bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE RISK OF DEMENTIA AMONG INDIVIDUALS WITH DEPRESSION AFTER A TRAUMATIC BRAIN INJURY
Authors: Ashby Joan , Nuno Miriam , Ugiliweneza Beatrice , Deshmukh Maya , Boakye Maxwell 
Published: December 2022

Abstract
Although traumatic brain injury (TBI) has been found to be associated with dementia and depression, large-scale studies of US non-Veteran populations are limited. This study assesses the role of depression on dementia risk after TBI. Data was analyzed from 80,423 individuals with TBI age 55+ in the IBM MarketScan Commercial Claims and Encounter Database and the Medicare Supplemental Database between January 1, 2000 and December 31, 2019. Dementia diagnosis was captured from inpatient or outpatient visits with a “wash out” period of one year. Depression was defined based on documented diagnosis and/or the prescription of antidepressants. The median age was 69 years, 51% female, with a majority covered by Medicaid (51%). 62% of TBIs were moderate/severe and 16% mild. 44,234 (55.1%) individuals were diagnosed with depression with a median of 2.1 months after TBI and 24.4 months prior to dementia. Depression rates differed by sex (female: 54%, male: 44%, p&lt; 0.0001) and insurance (Commercial: 36%, Medicaid: 49%, p&lt; 0.0001). The median time to dementia was 158 months. The median time to dementia was 128 months among those with depression, while patients without depression did not reach this estimate within 250 months of follow-up (p&lt; 0.0001). The risk of dementia increased significantly over time after depression among patients with TBI. This study provides evidence to support that depression after TBI represents a symptom of TBI rather than a prodrome of dementia. Future research will investigate the role of depression in the risk of dementia by race/ethnicity, insurance status, and TBI severity.
TAI CHI OR CONVENTIONAL EXERCISE ON PHYSICAL PERFORMANCE, SLEEP, AND QUALITY OF LIFE IN OLDER PEOPLE WITH DEMENTIA
Authors: Gao Ran , Greiner Chieko , Ryuno Hirochika , Ｇao Shuhong 
Published: December 2022

Abstract

Aims
This study was to compare the therapeutic efficacy of Tai chi and conventional exercise on physical performance, sleep efficiency and quality of life among older people with dementia.

Methods
Eighty-one elderly mild to moderate older people with dementia living in a nursing home in China were screened and randomized to three groups. The intervention groups received a 12-week Tai chi or conventional exercise intervention. Participants were assessed at baseline, week 6, and week 12 between December 2020 and July 2021. The primary outcome was short physical performance battery, secondary outcomes including the sleep efficiency and quality of life. Generalized estimating equations and one-way analysis of variance were the main statistical tests.

Results
The mean age was 80.7 (SD 7.7) years and 74.1% of participants were women. Analysis indicated that there was a significant difference in both intervention groups in short physical performance battery, sleep efficiency and quality of life relative to control from 0-12 weeks, and the Tai chi group had a substantial advantage over the conventional exercise group.

Conclusions
Tai chi and conventional exercise could improve physical performance, sleep efficiency and quality of life in older people with dementia. Furthermore, Tai chi could be a more effective approach to improve physical performance.
REJECTION OF CARE AND AGGRESSION AMONG OLDER VETERANS WITH DEMENTIA WITH AND WITHOUT POSTTRAUMATIC STRESS DISORDER
Authors: Kang Bada , Pan Wei , Karel Michele , Corazzini Kirsten , McConnell Eleanor 
Published: December 2022

Abstract
Veterans with co-occurring dementia and posttraumatic stress disorder (PTSD) living in residential long-term care encounter a range of physical and social stimuli, which may trigger trauma-related distress that can be exacerbated and manifested with care rejection and aggression. Yet, it is largely unknown how PTSD influences manifestation of care rejection and aggression in older veterans with dementia. Guided by the need-driven dementia-compromised model, this study examined the moderation effect of PTSD on pathways from background factors, and interpersonal triggers to care rejection and aggression among veterans with dementia with and without co-occurring PTSD. In this secondary analysis study, a multi-group structural equation modeling was conducted using program evaluation data of 315 veterans with dementia from the STAR-VA behavioral intervention implemented in 76 Veterans Health Administration-operated nursing homes. Although no moderation effect of PTSD on the overall model was found, findings revealed distinct patterns of relationships among background factors, interpersonal triggers, and care rejection and aggression between veterans with dementia with and without PTSD. The magnitude of the direct effects of interpersonal triggers on care rejection was greater in veterans with PTSD. Findings on the indirect effect of depression via interpersonal triggers on care rejection and direct effect of functional status on aggression only in veterans with PTSD implies that different mechanisms may underlie distressed behavior depending upon whether or not a veteran has PTSD. This study also underscores the importance of an enhanced focus on trauma-informed care, and individualized multi-component symptom management approach for veterans with dementia and PTSD.
RETURN MIGRATION AND AGING OF JAPANESE INDIVIDUALS LIVING IN GREATER NEW YORK: A QUANTITATIVE ANALYSIS
Authors: Toyama Itsuko , Nakashima Taeko 
Published: December 2022

Abstract
Our previous quantitative research studies have revealed that large numbers of older Japanese individuals living in overseas communities either maintain hope of receiving culture-oriented care or harbor aspirations of returning to Japan to live out their final days. Presently, by analyzing a quantitative research study on older Japanese individuals living in Greater New York in 2018, we clarify the characteristics of those individuals who have decided to return to Japan. In the research study, 2,057 questionnaires were distributed, and the overall return rate was 29.7%. Respondents were divided into three groups based on their answers regarding their intentions for the location of their final abode: the United States, Japan, or indecisive. We performed a multinomial logistic regression analysis based on age, gender, immigration status, having children in the United States, and academic background. The following is a summary of the findings: (1) as participants aged, the ratio of selecting either “Japan” or “indecisive” as opposed to “the United States” decreased, (2) compared to those holding citizenship, individuals with permanent residence selected both “Japan” and “indecisive” at greater rates (by approximately 3 times and 8.7 times, respectively); (3) compared to those having children in the United States, individuals without children in the United States selected both “Japan” and “indecisive” at greater rates (by approximately 1.8 times and 2.2 times, respectively); (4) individuals with a graduate career displayed a tendency to select “the United States,” and (5) gender and language proficiency were not critical attributes in determining the likelihood of selecting “Japan.”
BUILDING CAPACITY FOR PATIENT-CENTERED OUTCOMES RESEARCH IN THE AGING RESEARCH COMMUNITY
Authors: Gray Taylor , Webber Sophia , McGaffigan Erin 
Published: December 2022

Abstract
Patient-centered outcomes research (PCOR) models are increasingly used to ensure stakeholders inform evidence-based systems of care. Unfortunately, older adults, especially those of low income, frailty, and color, are often left out of PCOR, leading to continued health and service disparities. The Aging PCOR Learning Collaborative was funded by the Patient-Centered Outcomes Research Institute in 2020 to conduct a series of multi-media education, training, and mentoring activities to change how older adults are viewed and engaged in research. This project was strongly guided by multiple advisory structures, including two stakeholder advisory boards, two older adult paid advisors, and two student advisors, all of whom assumed an integral role in the design and implementation of project activities, dissemination of products, and analysis and reporting of evaluation methods. Project staff applied a multi-domain evaluation framework to analyze data relevant to these activities, which demonstrated the effective role of advisory structures and the project’s reach to over 300 older adults, researchers, funders, and academic leaders. This session will review the steps required to implement these activities as well as our project reach, outputs, and mid-term outcomes, providing one of the first glimpses into how to measure this significant shift in research paradigm.
EXPERIENCE OF UNFAIR TREATMENT IN HEALTHCARE SETTING AND RELATED STRESS AMONG OLDER AMERICANS: RACIAL/ETHNIC GAPS
Authors: Yi Eun-Hye , Hong Michin , Bolton Cherish 
Published: December 2022

Abstract
Guided by the intersectionality framework, this study examined the experience of unfair treatment in healthcare settings over lifetime and related stress. A subsample drawn from the California Health and Interview Survey 2017, including residents age 55 or higher, was used (N=12,261). Significant differences existed in unfair treatment and corresponding stress among racial/ethnic groups, including Whites, African Americans (AA), Hispanics, and Asian Americans (AS). Using weighted chi-square tests, we found that most Whites (75.99%) never experienced unfair treatment, while around 60% of AA answered never. Whites tended to feel extreme stress more when mistreated (23.47%) than Hispanics (14.83%) and AS (15.69%). Weighted logistic regression analyses revealed that younger older adults with lower mental health were more likely to experience unfair treatment across all race/ethnic groups. Intersectional factors contributing to unfair treatment experience were identified for each race/ethnic group. Being a female, living in poverty, poor health, being a naturalized citizen, and living in an urban area were factors for Whites while having higher education was a factor for AA. Mental health was associated with extreme stress for the unfair treatment in all racial/ethnic groups. Different contributors to the stress were found by race/ethnicity. Gender, poverty, citizenship, and length of staying in the U.S. were significant for Whites. For AA, poverty, healthcare insurance, and obesity were significant, and for AS, physical health and obesity were. This study highlights the importance of culturally/ethnically sensitive approaches shaping interventions and policies to enhance awareness about unfair treatment and preventing discrimination toward diverse older adults.
ACCEPTABILITY AND FEASIBILITY OF A CAREGIVER FINANCIAL PREPAREDNESS PROGRAM
Authors: Stratton Lauren , Grant Claire , Moreno Monica , Lanigan Kerry , Judge Katherine , Fazio Sam 
Published: December 2022

Abstract
Caregivers are often financially impacted, through health care costs, long-term care costs, and decreased income. A financial literacy program, Managing Money: A Caregiver’s Guide to Finances, was developed to provide information on financial impacts in caregiving. The virtual program was delivered synchronously with a live presenter through an online platform and was rated with high acceptability. The virtual program was then shifted to an online format. Changes included removing the live presenter and group format in favor of a voiceover and self-paced movement, the addition of videos, and online resources. The asynchronous, self-paced online delivery of the program was evaluated through a survey of 146 caregivers. Participants had a mean age of 45.85 (SD=5.65); 55% female; 75% White; 46% cared for their grandparent and 45% to their parent. A Likert scale was utilized to indicate satisfaction with the program (1=strongly disagree, 5=strongly agree). Overall, participants indicated that the program provided important information on managing money (M=3.97, SD=.83); helped to understand the content (M=3.89, SD=.91); was easy to read and understand (M=3.99, SD=.90); and would recommend the program (M=3.91, SD=.84). The explanation of content areas were rated on a Likert scale (1=poor, 4=excellent); participants rated areas including having conversations about finances (M=3.05, SD=.80); avoiding financial fraud and abuse (M=2.98, SD=.81); covering care costs (M=2.98, SD=.81); and organizing legal plans (M=3.09, SD=.80). Participants reported no difficulties that needed to be resolved when moving through the program. Overall, both the virtual and online formats were acceptable and feasible to caregiving populations.
EDUCATIONAL PREPAREDNESS IN MEETING THE NEEDS OF AN AGING POPULATION
Authors: Narine Donnette , Helsinger Abigail , Cummins Phyllis , Karam Rita , Punksungka Wonmai , Kramer Jenna , Yamashita Takashi 
Published: December 2022

Abstract
Community colleges play an important role in training adults in healthcare-related occupations, such as nurses and medical technicians, to meet the needs of an aging population in the U.S. In addition, community colleges with open access policies, have a long-standing record of serving a diverse population, including students of all ages. However, the relatively low program completion rates (e.g., about 30% in Ohio) are of concern in general, and among older students in particular. One of the reasons for the low completion rate is the lack of postsecondary education readiness or basic skills, such as literacy, numeracy, and digital skills. The COVID-19 pandemic has created additional challenges, including faculty shortages, lack of internet access, poor digital skills, and transitions to online classes. This study examined characteristics of health-related occupational programs at community colleges located in Washington, Indiana, and Ohio, focusing on adult student characteristics, and their administrators' and faculty’s views on basic skills and program completion. In addition, potential employers were interviewed regarding the skill expectations of community college hires. Using the semi-structured qualitative interview, community college administrators, faculty, and potential employers reported that numeracy skills, excellent grammar, and critical thinking skills are important to succeed both in the classroom and in the workplace. Creating a supportive atmosphere in the classroom and providing tutoring, either by the instructor or at a tutoring center, are also important for student success. More detailed results as well as other policy implications are discussed in this study.
DIFFERENCES IN COMMUNITY AND PROVIDER STAKEHOLDERS' PERCEPTIONS ON BRAIN HEALTH SERVICE GAPS AND SCREENING NEEDS
Authors: Rhodes Annie , Sargent Lana , Zanjani Faika 
Published: December 2022

Abstract

Introduction
Alzheimer's Disease and Related Dementias (ADRD) management and prevention is a priority for providers and community members. Aligning perceptions regarding resources and screening supports person-centered care while addressing the increased dementia burden attributed to systemic inequity and health disparities. This project aimed to identify needs in lower-income diverse populations.Research Question: What are the differences in perceived service gaps and screening preferences for brain health and ADRD?

Methods
A convenience sample of 15 providers and 20 community stakeholders (55+) completed a 2021 survey about Richmond's service gaps and screening needs for brain health and ADRD.

Results
40% of providers were ADRD focused, 65% of community members reported a memory concern. Overall, providers reported fewer service gaps: Administration on Aging Service Gaps 46.7%/75%, Caregiving gaps 80%/85%, Specialty Health gaps: 53.3%/80%. Clinical ADRD gaps 73.3%/80%, Memory Case Management gaps 86.7%/90%, Memory Social Services gaps 33.3%/90%, Memory Screening gaps 53.3%/85%. Provider and Community stakeholders were more aligned regarding screenings that should be included in a brain health/ADRD management program: Advance Care Planning screening: 80%/80%, Caregiving Status screening: 93.3%/90%, Memory Loss screening: Lifestyle Risk screening: 100%/95%, Cognitive-Comorbidity Risks screening: 100%/75%, Psychosocial Risks screening:100%/100%, Depression screening 100%/100%, Clinical Health screening 73.3%/90%, Substance Use Disorder screening 86%/75%, Sleep Problem screening 93%/75%

Conclusion
Although there were areas in which both providers and community members aligned, results show that providers underestimate brain health/ADRD service gaps experienced by the community. Both groups are amenable to comprehensive screening for services. However, providers are interested in more expansive ADRD screeners.
PLACE-BASED HEALTH DISPARITIES: FUNCTIONAL DISABILITY IN APPALACHIAN WEST VIRGINIA
Authors: Pullen Carly , Ibrahim-Bacha Kareem , Patrick Julie Hicks 
Published: December 2022

Abstract
Place-based health disparities contribute to disability across the lifespan. Additional examinations of contributors to morbidity and disability at mid-and late-life are needed to inform policies and programs. Using data from the 2020 Centers for Disease Control and Prevention’s (CDC) Behavioral Risk Factor Surveillance System (BRFSS), we examine some of the social determinants of health (e.g., age, gender, education, income) as predictors of access to health care and predictors of functional ability. The study included 5,880 adults living in West Virginia all between the ages of 18 to 65+ years. Access to healthcare was indexed by three variables, including whether one had medical insurance, saw personal physicians, and avoided medical treatment due to cost. Functional ability was indexed by reports of difficulty in three ADLs and the number of chronic health conditions. Although most paths were significant, our initial model fit the data poorly, X2 (DF = 39, N =5880) = 2503.6, p &lt; .001, CFI = .70, RMSEA = 1.0. We re-ran the model, using age as a moderator. In this set of analyses, the model fit well for middle-aged and older adults, but a different set of predictors characterized the relations for younger adults. Our results suggest that policies and programs that increase medical access for current middle-aged and older adults might decrease functional disability. Moreover, as younger adults age into midlife, they enter with lower economic and educational resources, further exacerbating their lack of access to health care and increasing disability.
NORMALIZING COGNITIVE EVALUATIONS IN ADULTS: GETTING PEOPLE IN THE SCREENING PIPELINE EARLY
Authors: Mehegan Laura , Raineville Chuck 
Published: December 2022

Abstract
To understand how adults and healthcare providers perceive a dementia diagnosis and cognitive evaluations, AARP fielded a nationally representative survey of adults aged 40 and older (N=3,022) along with a companion survey of healthcare providers in a position to diagnose dementia (N=500). Like healthcare providers, Americans aged 40 and older understand the benefits of diagnosing dementia at an early stage, 81% agree that early detection would motivate them to engage in healthier behaviors to slow the progression of the disease. Adults look to healthcare providers as authorities to determine when a cognitive evaluation should be triggered with 63% saying they would get an evaluation if their doctor recommended it and 49% of healthcare providers saying evaluations should be done if the doctor feels it is necessary and 39% saying it should be done yearly beginning at age 65. The research also showed that most adults (76%) want to know if they have dementia. Additionally, majorities of adults would engage in healthy behaviors if they knew it’s good for their brain health. Given the desire to prevent and improve outcomes, routine screening for cognitive function should be as commonplace as getting a screening colonoscopy. Unlike a colonoscopy, routine screening for cognitive function is not a normalized process yet. Data from both populations suggest an opportunity for routine evaluation due to a shared understanding of the long and short-term benefits of screening.
NONVERBAL STRATEGIES TO ENHANCE PERSON-CENTERED COMMUNICATION WITH PEOPLE LIVING WITH DEMENTIA
Authors: Bender Emma , Savundranayagam Marie , Murray Laura , Orange Joseph 
Published: December 2022

Abstract
Many people living with dementia experience difficulties comprehending language, and benefit from nonverbal communication (NVC). Yet, little published empirical evidence exists for care partners regarding NVC strategies that support person-centered communication with perons living with dementia. This study aimed to determine whether NVC strategies used by personal support workers accompany verbal communication demonstrating person-centered communication indicators (facilitation, negotiation, recognition, validation). Secondary data analysis of video-recorded interactions (n=40) between personal support workers and simulated persons living with dementia was conducted. The recordings were transcribed according to communication-units, which were coded for person-centered communication and NVC, using a novel coding system consisting of ten NVC strategies. The overlap between NVC strategies and verbal person-centered communication was examined. Findings revealed that personal support workers frequently accompany verbal person-centered communication with NVC strategies. Out of 1848 communication-units in which person-centered verbal communication was used, 69% overlapped with NVC strategies. Gaze overlapped with all person-centered communication indicators frequently, both individually (40% – 49% of overlapping communication-units) and when combined with touch (13-24%). Gestures using objects (with and without gaze) frequently accompanied facilitation (17%) and negotiation (21%), while positive facial expressions (with and without gaze) were commonly found in recognition (16%) and validation (16%). The use of NVC strategies which support person-centered communication may lead to communication enhancement, in turn improving interactions and relationships between persons living with dementia and their care partners.
FEASIBILITY OF THE ACTPLAN PROGRAM FOR AFRICAN-AMERICAN DEMENTIA CAREGIVERS: A SELF-DIRECTED MULTIMEDIA DELIVERY
Authors: Watkins Yashika , Tharpe Rita , Aggarwal Neelum , Bonner Gloria 
Published: December 2022

Abstract
African Americans (AA) are less likely than White Americans to complete advance care plans or end-of-life treatment documents. They face significantly greater risk of Alzheimer’s Disease, a silent epidemic for this population, and other dementias. The healthcare system’s lack of dementia support for AAs contributes to disparate care. A four-session caregiver group education program was conducted on advance care planning for AA dementia family providers. The program was based on Kolb’s Experiential Learning Model and initially found effective in an R01 study using in-person delivery by a professional. The present pilot assessed feasibility of delivering the program in a self-directed multimedia format without professional facilitation, using Session 1 on tube feeding decisions as the test session. Twenty-six AA dementia caregivers completed the session in groups of 5 to 8 at a church equipped with a large TV screen. On-screen prompts guided navigation through the program which included recorded lecture, slides, short videos on decision-making, and group discussions. Using quantitative and qualitative methods, pre-and post-survey instruments were administered and interviews conducted. Usability ratings averaged 84%. Knowledge and self-efficacy gains exceeded those of the R01, with a 35% increase in correct responses on knowledge items, versus 18% for the R01 subjects; and increase in perceived decisional self-efficacy of 31% versus 30% for the R01 subjects. Qualitative feedback was universally positive. These findings confirm the feasibility of the self-guided multimedia approach to delivery of the program. A large RCT is planned which, if successful, will support wide dissemination to AA caregivers in need.