bluuebunny/crossref_metadata_2025_split huggingface dataset:
PLACE OF DEATH FOR PEOPLE WITH DEMENTIA: EVIDENCE FROM THE CDC WONDER MORTALITY DATA
Authors: Amano Takashi 
Published: December 2022

Abstract
Previous studies have found that patients with dementia experience poorer end-of-life care compared to patients with cancer. Dying in the preferred place has become a common measure of the quality of end-of-life care, and it has been consistently reported that the majority of people prefer to die at home. Thus, this study examines whether dying from dementia is a significant determinant of the place of death in mortalities among older adults. The Mortality Data on Center for Disease Control and Prevention (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) between 2010 and 2019 were utilized. This study examined whether dying from dementia was associated with place of death (hospital, home, hospice facility, nursing home/long-term care facility) among deaths at 65 years or older. A multinomial logistic regression analysis was performed to estimate the association adjusted for covariates. We analyzed a total of 15,855,034 death records of which 12.34% were dementia deaths. The percentage of deaths at nursing homes was higher in deaths from dementia (56.5%) than other deaths (21.85%), whereas percentages of death at home were similar (20.7% for dementia death and 29.1% for other deaths). Multinomial logistic regression revealed that dementia deaths were 2.74 times more likely to occur at nursing homes than at hospitals compared to other deaths. Results suggest that dementia deaths are more likely to occur at nursing homes/long-term care facilities than other deaths. Further research should investigate the ways to improve the quality of end-of-life care for people with dementia in nursing homes/long-term care facilities.
CORRELATIONS OF GPS-BASED COMMUNITY MOBILITY METRICS BETWEEN PERSONS WITH DEMENTIA AND FAMILY CAREGIVERS
Authors: Chung Jane , Boyle Joseph , Wheeler David 
Published: December 2022

Abstract
Currently, the majority of dementia care is provided at home by informal caregivers. Most informal caregivers share a routine with their loved ones and change their activity patterns to adapt to a new routine of persons with dementia (PWDs). Given the dementia caregiving context, caregivers’ mobility behaviors and PWDs’ mobility may be positively associated. This study aimed to characterize patterns of GPS-derived community mobility in dementia dyads and examine relationships between PWDs’ and caregivers’ mobility patterns. Six dyads wore a GPS data logger inside and outside the home for 8-11 days. Twelve participants generated valid GPS track files (N=110). Four temporal and spatial mobility metrics were derived from GPS data (total distance, time use, median speed, and convex hull area). Then we calculated Pearson correlation coefficients between PWDs and their caregivers over all tracks. All dyads made active out-of-home trips, indicated by mean daily distance (range: 6,198 - 115,592m for PWDs; 5,125 - 108,857m for caregivers). Median speed of movement ranged from 0.09 to 1.29 km/hour for PWDs, and from 0.21 to 0.97 km/hour for caregivers. The mean size of convex hull over the monitoring period indicates a limited space usage level in both PWDs and caregivers, meaning restricted community mobility despite relatively large distance trips. The correlation coefficient was positive and significant for each metric (r = 0.70-0.97, p &lt; .001). These results suggest substantial agreement in the mobility metrics between PWD and their caregivers, indicating a high level of dyadic effects of a partner’s experience of community mobility.
EXAMINING SUBJECTIVE BURDEN AMONG SPOUSAL CAREGIVERS OF PARTNERS WITH DEMENTIA: THE IMPACT ON MARITAL QUALITY
Authors: Yorgason Jeremy , White Avalon 
Published: December 2022

Abstract
Although sometimes caregiving is associated with closeness in marriage, at other times the stresses may affect marriage relationships negatively. In the current study we explore how caring for a partner with dementia, and subjective burden are associated with marital quality. We further explore how dementia care and subjective burden might interact (suggesting a pileup of stress) to affect marital quality. Using data from 1,066 spousal caregivers that participated in the NSOC study and their corresponding care recipients from the NHATS study, the current analysis explored cross-sectional associations between spousal caregiving (primary vs. Secondary caregiver, subjective burden, gender, age, education) and partner care recipient characteristics (dementia classification, household income) predicting positive and negative marital quality. Results suggested that dementia classification and subjective burden were associated with lower positive marital quality and higher negative marital quality. The relationship between subjective burden and positive marital quality was moderated by whether or not the care recipient had dementia. Specifically, when dementia was present, the negative association between subjective burden and positive marital quality was stronger. Spousal caregivers often carry substantial burden to help their partners with activities of daily living. Care provision can alter the marriage relationship in negative ways when perceived burden is high. The current study suggests that the negative association between burden and positive marital quality is even stronger when caring for a spouse with dementia. Gender differences need further exploration, as well as how these patterns play out in early vs. later stages of dementia and across time.
DEVELOPING A MUSIC PROGRAM ON ZOOM FOR OLDER ADULTS WITH DECLINING COGNITION: A PROGRAM DEVELOPMENT REPORT
Authors: Dorris Jennie , DiCicco Heather , Becker James , Rodakowski Juleen 
Published: December 2022

Abstract
The coronavirus pandemic upended in-person programming for older adults with cognitive decline, presenting an urgent need to explore options to offer virtual programming. This program development report describes the adaptation of a music program for older adults with memory loss from in-person to a digital format. The objective was to develop a music program that was both engaging for the older adults, acceptable for the music instructor, and clearly defined for future research and implementation. This report describes the content of the music program and the systematic process of its development, including stakeholder interviews, acceptability surveys, fidelity reviews, and the developed instructor manual. With these structures in place, future research could begin to discern if digital music programming can support older adults in the same way that has been demonstrated in-person, potentially offering a new way to support the cognitive and social needs of a vulnerable population.
A MOBILE MUSIC APPLICATION FOR CAREGIVERS OF PERSONS WITH DEMENTIA: A USABILITY TESTING STUDY
Authors: Doyle Cassidy , Dobbs Debra , Wiechart Kelly , Wadhwa Rohan , Meng Hongdao 
Published: December 2022

Abstract
More than 11 million Americans spend an average of 26.3 hours caring for a person with dementia (PWD). Managing behavioral and psychological symptoms of dementia (BPSD) is a significant source of caregiver stress. Music-based interventions (MBIs) have been shown to be a pleasant activity enjoyed by both PWD and their caregivers, with the potential to help alleviate BPSD. However, current commercial music streaming services are not designed for families coping with dementia due to subscription and/or network connection requirements. This mixed-methods usability study tested caregivers’ experience with an open-source Android application (MUsic to Support Engagement and Resilience, or MUSER) as a potential platform for home-based MBI delivered by caregivers of PWD. In-lab and in-home testing sessions were conducted with 6 caregivers (2 former and 4 current caregivers, 1 male and 5 females). Semi-structured interviews were conducted before and after the in-home testing period between July and November 2021 to better understand User Experiences (UX). Family caregivers had a mean age of 57.8 (SD=26.2, range 20-77). The main themes identified from the interviews included ease of use, device and music preferences, and prior experience with technology. Overall, users reported high satisfaction and would recommend the application to other caregivers. Users reported that listening to music on the app elicited positive emotional effects (e.g., calmness and relaxation). The MUSER mobile music application can be used by caregivers to deliver MBI in the community. Future research should test whether a caregiver-delivered MBI would be efficacious in reducing BPSD among PWD.
EXERCISE BEHAVIOR IS DETERMINED BY PANDEMIC DISTRESS AND TASK BURDEN AMONG CAREGIVERS OF OLDER ADULTS
Authors: Nemati Donya , Keith NiCole , Kaushal Navin 
Published: December 2022

Abstract

Background
Caregivers who have dependents with dementia are at a much higher risk of heart disease and mental illnesses compared with non-dementia caregivers. Consequently, these outcomes have been exacerbated by societal barriers that resulted from the pandemic. Engaging in regular physical activity at a moderate-to-vigorous level (MVPA) is beneficial for caregivers has it has been shown to prevent several adverse health outcomes. However, pandemic-related (COVID-19) distress likely worsened caregiver burden which in turn compromised their MVPA levels. The purpose of this study was to understand how caregiving burden impacts MVPA when accounting for physical activity determinants from an augmented Theory of Planned Behavior (TPB) model.

Methods
Participants (n=127) were caregivers for older adults (65+) who have dementia. Participants completed measures of MVPA (behavior), TPB, pandemic-related distress (COVID Caregiver Risk Index) and burden scale for family caregivers. The study was investigated using a structural equation model.

Results
Participants were 45.5 (SD=3.4) years old, 76.4% female. Attitudes (β=.22, p=.012) and perceived behavioral control (β=.19, p&lt;.001) predicted intention. Attitudes and perceived behavioral control mediated the relationship between past behavior and intention (β=.17, p=.02). Covid distress predicted caregiver burden (β=.35, p&lt;.001), and caregiver burden mediated the effects between distress and behavior (β=-.12, p=.01).

Conclusions
Caregiver burden findings suggest that societal changes and demographic-specific burdens related to caregivers need to be considered for caregivers with dependents who have dementia. Taken together, exercise programs that focus on traditional behavioral determinants also need to include specific approaches to buffer caregiving burden experienced in this demographic.
REMOTE ELECTRONIC DATA CAPTURE OF MEDICATION USE AND AGITATION SYMPTOMS IN OLDER ADULTS WITH MCI OR DEMENTIA
Authors: Au-Yeung Wan-Tai , Miller Lyndsey , Gothard Sarah , Lindauer Allison , Kaye Jeffrey 
Published: December 2022

Abstract
Timely and objective knowledge regarding behavioral and psychological symptoms (BPS) in older adults with cognitive impairment or dementia residing in the community setting is challenging to obtain. The Monitoring Dementia-Related Agitation using Technology Evaluation (MODERATE) Study aims to identify longitudinal changes of agitation and related symptoms for dyads living at home with dementia. To date, MODERATE has enrolled seven dyads (a person living with MCI or dementia and a spousal caregiver). The mean age of the participants is 75.7 (8.5) years, the age of the spousal caregivers is 71.0 (6.0) years, and 5 out of 7 of the participants with MCI or dementia are male. We created an online survey, which is sent weekly to the caregivers, to inquire of any changes in medication and frequency of symptoms of agitation experienced by the persons with MCI or dementia in the past week. As of 02/22/2022, 102 weekly surveys (mean per participant = 14.6) were sent out via email; 99 responses were returned (response rate of 97.1%). One caregiver used a personal computer (PC) only, 2 used smartphone only and 4 used both PC and smartphone to complete the surveys. The median time to complete the online survey was 3.83 minutes with IQR 1.72 – 9.14 minutes. “Complaining, negativism, refusal to follow directions” were the most commonly reported agitated behaviors reported (43% of surveys). Caregivers can provide regular detailed symptom profiles and medication reports online. This approach may be used for more timely and informative management of BPS in dementia.
DECLINE OF AN ONLINE COGNITIVE COMPOSITE ASSOCIATED WITH MODIFIABLE LIFESTYLE FACTORS
Authors: Wu Chao-Yi , Wright Kirsten , Hantke Nathan , Kaye Jeffrey 
Published: December 2022

Abstract
Voluntary, self-administered online assessment platforms have gained popularity in monitoring cognition and lifestyle behaviors. This study used the AARP Staying Sharp online brain health assessment platform to estimate the progression of a cognitive composite and correlate it with six modifiable lifestyle behaviors (physical activity, diet, sleep, stress, social activity, and brain engagement) in 147,939 participants (68.6 ± 7.0 years old; 70% female). A cognitive composite was created using attention, immediate and delayed recall, and working memory tasks and lifestyle behaviors were collected by self-report. A lower frequency of exercise (p=0.01), a higher frequency of sitting (p=0.03), a lower frequency of getting in touch with family and friends (p=0.04), and the inability to manage stress (p=0.02) were associated with a decline in the online cognitive composite. A self-administered online assessment platform may be useful in informing lifestyle modification interventions for risk reduction of cognitive impairment and dementia.
WHAT DO LONG-TERM CARE LEADERS SAY ABOUT THEIR PREPAREDNESS FOR COVID-19? A QUALITATIVE STUDY
Authors: Liu Darren , Lane Sandi , Burston Betty , Rados Robert 
Published: December 2022

Abstract
The post-acute and long-term care (PALTC) sector has, in some respects, served as the epicenter in the U.S. during the COVID-19 pandemic. Many decisions were carried out by administrative and/or clinical leaders during this pandemic. The decisions were made based on their professional experiences, and recommendations by the Centers for Medicare & Medicaid Services (CMS). However, little research has reported on the perspective of those administrators who took the lead during this most difficult time. This study aims to understand how responses and decisions were formed during COVID-19 to ensure resources were available protect staff and residents. Accordingly, this study tried to answer two key questions: 1) What did the PALTC administrative and clinical leaderships learn? 2) What can we do better not if, but when COVID ever “…hits again?” We interviewed nursing home and/or assisted living administrators in two conveniently selected states: Pennsylvania and North Carolina. These interviews (each of which took about 30 minutes) were conducted over Zoom using structured and open-ended questions. The transcripts were entered and analyzed using NVivo – a qualitative data analysis software. The results revealed several themes including communications, relationship building, experience as an administrator, fears and resilience, as well as successful activities to support their staffs such as recognition, bonuses, and food bags prepared for their family. The findings highlight some important administrators’ thoughts which recommend key future strategies. These include whether preparedness assets, knowledge, resources, and policies were adequate and where the future efforts should focus.
IMMUNE RESPONSES TO MODERNA COVID-19 MRNA VACCINE IN FRAIL NURSING HOME PATIENTS
Authors: Semelka Charles , Sanders John , Alexander-Miller Martha 
Published: December 2022

Abstract
Prior COVID-19 mRNA vaccine trials included healthy older adults, but mRNA vaccine responses were not studied in frail older adults. We postulated that frailty was associated with immune responses of reduced quality and quantity following mRNA vaccination. A cohort of 15 older adults in a retirement facility were followed from the first Moderna mRNA-1273 vaccine dose in February 2021 with blood collections at baseline and weeks 4 (boost), 6, 18 and 28. Outcomes were IgG titers to SARS-CoV-2 Spike protein with secondary outcomes of T cell responses. Statistical analysis used log transformed geometric mean antibody titers in multivariable regression models with clinical predictors including, age, sex, prior infection status, and clinical frailty scale (CFS) score. Cellular immune response analysis used multivariable regression for function and phenotyping of T cell subsets. All participants with median (IQR) age: 90 years (84, 96) and CFS score: moderately frail 6 (5, 7) generated robust antibody responses with mean peak titer levels 10-fold higher than baseline. In the adjusted model, individuals with severely frail scores CFS=7 had lower antibody levels compared to mildly frail CFS=5, OR: 0.55 (0.35, 0.87) p=0.017. Both chronological age and sex had non-significant relationships with antibody titers. Spike peptide specific CD4 cells and T follicular helper cells were significantly decreased in more frail individuals (p=0.011 and p=0.008 respectively), though the relationship with antibody titers was non-significant. Frailty scores were a better predictor than age for serologic and cellular immune responses to COVID-19 mRNA vaccination in very old adults.
FRAILTY TRAJECTORIES AMONG WORLD TRADE CENTER GENERAL RESPONDERS
Authors: Ko Fred , Ornstein Katherine , Pedretti Nicolo Foppa , Colichino Elena , Bello Ghalib , Hung William 
Published: December 2022

Abstract
As the WTC cohort ages, it is important to examine whether there are differences in frailty trajectories over time in the cohort and examine clinical risk profiles of subpopulations with different trajectories. We used longitudinal data collected annually from the WTC data center and included all individuals with 3+ Clinical Frailty Index (FI) measurements after 9/11 to examine frailty trajectories using latent class growth mixture models. These patterns of change of Clinical-FI all showed an increasing trend over time, but there were three distinct patterns with different rates of increase. These were associated with distinct profiles of characteristics including sociodemographic, occupational and exposure level. WTC responders with higher age, working in construction, and higher-intermediate WTC level of exposure had higher rate of increase of Clinical-FI over time. While WTC responders with younger age, working in protective environment, and with higher education had lower rate of increase of Clinical-FI over time.
ANXIETY IN COMMUNITY-DWELLING OLDER ADULTS AND ITS RELATED FACTORS DURING THE COVID-19 PANDEMIC
Authors: Ma Yu , Greiner Chieko , Ryuno Hirochika 
Published: December 2022

Abstract
The rate of infection and magnitude of the effects of the coronavirus disease 2019 (COVID-19) pandemic has far exceeded the realm of what most people had previously experienced in their lives. There is an urgent need to ensure that strategies are in place to prevent and reduce anxiety in older adults. The present study aimed to assess anxiety in community-dwelling older adults and the related factors during the COVID-19 pandemic in Japan. A community-based cross-sectional study was completed in July 2021. The Japanese version of the Geriatric Anxiety Inventory was used to screen for anxiety symptoms. Demographical data and data for the following five other factors were collected: loneliness, mental well-being, perceived social support, coping behaviors to COVID-19, and fear of COVID-19. The association between anxiety and potential predictors was analyzed using binomial logistic regression. A total of 385 participants aged 65 to 86 years were included in the present study. 17% developed anxiety symptoms. Factors associated with anxiety were age, living alone, loneliness, significant people support, fear of COVID-19, and health monitoring as a COVID-19 coping behavior. Older age, living alone, and significant people support were associated with lower anxiety, and loneliness, fear of COVID-19, and health monitoring as a COVID-19 behavior were associated with higher anxiety in community-dwelling older adults during the COVID-19 pandemic. These findings can help to develop effective measures for reducing anxiety and will support the development of a psychological intervention for tackling the mental health of community-dwelling older adults during the COVID-19 pandemic.
SHOT ON THE SPOT VACCINATION COMMUNITY OUTREACH
Authors: McIntyre Alissa , Allen Rebecca , Cox Brian , Wilson Loretta , Payne-Foster Pamela , Oliver JoAnn S , Luo Yan , Lee Hee 
Published: December 2022

Abstract
Due to the COVID-19 pandemic disproportionately affecting Black communities, The University of Alabama (UA) partnered with the Rural Alabama Prevention Center (RAPC), a community-based healthcare organization to improve the vaccination rate from 34% vaccinated Alabama Black Belt residents to 70% over a year. Health literacy training is provided to community health workers and students who, along with the team members, volunteer at pop-up Shot on the Spot vaccination sites to administer surveys collecting demographics and vaccine hesitancy data. Team members provide health literacy information and answer questions non-vaccinated individuals have. This vaccination intervention has led to drastic rate increases, such as, Choctaw County having a 36.6% increase since the beginning of the project in August (30.7% to 67.30%). However, some counties have low vaccination rate changes, such as, Crenshaw County with a rate change of 15.4% (19.5% to 34.90%). Notably, the Alabama Black Belt currently stands at a higher vaccination rate compared to Tuscaloosa County (UA’s location), only having a rate of 44.3%. Within one year, there have been a total of 44 administered first and second vaccine doses and 435 booster doses, resulting in 50.24% vaccinated Black Belt residents. As the virus evolved into different variants, team members were able to observe an increase in administered booster doses in congruence with the rise of a new coronavirus variant. The partnership formed between RAPC and UA scientists and students is an important step in improving vaccination rates and building community research on minority and diverse populations.
FRAILTY AND AGE-RELATED CONDITIONS AMONG WORLD TRADE CENTER GENERAL RESPONDERS
Authors: Ornstein Katherine , Ko Fred , Park Amy , Sabra Ahmad , Ferreira Katelyn , Hung William , Lucchini Roberto , Thanik Erin 
Published: December 2022

Abstract
As WTC exposure may precipitate frailty, we examined patterns of frailty in the general responders cohort. We used two methods to assess frailty: a Clinical Frailty Index (FI) developed using a deficit accumulation approach utilizing clinical assessments performed during routine annual visits to a WTC clinical program in New York City; and a frailty questionnaire (5-point FRAIL scale) collected from a subsample of responders. Using a Clinical FI cutoff score of 0.25, over 25% of the 7,679 participants, median age 58.3 years (IQR 9.3), who had any visit to the WTC clinical program from 2017 to 2019, were frail. In a subsample of 100 participants with additional frailty assessment (FRAIL scale), we found that 27% were pre-frail, 5% were frail, 14% had recent falls, 9% had ADL dependencies; 34% had mild cognitive impairment. These data suggest that frailty and its related conditions are prevalent among the cohort despite younger age.