bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHRONIC BACK PAIN, LIMITATIONS ON USUAL ACTIVITIES, AND TREATMENT AMONG OLDER BRAZILIANS
Authors: Andrade Flavia , Chen Xiayu 
Published: December 2022

Abstract
Chronic back pain is prevalent among Brazilian older adults, leading to substantial social and healthcare costs. It also disproportionately affects low-income and less-healthy people. Using the latest Brazil’s National Health Survey (PNS-2019), multivariate logistic regressions were conducted to examine how biopsychosocial factors correlate with chronic back pain, limitations on usual activities, and pain treatment (N=17,184). PNS-2019 data showed that 31.3% (95% CI 30.1-32.5) of older adults ages 65 to 112 reported back pain. Chronic back pain was positively associated with being female, having more chronic conditions, depressive symptoms, and lower education. Among those who reported having back pain, 19.2% reported that pain limited their usual activities. Higher odds of having limitations were found among older adults with three or more chronic conditions, obesity, and depressive symptoms. However, it was lower among those with higher levels of alcohol consumption. Among older adults with back pain, 69.2% received some treatment for their pain - 24.1% exercised regularly, 14.3% received physical therapy, 48.1% medications/injections, 6.1% alternative methods, and 30.7% regularly visited health professionals. Treatment was higher among women and those with higher education. The results show significant disparities in the prevalence, limitations, and treatment of chronic back pain among older adults in Brazil. The findings point to the need for prevention and treatment programs for older Brazilians with lower socioeconomic and worse health conditions.
INTEGRATING TELEHEALTH AND COMMUNITY HEALTH WORKERS TO ENHANCE QUALITY CARE ACCESS: A NARRATIVE REVIEW
Authors: Engel Ilana , Zhang Alice , Stiles Robert , Nelson Eve-Lynn , Watts Amber 
Published: December 2022

Abstract
Community Health Workers (CHWs) often share cultural, geographic, or other lived experiences with patients and provide health education and support. Use of CHWs and telehealth approaches are promising strategies for addressing the needs of patients with metabolic syndrome (MetS). This narrative review analyzed how these approaches were integrated into programs expanding care access for patients with MetS. Searching PubMed, PSYCInfo, Embase, Web of Science, and Google Scholar resulted in 1,630+ abstracts screened and 12 articles meeting inclusion criteria. These studies examined implementation of tele-mentoring approaches (n=4), patient group classes via videoconferencing (n=2), or individual telehealth consultations facilitated by CHWs (n=7), with some programs including multiple intervention types. This review included adults ranging from 37-79 years old. Most studies focused on late mid-life (ages 50-64). Because health behaviors in midlife have important implications for MetS and related health concerns in later life, it is important to consider midlife interventions. Using the RE-AIM framework, we evaluated studies on five dimensions: reach, effectiveness, adoption, implementation, and maintenance. Reach and implementation indicators suggest reducing barriers to engagement (e.g., home visits) allows for higher participation and program completion rates. Measures of MetS-related behavioral outcomes were heterogeneous across study designs, making overall effectiveness difficult to determine. Adjusting time spent with patients according to health literacy and clinical needs is a strategy CHW programs use to provide equitable, cost-effective care. Programmatic considerations for implementing programs that include both CHWs and telehealth are discussed, with special consideration for what works in late middle age and in older adulthood.
EXPOSURE TO GENERATIVE MESSAGES BOOSTS COGNITIVE PERFORMANCE IN OLDER ADULTS
Authors: Gruenewald Tara , Standridge Natalie , Tadros Clarissa 
Published: December 2022

Abstract
Both self-perceived and primed generativity has been found to be linked to better cognitive and physical functioning, psychological well-being, and longevity in older adulthood. A prior experiment also found that priming older individuals with messages regarding the generative, or contributory value of their social group (older adults) boosted cognitive performance compared to exposure to a message about the societal burden of one’s group (Hagood & Gruenewald, 2018) . A key limitation of this earlier work was the lack of a neutral prime condition to determine whether being exposed to messages regarding the generativity of older adults enhanced their cognitive performance or being exposed to negative messages regarding the social burdens of one’s age group suppressed performance. This limitation was addressed in the current online experiment of 300 U.S. adults age 55 and older who were randomly exposed to either a social generativity, social burden, or neutral prime presented as a test of reading comprehension and recall. Participants completed other measures of cognitive ability before and after the priming task, including an assessment of verbal memory. An ANCOVA model including age as a covariate indicated a significant effect of priming condition (F(2,296) = 3.30, p = .038). Mean verbal memory performance did not vary between the neutral and social burden priming conditions, while performance was significantly higher in the generativity prime condition (d=.29). Experimental findings provide support for the hypothesis that exposure to generative messages about one’s social group can boost cognitive performance in a national sample of older adults.
LIVED EXPERIENCES OF OLDER CHINESE IMMIGRANTS IN AFFORDABLE HOUSING DURING THE PANDEMIC: STRESS AND RESILIENCE
Authors: Yu Kexin , Chi Iris , Sun Fei 
Published: December 2022

Abstract
Older immigrants in affordable housing have unique sets of challenges during the COVID-19 pandemic posed by limited English proficiency and resources. The aggregated living condition could increase their risk of being exposed to the contagious disease. This symposium reports empirical findings of the social Network of Immigrant Chinese older adults in affordable Housing Environment (NICHE) project, which focused on the influence of COVID-19 on underprivileged Chinese older immigrants. We conducted 27 semi-structured interviews with foreign-born older Chinese immigrants (mean age 78.1, 69.23% female) in an affordable housing in Los Angeles to learn about their lived experiences and coping strategies during the COVID-19 pandemic. The first presentation focused on the changes in older Chinese immigrants’ social life after the onset of the pandemic and aimed to understand the pandemic’s impact on their depressive symptoms and loneliness. The second presentation describes older Chinese immigrants’ perceived pandemic-related stressors and resilience across phases of the pandemic, including at the beginning, after they got vaccinated, and the rising of delta variant. The participants explained what supportive services had been helpful and what support they wished they could have over the past two years in the pandemic. The third presentation reports the experience of being discriminated against during the pandemic, the Chinese older adults’ attitudes towards these discriminatory events, and coping strategies. Together, these three presentations will depict the lived experience of Chinese immigrants over two years during the pandemic and discuss intervention strategies and policy considerations for preparing for future crisis like the COVID-19 pandemic.
CHILDHOOD SOCIOECONOMIC POSITIONING AND LATE-LIFE COGNITIVE FUNCTIONING: A CRITICAL REVIEW
Authors: Skoblow Hanamori , Proulx Christine 
Published: December 2022

Abstract
The predictors of cognitive functioning are varied and complex. Gerontologists are increasingly interested in the long arm of childhood, suggesting that late-life cognitive functioning may be partly the result of influences across the life span. Research shows that childhood economic hardship is associated with disparities in cognitive functioning in older adulthood. Framed by the life course perspective, we reviewed 27 articles that examine associations between childhood socioeconomic positioning (SEP), commonly assessed via parents’ educational attainment, and late-life cognitive functioning in 11 different US datasets. The influence of childhood SEP on cognitive functioning is stronger when cognitive functioning is assessed at a single time point rather than as change over time, suggesting that childhood SEP might not affect the rate at which cognition declines in later life, but does impact where decline begins. The majority of research supported the pathway hypothesis, suggesting that childhood SEP’s influence on adult cognitive functioning works primarily through the mechanism of adults’ own educational attainment and SEP. Several studies support the accumulation of (dis)advantage hypothesis and point to the compensatory potential of upwards social mobility. Support for the latency model, which posits that early-life economic hardship results in enduring outcomes that influence cognitive functioning in older adulthood, above and beyond one’s adult SEP, is present, although weaker than the other hypotheses. Implications include strengthening policies that relieve economic strain and promote educational access among families with young children and also among young adults, as addressing the precursors of cognitive functioning in tomorrow’s older adults is paramount.
RELATIONSHIP BETWEEN PHYSICAL AND MENTAL HEALTH WITH SUBJECTIVE COGNITIVE DECLINE AMONG OLDER ADULTS IN PUERTO RICO
Authors: Buckley Thomas 
Published: December 2022

Abstract
Worse physical and mental health are risk factors for cognitive decline in older adults. In Puerto Rico, existing healthcare services are lacking, further exacerbating this risk. This study examines how mental and physical health factors affect subjective cognitive decline for older adults in Puerto Rico. Data comes from the 2020 Behavioral Risk Factor Surveillance System, restricted to adults age 60+ residing in Puerto Rico (n = 1603). Subjective cognitive decline was measured with two dichotomous variables (no/yes): increases in confusion or memory loss and difficulty making decisions in the past year. Multivariate logistic regression models were run for each outcome variables. Predictor variables were number of days in past month with poor mental health, diagnosis of depression or mood disorder, self-rated health, and access to healthcare services, along with covariates. Higher number of days with poor mental health (B = 2.44, p &lt; .001), diagnosis of depression or mood disorder (B = 3.76, p &lt; .001), and cost barriers to accessing healthcare (B = 2.90, p = .002) were associated with increased odds of increased confusion or memory loss. Significant predictors of increased odds of decision-making difficulty included higher number of days of poor mental health (B = 1.88, p &lt; .001), diagnosis of depression or mood disorder (B = 3.80, p &lt; .001), and worse self-rated health (B = 2.13, p &lt; .001). To promote better cognitive health, intervention efforts should focus on those with poor mental and physical health, including identify strategies to improve access to healthcare services.
PHYSICAL FRAILTY AS A PREDICTOR OF INCIDENT DISABILITY IN SPECIFIC-IADL ITEMS AMONG OLDER ADULTS
Authors: Lee Jane , Kim Miji , Won Chang Won 
Published: December 2022

Abstract
This study investigated the 2-year impact of physical frailty on disability (activities of daily living [ADL], instrumental ADL [IADL], and mobility) and mortality among community-dwelling older adults in Korea. We used data from 2,905 older adults aged 70–84 years who participated in the Korean Frailty and Aging Cohort Study (KFACS) at baseline (2016–2017) and Wave 2 (2018–2019) with all five components of Fried’s physical frailty phenotype. Of these,277 (7.8 %) were frail and 1,312 (45.2 %) were robust. In the 2-year follow-up, multivariate analysis showed significant differences in frailty status for all disabilities (ADL, IADL, mobility) and mortality incidence. Both pre-frail (odds ratio [OR]=1.48, 95% confidence interval [CI]= 1.06–2.05) and frail (OR = 5.11, 95% CI=2.78–9.39) statuses showed increased risks of mobility disability. The incidence of ADL disability was significant only in frail older adults (OR =10.26, 95% CI=3.16–33.31). Both pre-frailty (OR =1.55, 95% CI=1.03–2.32) and frailty (OR =4.11, 95% CI=2.35–7.18) status were significantly associated with the incidence of IADL limitations. Frailty status was associated with disability in mobility-related items of IADL (going out, using transportation, and shopping) among men, and was associated with most IADL items among women after 2 years. The results of this study emphasize the need for sex-specific policies and frailty prevention programs, with a focus on detecting frailty before it leads to irreversible disability or other negative health outcomes. These findings may provide a framework for frailty prevention in community-dwelling older adults.
STRESS AND RESILIENCE ACROSS PHASES OF COVID-19: A QUALITATIVE STUDY WITH OLDER CHINESE IMMIGRANTS
Authors: Tung Yi-Hsuan , Yu Kexin , Liang Jiaming , Wu Shinyi , Chi Iris 
Published: December 2022

Abstract
The COVID-19 pandemic has challenged older Chinese immigrants’ lives in physical, psychological, social, and spiritual aspects. This study employed a socioecological perspective of resilience to examine how older Chinese immigrants perceived and navigated through pandemic-related adversities. We conducted a time-bound retrospective qualitative investigation to capture participants’ lived experiences between December 2019 to August 2021. Three phases of the pandemic-related adversities were identified, including uncertain threats and psychological impacts at the beginning, unmet needs and fatigue at 2nd and 3rd wave of infections, and benefit-risk balance after vaccinated. Despite adversities, the integration of strengths, opportunities, and social services at the individual, interpersonal, and neighborhood levels allows participants to appraise and individualize their problem-focus coping (e.g., risk mitigation), selective engagement (e.g., maintaining habits through other means), or emotion-focus coping strategies (e.g., acceptance). Findings highlight the importance of personal and community resources in fostering resilient responses.
THE RELATIONSHIP BETWEEN PHYSICIAN VISITS AND ADVANCE CARE PLANNING
Authors: Wang YuHsuan (Olivia) , Enguidanos Susan 
Published: December 2022

Abstract
Some studies have shown that advance care planning (ACP), discussions about future care given a serious illness, are associated with improved quality of death and better end-of-life care. Studies also have found that physicians play an important role in ACP. In fact, in 2016 CMS began reimbursing physicians for ACP discussions. However, little is known about the relationship between the number of physician visits and engaging in ACP . This study investigated the association between outpatient physician visits and ACP engagement. Only respondents over 65 were included in our study. We conducted logistic regressions using the 2016 Health and Retirement Study. We used ACP engagement (n=9838), advance directive (AD; eg, living will) completion (n=9746), and healthcare power of attorney (e.g., proxy) assignment (n=9724) as outcome variables. In addition to the frequency of physician visits, we controlled for basic demographics (age, gender, marital status, race, and socioeconomic status), number of chronic conditions, and self-rated health in our models. For each additional physician visit, the probability of having an ACP conversation, (p&lt;.001), AD completion (p&lt;.001), and healthcare proxy assignment (p&lt;.001) increased by 1.6%,1.4%, and 1.9% respectively after controlling for covariates. Number of chronic conditions also was independently and positively associated with ACP-related activities. Additionally, greater perceived health was associated with higher odds of AD completion (OR= 1.08, p&lt;.05) and healthcare proxy assignment (OR= 1.07, p&lt;.05). This study found that frequent encounters with physicians are associated with higher rates of ACP engagement even after controlling for health conditions.
EFFECTS OF PATIENT QUESTION PROMPT LIST USE ON PARTICIPATION DURING OUTPATIENT PALLIATIVE CARE APPOINTMENTS
Authors: McDarby Meghan , Silverstein Hannah , Carpenter Brian 
Published: December 2022

Abstract
Question prompt lists (QPLs) support patients who are seeking information during medical appointments by providing preset questions a patient might ask their provider. Prior research suggests that QPLs promote communication, including question asking, during appointments. The current study evaluated use of a 25-question QPL during initial outpatient palliative care appointments. We applied tenets of Social Cognitive Theory to investigate the relation between question asking and self-efficacy. Participants were patients attending their first outpatient palliative care appointment at an academic hospital. Participants were randomly assigned to receive the QPL before their appointment (n = 29) or to receive usual care (n = 30). Audio recordings of appointments were transcribed and coded for total questions asked. Participants also responded to a single-item measure of self-efficacy in question asking at pre- and post-appointment. On average, participants in usual care appointments asked 9.37 questions (SD = 10.3, range= 0 – 49), and participants in QPL appointments asked 11.24 questions (SD = 10.1, range = 0 – 45), but with no significant difference between groups, F(1,56) = 0.14, p = .71. All participants reported an increase in self-efficacy from pre- to post-assessment, F(1,83) = 18.76, p &lt; .00, but there was no interaction effect of time and condition, F(1,83) = .81, p = .37. Despite their promise in previous studies, our results suggest QPLs may lack potency to shift question asking, at least in palliative care appointments, and that other mechanisms of Social Cognitive Theory may better characterize the relation between question asking and self-efficacy.
INDIVIDUALS' KNOWLEDGE ABOUT A LOVED ONE’S END-OF-LIFE CARE WISHES IS ASSOCIATED WITH THEIR OWN ADVANCE CARE PLANNING
Authors: Zhang Peiyuan , Cagle John 
Published: December 2022

Abstract
Despite evidence that ACP can improve quality of life for both patient and family, it remains underutilized. Only 37% US adults have a complete advance directive (Kuldeep et al., 2017). Existing studies primarily examined factors associated with patients’ ACP engagement but very few explored ACP among patients’ family. The goal of this study is to examine whether individuals’ knowledge about a loved one’s end-of-life (EOL) care preferences is associated with their ACP engagement. Data are from the US arm of the 2015 Four-Country Survey on Aging and End-of-Life Medical Care. The sample included N=609 adults who experienced the death of a family or close friend in the past 5 years.Three binary dependent variables were measured by different facets of ACP: having a serious conversation about EOL medical care wishes (1) with loved ones, (2) with doctors and (3) documenting those wishes. The primary independent variable was participants’ knowledge about their deceased family’s EOL treatment wishes.Three separate logistic regression models were used. Individuals who had a greater knowledge about their loved one’s EOL treatment wishes were twice as likely to have a conversation with family about their own EOL wishes (OR=2.32, P&lt; 0.001) and documented wishes than those who didn’t(OR=2.03, P&lt; 0.05). Results have direct implications for clinicians who work with families in EOL care settings. They may have opportunities to engage individuals – other than patients – in ACP. Focusing the experience of involvement in a loved one’s EOL care may be an effective strategy to enhance ACP engagement.
ADVERSE SOCIAL EXPERIENCES, SOCIAL SUPPORT, AND HEALTH OUTCOMES AMONG BLACK AND WHITE FAMILY CAREGIVERS
Authors: Browning Wesley , Atkins Ghislaine , Bowen Pamela , Crowe Michael , Dreer Laura , Ruggiano Nicole , Clay Olivio 
Published: December 2022

Abstract
Family caregivers provide care for loved ones who have difficulty performing activities of daily living. Previous research has examined the influence of direct and indirect stressors on caregiver’s health outcomes but has often neglected the role of tertiary stressors (stressors that are not caused by caregiving but influence caregivers’ appraisals of stress). This study examined the impact of tertiary stressors called adverse social experiences (ASEs), including negative interaction (criticism from others, excessive demands by others, being taken advantage of, and others prying into caregivers’ personal affairs), experiences of discrimination, and low physician trust on caregiver health outcomes including depressive symptoms along with mental and physical health quality of life (QoL). This study also investigated the effects of social support on health outcomes in caregivers. Linear regression models were used to analyze these relationships within a group of 56 Black and White adult caregivers (18+) recruited online via social media and listservs from April to June 2021. Caregivers provided at least 5 hours of care weekly for recipients aged at least 45 years old. Negative interaction predicted more depressive symptoms, whereas emotional support and satisfaction with support were predictors of less depressive symptoms and better mental health QoL (p’s &lt; .05). Experiences of discrimination and physician trust did not predict health outcomes. These findings suggest researchers should further investigate the impact of ASEs, particularly negative interaction, on caregiver health. Healthcare providers of caregivers should consider how ASEs and social support may affect caregivers’ health and ability to care for their relatives.
FAMILY CAREGIVERS’ PSYCHOLOGICAL WELL-BEING AND PHYSICAL HEALTH IN THE CONTEXT OF THE WORK ENVIRONMENT
Authors: Hodgdon Barbara , Wong Jen 
Published: December 2022

Abstract
As working family caregivers navigate work and care responsibilities, the work environment may contribute to their psychological well-being and physical health outcomes. Working caregivers who provide multi-generational care (e.g., sandwiched caregivers) experience greater vulnerability when compared to non-sandwiched caregivers (e.g., filial caregivers). This vulnerability could be mitigated by supportive work characteristics (e.g., greater decision authority and supervisor support). Informed by the life course perspective, this study compared the psychological well-being and physical health of working sandwiched and filial caregivers, and the moderating role of work characteristics (decision authority and supervisor support). Sandwiched (n=80; Mage=46.3) and filial (n=62; Mage=55.7) caregivers from the Midlife in the United States (MIDUS-II) Survey provided information about their background, caregiving, employment, well-being, and health via a set of questionnaires and phone interview. Regression analyses showed that sandwiched caregivers exhibited lower levels of generativity than filial caregivers. Moderation analyses revealed that sandwiched caregivers with greater decision authority trended toward exhibiting greater autonomy than other caregivers. Sandwiched caregivers with greater decision authority also exhibited significantly less difficulty with instrumental activities of daily living (IADLs) than other caregivers. Finally, sandwiched caregivers with greater than average supervisor support trended toward exhibiting higher level of generativity as compared to other caregivers. Results highlight the impact of sandwiched caregiving on autonomy, generativity, and IADLs in the context of decision authority and supervisor support. Findings may inform workplace programs and policies aimed at enhancing caregivers’ sense of decision making and increasing supervisor support in order to promote caregivers’ psychological well-being and physical health.