bluuebunny/crossref_metadata_2025_split huggingface dataset:
PRELIMINARY FINDINGS OF A STUDY ON LONGITUDINAL CHANGES IN EXPRESSED EMOTION IN FAMILY CAREGIVERS WITH DEMENTIA
Authors: Liu Xiaoji , Kanaya Reiko , Shigenobu Kazue , Takiue Keigo , Yamakawa Miyae 
Published: December 2022

Abstract

Purpose
The aim of this study was to explore and describe changes in expressed emotion (EE) among family caregivers of dementia and its associated factors at different time points over 3 months. Method: A longitudinal observation study using a 3-month survey was conducted in home care settings, Japan. We collected data on the demographic details of family caregivers currently providing care, which included care burden (Zarit Burden Inventory, ZBI), closeness of the caregiving relationship (Relationship Closeness Scale, RCS), depression (Geriatric Depression Scale, GDS). We used the validated Family Attitude Scale (FAS) to assess EE, in which higher scores indicate a greater intensity of emotional expression.

Results
To date, 45 family caregivers completed the present study. FAS scores were 39.67 ± 24.90 at month 1 (T1), 38.64 ± 23.28 at month 2 (T2), and 39.69 ± 24.52 at month 3 (T3). The change in FAS scores did not show a statistical difference over the three-month period (p=0.816). Multiple regression analysis of FAS at T1 showed that the main influencing factors were gender, marriage, RCS, care burden, and depression (R2=0.763, p &lt; 0.001); the main influencing factors at T2 were marriage and care burden (R2=0.584, p &lt; 0.001); the main influencing factors at T3 were care burden and depression (R2=0.674, p &lt; 0.001). Conclusions: Early identification of risk factors may help in the development of interventions to prevent high levels of EE in family caregivers. We plan to continue refining our analyses to test the validity of our hypothesis.
HEALTHY CAREGIVER SELECTION AMONG DEMENTIA CAREGIVERS: THE ROLE OF SOCIAL SUPPORT
Authors: Jiang Hantao , Wang Xueqing 
Published: December 2022

Abstract
As of 2019, more than 4 million older adults aged 65+ in the United States are cognitively impaired, including the diagnoses of mild cognitive impairment (MCI) and dementia. Caregivers to these older adults bear significant burden, reflected as high prevalence of chronic stress and mental health problems among the caregiver population. It is thus crucial to understand the wellbeing of the caregiver population to design effective policies. Previous studies have documented survival advantage of dementia caregivers compared to non-caregiving individuals as well as other types of caregivers, namely caregivers to persons with MCI or other types of chronic conditions. However, it remains less clear how the role of social support explains dementia caregiver’s survival advantage. In this paper, we directly compare the level and type of social support between different types of caregivers, and examine to what extent the difference in social support explains the survival and health advantage of dementia caregivers compared to caregivers to persons with MCI, non-cognitive impairment chronic conditions and non-caregiving individuals. We use the 12 waves of the Health and Retirement Study and apply multivariate and survival analysis to calculate difference in age-specific hazard ratios. Our preliminary results show that dementia caregivers tend to secure stronger support from family members than caregivers to persons with MCI. Our results have potential to shed light on the empirical puzzle of healthy caregiver selection effect and have direct implications for designing effective intervention to improve health of the caregiver population.
HEALTHCARE LITERACY AMONG INFORMAL CAREGIVERS: THE ROLE OF SOCIAL SUPPORT SYSTEM AND BURNOUT
Authors: Medcalf Robyn , Dayrit Jessika , Salom-Bail Shirley , Islaya Cesz , Foutz-Lowe Shelly , Alladi Renuka 
Published: December 2022

Abstract
Informal caregivers are integral components in the lives of individuals with health problems. However, little is known if the number of hours of informal care correlates with healthcare literacy levels. Thus, using the Center for Disease Control (CDC) Behavioral Risk Factor Surveillance (BRFSS) 2016 public dataset, the aim of this study examines the association between informal caregivers’ hours of care and their health literacy level, by controlling their social/emotional support, type of care they provide, and socioeconomic level. Data was weighted for complex sampling design and logistic regression to examine the data (Nf3,249). The study’s results show that being full-time or part-time caregiver has no association to healthcare literacy in verbal (OR=0.99, 95% CI=0.57–1.71) and written (OR=1.21, 95% CI=0.78–1.85) comprehensions. Further, caregiver’s type of care does not correlate to healthcare literacy level in verbal (OR=0.87, 95% CI=0.58–1.32; OR=0.93, 95% CI=0.59–1.45) and written (OR=0.91, 95% CI=0.66–1.27; OR=0.81, 95% CI=0.57–1.16) comprehensions. However, caregivers who rarely-to-never receive social/emotional support are four times more likely to have difficulties understanding verbal health information than those who have always-to-usually receive social/emotional support (OR=4.02, 95% CI=2.45–6.61). Caregivers who rarely-to-never receive social/emotional support are two times more likely to have difficulties understanding written health information compared to those that have always-to-usually receive social/emotional support (OR=2.30, 95% CI=1.51–3.51). Caregivers with lower socioeconomic backgrounds are at higher probability of low healthcare literacy level. Our study suggests further longitudinal and qualitative research, to understand healthcare literacy level among informal caregivers, and how social support systems correlates to healthcare literacy level.
USING ASSISTIVE TECHNOLOGIES AS A MEASURE TO SUPPORT WELL-BEING IN LATE-LIFE DISABILITIES
Authors: Su Tai-Te , Mejía Shannon 
Published: December 2022

Abstract
In the United States, the trends of disabilities among older adults have been largely stable over the past decade. However, the impact of disabilities on health and quality of life remains substantial and requires continued research. Along with a set of compensatory strategies, assistive technologies play a promising role in augmenting individuals’ capacity and reducing environmental demands in daily activities. Using data from the five survey rounds of the National Health and Aging Trends Study (2015‒2019), we aimed to investigate the longitudinal associations between disabilities, assistive technologies, and subjective well-being among older adults. A multi-class hierarchical spectrum was constructed to capture the state of disability and assistive technology use. Overall, results showed that subjective well-being decreased progressively along the spectrum. Additionally, assistive technologies were found to differentiate the associations between disabilities and well-being outcomes. Discussions focused on the insights and implications for successful accommodation to disabilities in later life.
EXERGAME INTERVENTION TO PROMOTE FAMILY CAREGIVERS’ SOCIAL SUPPORT, PHYSICAL ACTIVITY, AND WELL-BEING
Authors: Lin Xin Yao , Lachman Margie 
Published: December 2022

Abstract
Family caregivers often experience high stress, social isolation, poor mental and physical health, and have a sedentary lifestyle. The current study was a randomized trial (Nf76) comparing the effectiveness of Go&Grow (social vs non-social exergame app) to promote well-being through increased social support and physical activity for family caregivers over a 6-week intervention. Both groups received daily reminders to use the app. Findings showed the treatment group increased significantly more than the control group in well-being (management of distress) and social support (satisfaction with contact quality). There was an indirect effect of change in social support in which the treatment group increased more than the control group in satisfaction with contact quality, which in turn led to more positive affect and less loneliness. The increase in steps ranged from 3% to 12% across conditions. Social support moderated the relationship between condition and step changes, such that those in the treatment group who increased more in overall social support and knowing others’ experiences increased steps more than those with less support, while change in steps for the control group was not related to support level. In the treatment group, those who used the social features of the app more frequently had a greater increase in steps compared to those who used the social features less often. These findings can offer new insights into implementing behavior change mechanisms using exergames for sedentary and socially isolated family caregivers to improve their health with modifiable behavioral factors such as physical activity and social support.
POSITIVE AGEING AND DEATH OR DYING: A SCOPING REVIEW
Authors: Otto Robin , Fields Noelle , Anderson Keith , Bennett Michael 
Published: December 2022

Abstract
Ageing world populations and increases in life expectancy have facilitated an interest in developing ageing models that promote inclusivity and positive perceptions of ageing. This scoping review examines how and to what extent research that utilizes successful, active, productive, and healthy ageing framework(s) include death or dying. The study followed Joanna Briggs Institute’s methodological standard for scoping reviews and PRISMA guidelines and conformed to Arskey and O’Malley’s five-stage framework. A thematic analysis was used to identify how research utilizes the concepts of death and dying in the context of positive ageing models. The analysis identified five core themes: (a) the critique that death and dying dimensions in positive ageing models are absent; (b) older adults’ outlooks on death and dying while ageing well; (c) religious and spiritual dimensions of ageing well; (d) negative consequences of positive ageing models without death and dying dimensions; and (e) the future of death and dying in positive ageing models. The results bolster support for a paradigm shift that redefines what it means to age successfully without denying death. Incorporating the topics of death and dying into ageing conversations encourages individuals to ponder their end-of-life preferences and proactively participate in their advanced care plans. Death and dying conversations help care providers support people to live and die in a manner that is meaningful to them and inspire those receiving care to live fully and deeply and to think about the legacy that they want to leave.
EXPANDING WORLDS: ASSESSING STRATEGIES TO IMPLEMENTING A VIRTUAL REALITY PROGRAM IN RESPITE CARE
Authors: Quinones-Visot Emily , Bakk Louanne , Allen Katy , Milnamow Mary , Dauenhauer Jason 
Published: December 2022

Abstract
Virtual reality (VR) is an immersive experience that simulates real or imagined environments and provides an innovative solution to social isolation and loneliness. Implementation science was used to identify barriers and facilitators to implementing a novel VR intervention as part of a community-based participatory research project at Lifespan of Rochester within their Partners in Care (PIC) volunteer respite program. The VR intervention will be facilitated by PIC staff and volunteers with caregivers of community-dwelling persons living with dementia (PLwD) receiving respite services. A mixed-methods design was used to identify perceived barriers and facilitators to implementation. Focus groups and self-administered surveys were completed by PIC staff (Nf10) to assess their thoughts and concerns related to program implementation. Surveys included validated measures to assess self-rated ability to perform VR functional components, attitudes toward VR, beliefs on the acceptability, appropriateness, and feasibility of the VR program, effectiveness of improving comfort, confidence, and preparedness of facilitators. Identified barriers included lack of VR knowledge, skills, and confidence in capabilities; concerns related to safety, confusion, and triggers for PLwD; and the need to strengthen buy-in from staff. Implementation strategies were selected from the Expert Recommendations for Change project and tailored to support effective uptake and behavior change among PIC staff and volunteers. Identified evidence-based strategies included training and shadowing opportunities, identifying champions, and developing a trauma-informed approach manual. These findings illustrate the need to carefully examine organizational factors that can impede the implementation. The benefits of this approach and the lessons learned will be discussed.
DEVELOPING AN INTERPROFESSIONAL GRADUATE CERTIFICATE IN LONG-TERM SERVICES AND SUPPORTS
Authors: Towsley Gail , Elrod Leigh , Cox Nicholas , Varela Alberto , Edelman Linda 
Published: December 2022

Abstract
The demand for long-term services and supports (LTSS) is increasing and the capacity and competencies of the interprofessional LTSS workforce need to be expanded to provide value-based, person-centered care. The purpose of this presentation is to describe the process of developing an interprofessional LTSS graduate certificate in Gerontology. We broadened an existing nursing graduate certificate to encompass content related to skilled nursing facilities, assisted living and home health and hospice agencies. We will discuss: 1) how we engaged faculty from seven graduate programs: Pharmacy, Physical Therapy, Occupational Therapy, Dentistry, Social Work, Nursing and Physician Assistant to co-create the certificate; 2) challenges and benefits to developing a certificate; and 3) the 15-credit hour certificate components. Our faculty partners were committed to offering a LTSS focused graduate certificate which includes didactic courses and clinical hours. Four students have enrolled in the LTSS graduate certificate in Gerontology since implementation in Spring 2021.
ADOPTION OF SNFISTS BY US NURSING HOMES DID NOT REDUCE REHOSPITALIZATION RATES AMONG POST–ACUTE CARE PATIENTS
Authors: Jung Hye-Young , Kim Seiyoun , Ryskina Kira 
Published: December 2022

Abstract
SNFists, physicians and advanced practitioners who focus their practice in nursing homes, have grown in prevalence in recent years. In this retrospective cohort study, we measured the role of nursing home adoption of SNFists in rehospitalization rates. We used 100% Medicare facility and professional claims for hospitalized fee-for-service beneficiaries discharged to nursing homes in 2012-2019. We defined SNFists as generalist physicians and nurse practitioners with at least 80% of their Medicare Part B claims for nursing home care. All nursing homes that did not have a SNFist in 2012 were followed through 2019. We used an event study approach with staggered SNFist adoption to estimate the effect of a nursing home adopting at least one SNFist on the facility’s unplanned 30-day rehospitalization rate, adjusted for patient case mix, facility and market characteristics. Models included facility and year fixed effects. Standard errors were clustered at the facility level. Of the 6,616 nursing homes in the sample, 77% adopted SNFists by 2019. Nursing homes that adopted SNFists did not experience a statistically significant change in rehospitalization rate compared to those that did not adopt: rehospitalization rates decreased by 0.02 percentage points (95% CI -0.35 to 0.32; p=0.93) one year after SNFist adoption and by 0.15 percentage points (95% CI -1.01 to 0.70; p=0.73) six years after adoption, compared to the baseline difference between the groups in the year before adoption. In sum, despite the wide adoption of SNFists by US nursing homes, we did not observe an associated decrease in rehospitalization rates.
EXPLORING THE IMPLEMENTATION OF FOUR TRANSITIONAL CARE INTERVENTIONS FOR OLDER ADULTS: A COLLECTIVE CASE STUDY
Authors: Fakha Amal , Leithaus Merel , de Boer Bram , van Achterberg Theo , Hamers Jan , Verbeek Hilde 
Published: December 2022

Abstract
Four transitional care interventions, aiming to improve transitions between hospital and home settings for older adults, were implemented in Belgium. These interventions are complex in nature and their implementation in practice is often challenging. This study explores the implementation of these interventions from the perspectives of healthcare professionals involved in the process, and by investigating three implementation aspects: influencing factors, strategies used, and outcomes. A retrospective qualitative collective case study was conducted using semi-structured interviews with thirteen healthcare professionals. Thematic analysis was used, and the Consolidated Framework for Implementation Research guided the final data interpretation. Key findings indicated that implementation barriers were mostly at the organizational level (i.e., resources, structure, networks & communication), while facilitators were at the individual level (i.e., personal attributes, champions). The prominent strategy used to implement these interventions was engagement and additional strategies were suggested for the future sustainability of the interventions (i.e., building strategic partnerships, developing policies to support transitional care). The overall implementation was perceived as favorable with high adoption as a key outcome. This study highlights the crucial role of healthcare professionals, being motivated and committed to fostering the implementation of interventions in transitional care. It is important to use implementation strategies targeting factors at both the individual level as well as the organizational level for implementing transitional care interventions in the future.
GERIATRICIAN CO-MANAGEMENT AND EDUCATION OF JUNIOR DOCTORS IMPROVE THE CARE OF HOSPITALIZED OLDER SURGICAL PATIENTS
Authors: Thillainadesan Janani , Aitken Sarah , Monaro Sue , Cullen John , Kerdic Richard , Hilmer Sarah , Naganathan Vasi 
Published: December 2022

Abstract
We evaluated changes in processes of care after the introduction of a novel model of care for older vascular surgery inpatients. This model, called Geriatrics Co-management of older vascular surgery patients (GeriCO-V) embedded a geriatrician into the vascular surgery team who provided proactive geriatrics assessment of patients and education for junior surgical doctors. A pre-post study of the GeriCO-V model comparing prospectively recruited pre-intervention (n=150) and post-intervention (n=152) cohorts of consecutively admitted vascular surgery patients aged ≥65 years at an acute care academic hospital. Education of junior surgical doctors was embedded in the new model of care and included role modelling, provision of delirium and frailty screening lanyards and mobile Apps for ‘just-in-time’ learning, and a Wiki page of tips on assessing older patients. We measured processes of care by review of medical charts. After implementing the novel geriatrician and education embedded model of care, there was a significant increase in several processes of care by the junior surgical doctor: screening for cognition (8% vs 76%, p&lt;.001) and delirium (2% vs 69%, p&lt;.001), documentation of functional history (34% vs 76%, p&lt;.001), medications (53% vs 74%, p&lt;.001) and treatment preferences (5% vs 46%, p&lt;.001) and prescribing of pharmacological venous thromboprophylaxis (93% vs 99%, p=.03) and co-prescription of laxative with opioid (60% vs 81%, p=.002). A collaborative model of care that embeds proactive geriatrician care and education of junior surgical doctors improves the quality of care for older vascular surgical patients.
KEY PREDICTORS OF COGNITIVE AGING
Authors: Turiano Nicholas , Boron Julie Blaskewicz 
Published: December 2022

Abstract
Understanding who will experience cognitive dysfunction and dementia is as important as identifying methods to combat such deterioration. This symposium seeks to highlight new advances in understanding cognitive deterioration and promote resilience in adulthood. Odd and colleagues utilized a national sample (2,643 adults aged 34-85) to show that 9-year decreases in executive function and episodic memory predicted increased risk of dying. Use of a brief cognitive assessment administered via telephone was unique – a method that may assist clinicians administering cognitive screenings to older adults in isolated areas. Graham and colleagues utilized a daily diary approach in 116 older adults (aged 60-90) to show that greater daily fluctuations in mindfulness were associated with higher episodic memory and executive functioning. Further, mediational evidence suggested that on days when mindfulness was greater, individuals perceived a younger subjective age. Willroth and colleagues provide evidence that higher scores on eudaimonic well-being in older adults (n=349) predicted greater cognitive resilience. Specifically, even though some participants had neuropathological burden (e.g., increased beta-amyloid, neurofibrillary tangles), they did not exhibit pronounced cognitive declines. Using data from 14 longitudinal studies, Yoneda and colleagues examined the impact of physical activity on cognitive impairment and death. Multi-state survival analyses demonstrated engagement in more physical activity reduced risk of cognitive impairment and death. This symposium suggests that examining changes in cognition, incorporating subjective and objective indices of cognitive impairment, utilizing long-term longitudinal and daily diary designs, and testing key modifiable behaviors is crucial to understanding and promoting optimal cognitive functioning in adulthood.
WELL-BEING AND RESILIENCE TO DEMENTIA-RELATED NEUROPATHOLOGY
Authors: Willroth Emily , James Bryan , Graham Eileen , Kapasi Alifiya , Bennett David , Mroczek Daniel 
Published: December 2022

Abstract
Not all older adults with dementia-related neuropathology in their brains experience cognitive decline or impairment. Instead, some people maintain relatively normal cognitive functioning despite neuropathologic burden, a phenomenon called cognitive resilience. Using a longitudinal, epidemiological, clinical-pathologic cohort study (N=349), the present research investigated associations between well-being and cognitive resilience. Consistent with pre-registered hypotheses, higher eudaimonic well-being (i.e., Ryff Psychological Well-being Scale) and higher hedonic well-being (i.e., Satisfaction with Life Scale) were associated with better-than-expected cognitive functioning and less-than-expected cognitive decline relative to one’s neuropathological burden (i.e., beta-amyloid, neurofibrillary tangles, Lewy bodies, vascular pathologies, hippocampal sclerosis, and TDP-43). The association of eudaimonic well-being in particular was present above and beyond known cognitive resilience factors (i.e., socioeconomic status, education, cognitive activity, low neuroticism, low depression) and dementia risk factors (i.e., ApoE genotype, medical comorbidities). This research highlights the importance of considering eudaimonic well-being in efforts to prevent dementia.