.
DOES NEIGHBORHOOD DISADVANTAGE ALTER MEMORY AFTER A CANCER DIAGNOSIS? A US HEALTH AND RETIREMENT STUDY
Authors: Westrick Ashly , Ospina-Romero Monica , Clarke Philippa , Kobayashi Lindsay 
Published: December 2022

Abstract
We aimed to determine the influence of neighborhood socioeconomic status (NSES) on long-term cancer-related memory decline of older adults. Incident cancer diagnosis and memory were assessed in the U.S. Health and Retirement Study (N=15,074, 1998-2016). Proportion of female-headed households with children, households with public assistance income, people with income below poverty, and proportion 16+ years unemployed was categorized into NSES tertiles. Linear mixed-effects models compared the standardized memory trajectories by cancer status and NSES. Cancer-free individuals living in more disadvantaged neighborhoods had worse mean memory function at age 75 and steeper memory declines than participants from less disadvantaged neighborhoods. An incident cancer diagnosis was associated with an acute memory drop at diagnosis for those living in the least disadvantaged neighborhoods. Cancer survivors had better memory prior to but not after diagnosis compared to cancer-free individuals across NSES. These findings could inform future interventions to promote cancer survivor’s long-term aging.
IMPACT OF COVID-19 MITIGATION POLICIES: LESSONS LEARNED FROM US AND MIDDLE-HIGH INCOME COUNTRIES
Authors: Zanwar Preeti , Vinod Joseph K J , Omar Zaliha , Santos Flavia , Zazdravnykh Evguenii , Heyn Patricia , Perianayagam Arokiasamy 
Published: December 2022

Abstract
The COVID-19 pandemic has been a natural global epidemiological experiment unique to our century and a massive shock to older adults and to systems that care for them. There was a lack of a global unified plan to mitigate and control the spread of COVID-19. Several middle-or-high income nations struggled to control the viral spread resulting in increased mortality due to a combination of lack of public health measures and existing disparities which were magnified during the pandemic. The purpose of this review by a team of international experts is to (1) to examine reasons for the varied COVID-19 responses within U.S. and among other middle-or-high-income countries and the emergence of variants and vaccine inequities, and (2) to examine the country specific burden of cultural/structural/political determinants on access to care and mortality among older adults in various settings.
INFECTION PREVENTION CHALLENGES AND OPPORTUNITIES IN SMALL LONG-TERM CARE FACILITIES
Authors: Ham Carolyn 
Published: December 2022

Abstract
Small, individually owned long-term care facilities experienced unique challenges to accessing infection prevention knowledge and resources during the COVID-19 pandemic. Three data sets were analyzed: 1) Multi-state qualitative interviews with public health and regulatory staff in spring 2021; 2) Online survey of Washington state adult family home providers on infection control knowledge and practices in fall 2020; 3) Non-regulatory Infection Control Assessment and Response evaluations conducted between March 2020 and January 2021. Consistent findings across datasets were ongoing difficulty obtaining personal protective equipment (PPE), inability to implement isolation precautions and high vulnerability to staffing shortages. Small facilities showed strengths in consistency of leadership and engagement with public health outreach. Facility size is a key factor in infection prevention disparities for older adults living in residential care. Promising policy interventions are prioritization of small facilities for PPE distribution and increasing the availability of public health infection prevention expertise.
ESPO AND ACADEMY FOR GERONTOLOGY IN HIGHER EDUCATION SECTION SYMPOSIUM: TEACHING STRATEGIES FOR INTEGRATING DIVERSITY IN AGING EDUCATION PRACTICES
Authors: Su YanJhu , Qu Shan , Montepare Joann 
Published: December 2022

Abstract
This symposium intends to echo one of the core values for the GSA 2022 Annual Scientific Meeting — embracing diversity. In an increasingly humanistic society, addressing and accommodating diversity is a constant topic in the field of education. Diversity includes many different factors: race, ethnicity, gender, sexual orientation, socioeconomic status, ability, age, religious or political beliefs. There is no longer just one type of student in the classroom. Therefore, it is very important to adjust our teaching methods to accommodate the diverse backgrounds of students and to help students understand their different fellow classmates. In accordance with the AGHE gerontological education competencies, these authors will provide insightful teaching strategies for integrating diversity in aging education practices. The first speaker will introduce a new pedagogy in promoting learning in diverse classrooms — Sharestart. The second speaker will focus on building community-based partnerships to promote diverse, intergenerational service-learning opportunities for interprofessional gerontology students. The third speaker will discuss their experience on fostering connections across generations in the LGBTQ+ community through intergenerational conversations. The fourth speaker will present humanist values on understanding aging diversity. Finally, the fifth speaker will discuss curriculum mapping as a strategy to teach diversity in gerontology programs.
HOPELESSNESS AMONG MIDDLE-AGED AND OLDER ADULTS: A COMPARISON OF NATIVE WHITES, NATIVE MINORITIES, AND IMMIGRANTS
Authors: Guo Man , Wang Yi , Carter Kara 
Published: December 2022

Abstract
Sense of hopelessness is closely linked to poor physical/mental health and elevated suicidal risk. The aging and immigration processes put middle-aged and older immigrants at a greater risk of feeling hopeless. However, we know little about hopelessness among this population. This study asks two questions: do middle-aged and older immigrants have higher levels of hopelessness compared to native-born Whites and native-born ethnic minorities? If so, what factors contribute to such differences? Data was from the 2018 psychosocial assessment of the Health and Retirement Study (N = 5,534). ANOVA was used to compare levels of hopelessness among three groups of middle-aged/older adults (50 yrs+): native-born Whites (n =3,603), native-born minorities (n = 1,209), and immigrants (n = 722). Linear regressions were used to examine the association between nativity/race and hopelessness, with five sets of explanatory variables (i.e., SES, health, social support, social engagement, and neighborhood characteristics) entered in the models individually and then collectively. The findings showed that middle-aged/older immigrants had the highest levels of hopelessness, followed by native minorities, and then native Whites. Controlling for each set of the explanatory variables respectively reduced the group differences between native Whites and native ethnic minorities, but not between Whites and immigrants. When controlling for all the explanatory variables, the levels of hopelessness no longer differed significantly between immigrants and native Whites. Findings suggest that immigrants’ multiple disadvantages in personal, family, and social lives may contribute to their heightened levels of hopelessness. Interventions are sorely needed to protect against hopelessness for this population.
TELEPHONE FRAUD AGAINST OLDER ADULTS IN CHINA: EVIDENCE FROM THE CHINA HEALTH AND RETIREMENT LONGITUDINAL STUDY
Authors: Zhan Rong-Fang , Mpofu Elias , Yin Cheng 
Published: December 2022

Abstract

Background
Falling victim to telephone fraud is a devastating crisis for older adults because they can lose their life savings, adversely affecting their well-being. This study aimed to identify risk factors associated with telephone fraud among Chinese older adults. Method: A case-control study was conducted using the fourth wave of the 2018 China Health and Retirement Longitudinal Study data on older adults 60 years and above (N = 445 with telephone fraud experience; 9,994 with no fraud and other fraud experience). Control variables for the logistic regression analysis included the individual’s demographics of gender, residential location, marital status, and educational level.

Results
Older adult males (OR = 1.424, 95% CI = 1.156-1.755, p = 0.001), urban residence (OR = 2.257, 95% CI = 1.706-2.986, p &lt; 0.001), urban-rural integration zone (OR = 2.322, 95% CI = 1.654-3.260, p &lt; 0.001), received higher education [OR = 1.704, 95% CI = 1.211-2.397, p = 0.007]), and higher pension classification (OR = 1.352, 95% CI = 1.220-1.500, p &lt; 0.001) were associated with increased risks of telephone fraud.

Conclusion
Telephone fraud affects older adults in China at the upper rather than lower end of the socio-economic gradient, suggesting vulnerability from their use of digital technologies compared to those on the lower ladder of the socio-economic gradient. Findings highlight the need for fraud education of older adults with access to the digital broad band to reduce their risk for telephone fraud.
LEISURE PARTICIPATION AND COGNITIVE IMPAIRMENT AMONG HEALTHY OLDER ADULTS IN CHINA
Authors: Zhang Wei , Feng Qiushi , Fong Joelle , Chen Huashuai 
Published: December 2022

Abstract
Leisure participation is beneficial to various health outcomes. This study examined a comprehensive list of leisure activities in relation to incidence of cognitive impairment among healthy older adults (65+) in China. Using data from the 2002-2018 Chinese Longitudinal Healthy Longevity Survey, we found that most of the leisure activities were protective of cognitive decline and three leisure activities (watching TV, doing housework, and playing cards/mah-jong) stood out as the most important ones. Additionally, our results revealed subgroup variations in the association between leisure participation and cognitive function: Leisure activities such as reading newspapers/books (not significant for the illiterate), gardening (not significant for the illiterate), and regular exercise (not significant for the rural residents) had different effects across different demographic social groups. Our findings suggest that intervention programs designed to prevent cognitive decline for older adults should consider subgroup and cultural variations in order to yield the best outcomes.