bluuebunny/crossref_metadata_2025_split huggingface dataset:
INTERSECTIONALITY OF SENSORY LOSS AND RACE: IMPLICATIONS FOR BRAIN AND MENTAL HEALTH IN OLDER ADULTS
Authors: Deal Jennifer , Brenowitz Willa , Thorpe, Jr. Roland J 
Published: December 2022

Abstract
Despite recent evidence that sensory loss may increase risk of dementia, mood disorders, and poor physical health in older adults, nearly all research to-date has been conducted in populations that are predominantly White and from high-income countries. This session will investigate the intersectionality of race with sensory loss with a focus on health equity and inclusion of traditionally underrepresented populations. It will evaluate sensory loss across multiple senses, how patterns vary by race, and whether socioeconomic status can explain these differences. In the US, prevalence of impairment in vision, touch, and smell is lower in Whites compared to Black or Hispanics. Interestingly, hearing loss prevalence is lower in Blacks than Whites, but dementia incidence is higher. This session will describe incident dementia risk associated with hearing loss in Black compared to White Americans. It will also address the relationship between dual (hearing and vision) loss and depressive symptoms in India to explore the generalizability of findings to lower middle-income countries. Sensory impairments may intersect with racial discrimination to exacerbate social and health disparities. This session will also describe racial disparities in food insecurity among Americans with vision loss. Finally, we will present results of a randomized controlled trial of an innovative, community-delivered approach to affordable, accessible hearing care. The study represents the largest U.S.-based trial cohort to date of low-income older adults and older African American adults with hearing loss.
HEARING LOSS AND INCIDENT DEMENTIA OVER 7 YEARS IN BLACK AND WHITE OLDER ADULTS IN ARIC-NCS
Authors: Shin John , Jiang Kening , Reed Nicholas , Knopman David , Mosley Thomas , Sharrett Richey , Lin Frank , Deal Jennifer 
Published: December 2022

Abstract
Hearing loss is a risk factor for dementia; whether this association differs by race is unknown. Although hearing loss is less prevalent in Blacks than Whites, we hypothesized the hearing loss-dementia relationship is stronger in Blacks. All-cause dementia and mild cognitive impairment (MCI) were adjudicated using longitudinal cognitive data. Hearing was measured using pure tone better-ear thresholds (0.5-4 kHz). Cox proportional hazards models adjusted for demographic and clinical covariates and included an interaction term between hearing and race. In 3,605 participants from a population-based cohort (68-89 years, 23% Black, 59% female), estimates for 7-year dementia risk per 10 decibels increase in hearing loss were stronger in Blacks (hazard ratio [HR]:1.24, 95% Confidence Interval (CI):1.07,1.43) than Whites (HR:1.07; 95%CI:0.96,1.19). Hearing loss is a risk factor for dementia in Black Americans. These findings emphasize the need to address existing racial disparities in hearing healthcare.
TO LOVE AND LOATHE: EXAMINING THE COSTS AND BENEFITS OF AMBIVALENT TIES IN OLDER ADULTHOOD
Authors: Hamilton Lucas , Peng Siyun , Krendl Anne , Perry Brea 
Published: December 2022

Abstract
Ambivalent ties are relationships that offer support but beget stress, which generally has a detrimental impact on health. Existing theory suggests that older adults gradually remove such ties over time; however, it is not uncommon for ambivalence to exist in older adults’ close relationships (i.e., partners, children). Social network data was used from 286 older adults with about half having mild cognitive impairment. Roughly two-thirds of the sample reported at least one ambivalent tie, most commonly partners, children, and friends. Logistic regressions revealed distinct characteristics of these ties. Participants who reported at least one ambivalent tie (most notably, partners and friends) had social networks with structures known to confer cognitive benefits. Importantly, these effects dissipate with diminished cognitive status. Altogether, ambivalent ties may confer benefits when resources are available to manage such relationships. When resources are taxed, however, ambivalent ties may contribute to cascading health declines.
LATE-LIFE SOCIAL NETWORKS AND INCIDENT ALZHEIMER'S DISEASE: THE KUAKINI HONOLULU-ASIA AGING STUDY
Authors: Kallianpur Kalpana , Masaki Kamal , Chen Randi , Willcox Bradley , Allsopp Richard , Davy Philip , Dodge Hiroko 
Published: December 2022

Abstract
We assessed longitudinal associations between social networks and incidence of all-cause dementia, Alzheimer’s disease (AD) and vascular dementia in Kuakini Honolulu-Asia Aging Study participants over a 10-year follow-up period. Median split of Lubben Social Network Scale (LSNS) scores defined weak/strong social networks among 2636 men who were dementia-free at baseline (median age 77 years) and during the first 3 years. Kaplan-Meier curves showed that those with strong networks at baseline were less likely to develop all-cause dementia (p&lt;0.0001) and AD (p=0.0006); probability of dementia-free survival at 10 years for strong and weak social network groups was 93.8% and 89.0%, respectively. Cox regression models adjusting for age and other baseline factors revealed associations of weak networks with increased risk of all-cause dementia (HR=1.52, 95%CI=1.11-2.08, p=0.009) and AD (HR=1.67, 95%CI=1.11-2.51, p=0.014). As strong social networks may protect against incident dementia and AD, and are associated with other health benefits, prevention of social isolation of older adults should be considered a priority.
UNDERSTANDING CULTURAL NARRATIVES OF DEMENTIA: TASKS AND TOOLS FOR HUMANITIES SCHOLARSHIP
Authors: Berlinger Nancy 
Published: December 2022

Abstract
Humanities scholarship on dementia has long focused on the depiction of dementia in literature, film, and other genres. Recent research on neurodiversity includes humanistic scholarship on creativity within dementia. It is time for interdisciplinary humanities scholarship to focus on narratives of dementia that circulate within aging societies, are embedded in policy, and shape experiences of typical people living with dementia or providing dementia care. This paper argues for the normative importance of studying values-laden cultural narratives, recognizing competing or evolving narratives within a society, and demonstrating how to reframe flawed narratives beyond necessary attention to ageist and ableist language. It presents examples of approaches to social narrative analysis; describes tools and training that could be integrated into humanities scholarship on dementia and aging, and considers the potential role of social narrative analysis in articulating and launching policy ideas for aging societies.
NARRATIVE MEDICINE AS INTERDISCIPLINARY PRACTICE
Authors: Kriebernegg Ulla 
Published: December 2022

Abstract
When dealing with patients who talk about their illnesses, medical doctors need to interpret the stories they hear. Also, they need to make sense of their own experiences regarding their medical encounters. Narrative and its analysis plays a central role in such processes that require empathy and self-reflection. The interdisciplinary practice of teaching medical students concepts and theories from literary studies as well as discussing literary texts with them can expand their scientific medical understanding. This paper explores the concept of narrative in the context of geriatric medical humanities and narrative medicine, looking at how narrative competence translates into medical practice. Presenting findings from a seminar on Narrative medicine at the Medical University of Graz, Austria, it also addresses some methodological and didactic challenges of this interdisciplinary approach.
LONG-TERM PREDICTION OF DEMENTIA USING MACHINE LEARNING ALGORITHMS
Authors: Berglund Johan Sanmartin , Javeed Ashir 
Published: December 2022

Abstract
The core interest of this project is the development of predictive estimates and the identification of modifiable risk factors for the development of neurocognitive disorders based on multifactorial data from multiple health databases.We are conducting epidemiological research on predicting neurocognitive diseases of older adults included in the National E-Infrastructure on Aging Research (NEAR) using deep learning and other AI methods. Exploring the impact of lifestyle and environment on dementia development in the subjects together with biomarkers and images and predicting dementia using machine learning techniques would give insights into the long-term development. In addition, the possibility of screening a large number of persons and consequent early prediction of dementia based on optimized machine learning techniques could be of great importance for early treatment.
IMPACT OF FRAILTY ON THE DIGNITY OF COMMUNITY-DWELLING OLDER PEOPLE
Authors: Kakhki Ali Darvishpoor , Moradoghli Fereshteh , Esmaeili Roghayeh 
Published: December 2022

Abstract
The population of people aged 60 and older is rapidly increasing in developing countries such as Iran due to declining birth rates and increased life expectancy. Old age is associated with increased risk for frailty and reduced dignity. This study investigated the impact of frailty on the dignity of older people in Tehran, Iran. This cross-sectional study was conducted on 200 individuals aged 60 years and older. Data collection relied on the Demographic Questionnaire, Frailty Index for Elders (FIFE) and the Patient Dignity Inventory (PDI). Data were analyzed with SPSS 25. The mean age of the participants was 68 (±5.05) years; 62% of the participants were at risk for frailty, and 69% had few dignity-related problems. The multiple regression results showed that frailty was significantly associated with dignity (ß = -0.571, p &lt; 0.001). The association was significant across all the dimensions of dignity measured by the PDI. The highest predictors of frailty included dependency (ß = -0.584, p &lt; 0.001), followed by existential distress (ß = -0.560, p &lt; 0.001), symptom distress (ß = -0.400, p = 0.400), social support (ß = -0.391, p &lt; 0.001), and peace of mind (ß = -0.338, p &lt; 0.001) in dignity. The results show that higher levels of frailty in older people are associated with decreases in their dignity, and frailty was the leading predictor of dignity. Providers should develop programs to prevent and reduce frailty in those at risk and to enhance the dignity of the already frail.
PHYSICAL ACTIVITY TRENDS IN A NATIONWIDE MHEALTH PROGRAM: A POPULATION-BASED COHORT STUDY
Authors: Ang Gregory , Edney Sarah , Tan Chuen Seng , Lim Nicole , Tan Jeremy , Riemenschneider Falk , Chen Cynthia 
Published: December 2022

Abstract
Physical inactivity is a global public health challenge, leading to an increase in chronic diseases. Effective large-scale physical activity interventions are needed. We examined the effectiveness of a nationwide mHealth intervention in Singapore, National Steps Challenge Season 3 (NSC3). NSC3 included gain-framed financial incentives for reaching pre-defined daily step targets, nudging via reminders and real-time feedback on physical activity levels. Our study includes 411,528 participants, with 53,371 (13.0%) participants aged 59 and above. Regression discontinuity design examined changes to daily step counts prior to and during NSC3. NSC3 was associated with an overall mean increase of 1437 steps per day (95% CI: 1408 to 1467). Participants in older age groups were associated with larger mean step increases. Females aged between 59 to 68 and 69 and above were associated with average increases of 1640 steps per day (95% CI: 1510 to 1770) and 2300 steps per day (95% CI: 2050 to 2550), respectively. Males in the same age groups were associated with average increases of 1360 steps per day (95% CI: 1200 to 1520) and 1640 steps per day (95% CI: 1370 to 1900), respectively. We provide real-world evidence that suggests NSC3 improved participants’ step counts, with a larger increase among older adults. As older adults have a higher risk of chronic diseases, lower physical inactivity has potential health benefits such as reducing the incidence of hypertension and improving cardiovascular health biomarkers. While results are promising, further investigations are necessary to ensure sustained engagement among older adults.
SOCIAL PARTICIPATION AND DEPRESSIVE SYMPTOMS AMONG SPOUSAL AND ADULT CHILD CAREGIVERS
Authors: Irani Elliane , Wang Fei 
Published: December 2022

Abstract
Participating in social activities through formal (e.g., social or religious organizations) and informal (e.g., gatherings with family members or friends) avenues is known to positively contribute to mental wellbeing. Family caregivers are at risk for limited social participation and increased depressive symptoms. However, little is known about which social activities are associated with depressive symptoms among spousal and adult child caregivers. The purpose of this study was to examine the effects of participating in various social activities on depressive symptoms among spousal (n=422) and adult child (n=1,112) caregivers using data from the 2017 wave of the National Study of Caregiving. Caregivers reported on participating in six social activities in the past month (e.g., visiting family and friends, attending religious services, doing volunteer work, working for pay) and completed the 2-item Patient Health Questionnaire to assess depressive symptoms. Data were analyzed using multiple linear regression, with separated models for spousal and adult child caregivers. Sociodemographic characteristics, self-rated health, and dementia caregiving status were included as covariates. For spousal caregivers, visiting friends or family and attending religious services were associated with lower depressive symptoms (b=-.55, p=.010 and b=-.33, p=.036, respectively). For adult child caregivers, going out for enjoyment was associated with lower depressive symptoms (b=-.80, p&lt;.001). Findings suggest that spousal and adult child caregivers may benefit from participating in different types of social activities. Interventions targeting social participation to reduce depressive symptoms need to be tailored to the needs and preferences of spousal and adult child caregivers to be most effective.
THE MULTIDIMENSIONAL SUCCESSFUL AGING SCALE: DEVELOPMENT AND VALIDATION
Authors: Chung Edwin K H , Yeung Dannii 
Published: December 2022

Abstract
Subjective successful aging involves a self-appraisal of individual aging process over multiple dimensions of later life (Feng et al., 2015). However, studies often ignore its multidimensional nature and simply utilize a single item as the measurement (e.g., Stewart et al., 2019). Two studies were hence conducted to develop and validate the Multidimensional Successful Aging Scale (MSAS). In Study 1, MSAS was administered among 414 community-dwelling older Chinese adults (Mage=64.50 years, SD=4.01; range = 60 – 82; 55.3% females). Repeated exploratory factor analysis revealed a nine-factor solution of 25 items, accounting for 64% of the variance. The nine factors include harmonious family, active engagement, supportive friendship, adaptive coping, social contribution, living independently, civic awareness, positive attitudes, and perceived constraints. The nine factors exhibit similar strength of associations with most of the well-being measures, but certain factors show stronger correlation with depressive symptoms, suggesting the uniqueness of each factor. In Study 2, the nine-factor model of MSAS was replicated in a sample of 558 older adults (Mage=69.11 years, SD=6.68; range = 60 – 97; 59.2% females) and the results of CFA indicated a good model fit (χ2 = 527.86, df = 239; CFI =.97; TLI =.96; RMSEA =.05; SRMR = .04). The strict and metric forms of measurement invariance were shown across age groups and gender, respectively. Overall, the MSAS demonstrates satisfactory psychometric properties. These findings disclose that the older adults’ perceptions of successful aging cover broader dimensions than those identified in the Rowe and Kahn’s (1997) model.
EFFECT OF STATE WAGE POLICIES ON DIRECT CARE WORKER WAGES
Authors: Tyler Denise , Khavjou Olga , Hunter Melissa , Squillace Marie , Dey Judith , Oliveira Iara 
Published: December 2022

Abstract
Direct care workers (DCWs) have low wages and some states have tried to improve their wages through policies such as Medicaid wage pass-throughs and wage floors specific to DCWs. The purpose of this study was to examine the wages of DCWs in comparison to those of other entry level workers and assess the effect of state wage policies on changes in DCW wages. We analyzed state-level hourly wages using Bureau of Labor Statistics (BLS) data for two categories of DCWs separately—(1) home health and personal care aides and (2) nursing assistants and compared these to wages for other entry-level workers. Results show that many states that implemented policies to improve the wages of DCWs reduced the gap between these workers’ wages and the wages of other entry-level workers, but the gap was still substantial in many states. Additional efforts will be needed to increase DCW wages.
COVID-19 PANDEMIC INCREASED NURSING FACILITIES' RELIANCE ON CONTRACT STAFF TO ADDRESS STAFFING SHORTAGES
Authors: Porter Kristie , Segelman Micah , Gasdaska Angela , Squillace Marie , Dey Judy , Oliveira Iara , Tyler Denise 
Published: December 2022

Abstract
Nursing facilities (NFs) used a variety of strategies to mitigate worsening nursing staff shortages during the COVID-19 pandemic. We conducted analysis of payroll based journal PBJ data and interviewed 9 experts to understand COVID’s impact on NF staffing, especially changes in contract staffing. In 2020, NFs increased their use of contract staff hours per resident day (HPRD) by 24%. Use of contract staff during the first year of the pandemic (comparing 2020 to 2019) varied by some facility characteristics (e.g., profit status). NF providers, and industry and academic experts confirmed facilities used multiple strategies beyond using contract staffing, such as temporary nurse aides, hazard pay and flexible schedules to maintain staffing throughout the pandemic. Competition for nursing staff from other healthcare settings and non-healthcare industries has grown throughout the pandemic, continuing to threaten the stability of the NF workforce.
EXPLORING QUALITY AND COVID MEASURES OF NEW YORK STATE LONG-TERM CARE FACILITIES INVOLVED IN THE SAFE STAFFING LAWSUIT
Authors: Semprini Jason , Kaskie Brian 
Published: December 2022

Abstract
In April 2021, New York's "Safe Staffing" law capped Long-Term Care Facility (LTCF) profits. LTCFs with "excess profits" are now challenging the law in court. This study examined how LTCFs involved in the lawsuit differed from other NY state LTCFs before and during the COVID-19 pandemic. LTCF “Safe Staffing” lawsuit data were obtained from Long Term Care Community Coalition, then linked with Centers for Medicare and Medicaid Services COVID-19 and Small Business Association Paycheck Protection Program (PPP) data. First, we tested for differences across quality measures. We found that, compared to LTCFs not involved in the lawsuit, LTCFs in the lawsuit were more likely to be located outside of a hospital, report more certified beds and higher occupancy rates, and have higher overall quality scores. LTCFs in the lawsuit also reported lower staff ratings and staffing hours, which have previously been identified as a determinant of higher mortality in LTCFs. To create valid comparisons given these systematic differences, we specified “Doubly Robust” Augmented Inverse Probability Weighted regression models and tested if lawsuit involvement was associated with COVID-19 outcomes. Despite finding higher rates of admitting patients infected with COVID-19 in “excess profit” LTCFs, we did not find that COVID-19 deaths differed by lawsuit involvement. Finally, lawsuit involvement was associated with a higher probability of receiving a PPP loan. Before and during the pandemic, LTCFs with "excess profits" appeared fundamentally different than other NY LTCFs. How these differences impact the health of older adults receiving long-term care beyond the pandemic remains unknown.
FACTORS ASSOCIATED WITH THE AVAILABILITY OF SPECIALIZED RESOURCES TO TACKLE OBESITY IN HIGH MEDICAID NURSING HOMES
Authors: Orewa Gregory , Davlyatov Ganisher , Pradhan Rohit , Lord Justin , Weech-Maldonado Robert 
Published: December 2022

Abstract
The purpose of this research is to explore the factors associated with the availability of specialized resources required to care for obese residents in high Medicaid nursing homes (NHs) (85% or higher). Due to the vagaries of payment models---Medicaid payments lag other modes of NH reimbursements—high Medicaid NHs typically report poorer quality and financial performance. Operating in a financial perilous environment, and with obesity among the elderly on the rise, high Medicaid NH may particularly struggle to obtain the appropriate resources essential to cater to obese residents' needs.Utilizing the resource-dependent theory, we hypothesized that occupancy rate, acuity index, and payer mix may be positively associated with the availability of obesity related specialized equipment in high Medicaid NHs. The study was conducted by merging survey and secondary data sources for the year 2017-2018. Obesity related data was collected via mail surveys sent to Directors of Nursing in high Medicaid NHs, The survey data was merged with the following secondary data sources: Brown University’s LTC Focus, Area Health Resource File, and the Medicare cost reports. The dependent variable was the summative obesity score that ranged from 0-19 with the larger number indicating greater availability of obesity-related equipment/services. An ordinary least square regression with propensity score weights (to adjust for potential non-response bias), and appropriate organizational/market level control variables were used for our analysis. Results suggest that payer mix (&gt;Medicare residents) and acuity index were positively associated with the summative obesity score (p &lt; 0.05). Policy and managerial implications are discussed.
INFORMATION SHARING TO SUPPORT CARE TRANSITIONS FOR PATIENTS WITH COMPLEX MENTAL AND BEHAVIORAL HEALTH NEEDS
Authors: Bucy Taylor , Cross Dori 
Published: December 2022

Abstract
Information sharing practices between hospitals and skilled nursing facilities (SNFs) are insufficient to effectively support patient handoffs. Information needs are even greater for SNFs that admit patients with complex behavioral needs. It is unclear whether these needs have prompted hospital investment in enhanced information sharing with these SNFs, and what strategies these facilities are using to meet informational needs. We use data from a 2019 nationally representative SNF survey (N=265, response rate 53%) designed to gather information on information sharing practices with hospital partners. 122 SNFs (57% of respondents) report accepting at least two of the following complex conditions: serious mental illness, substance use disorder, or medication assisted treatment. Using logistic regression models that adjust for facility ownership and rurality, SNFs that accept complex patients are significantly more likely to receive information on behavioral, mental, and functional status compared to facilities who accept none or only one type of complex patient (odds ratio=2.42; p=0.023). Unadjusted models indicate that facilities that accept complex patients lag in IT-facilitated access to hospital information, and report more difficulty securing timely access to information. The significance of these findings do not persist after adjustment, suggesting structural differences in the types of SNFs that hospitals are partnering with to improve information sharing. We conclude that while SNFs that accept complex patients are mostly keeping pace or even doing slightly better in terms of access to hospital information that supports transitional care, further investment is needed to improve hospital information sharing behaviors.