bluuebunny/crossref_metadata_2025_split huggingface dataset:
CONCURRENT CHANGES IN COGNITIVE FUNCTION AND FUNCTIONAL LIMITATIONS: A BIVARIATE LATENT TRAJECTORY ANALYSIS
Authors: Handing Elizabeth , Aichele Stephen 
Published: December 2022

Abstract
With a rapidly aging global population, declines in cognition and functional abilities are an increasingly salient challenge and fear among many older adults. Researchers and clinicians often study changes in cognition and changes in functional limitations as separate trajectories although they frequently co-occur. In this study, we used two-stage structural equation modeling (SEM) to estimate longitudinal trajectories of cognitive and functional limitations using data from the Health and Retirement Study (2010-2016) (N = 12,431, aged 50–91). First, individuals’ longitudinal factor scores (at three measurement occasions, spanning 6 years) were estimated for cognition (indicated by verbal fluency, numeracy, and recall memory) and functional limitations (indicated by difficulties performing daily living activities, instrumental activities, and mobility). A bivariate latent trajectory model was then fit to these scores. Model fit was acceptable (CFI = .91; RMSEA = .036). Parameter estimates showed that, on average, cognition declined slightly (-.08SD/decade) and functional limitations increased gradually (0.38SD/decade). Importantly, individual cognitive declines were significantly correlated with increases in functional limitation (r = -.19, p &lt; .001). This study fills an important research gap by using advanced statistical modeling (bivariate latent growth models) to examine the joint trajectory of cognition and functional decline which underscores the need to consider the interplay of these two abilities. Methods that quantify both individual and group trajectories can aid in better identification of aging patterns and lead to new ways of thinking about interventions to reduce the burden of concurrent decline.
EXAMINING AGE, RACE, AND COMMUNITY ON PREVENTIVE HEALTH AND COVID-19 VACCINATION AMONG ADULTS 65+
Authors: Patskanick Taylor , Ashebir Sophia , Balmuth Alexa , Lee Sophia , Le Joie , D'Ambrosio Lisa , Coughlin Joseph 
Published: December 2022

Abstract
During the ongoing spread of COVID-19 and its variants, older adults remain an age group particularly at-risk for poorer health outcomes, not only related to infection with COVID-19, but also due to disruptions in access to preventive health services, including routine vaccination. In the U.S., older adults have generally had high uptake of the COVID-19 vaccines, but differences persist regionally and between older adults from minority racial backgrounds. The purpose of the following study was to better understand how groups of Black and white-identifying adults ages 65+ described the impact of the COVID-19 pandemic on their preventive health behavior and healthcare use, including what contributed to their decision to receive or not receive a primary COVID-19 vaccination series. Seventy-five participants were purposively sampled and stratified into virtual focus groups based on their age, racial identity, vaccination status, and relationship to a local community. Findings leverage data from a pre-group questionnaire and focus groups conducted in November 2021. Analyses revealed differences among sub-groups about how the pandemic has impacted their relationship to their local community. Participants described the extent of the pandemic’s disruption to their healthcare access, including modifications to in-person care, use of telehealth, and engagement in new health behaviors. Decision-making related to the COVID-19 vaccine differed among the vaccinated and unvaccinated and white and Black-identifying groups, including factors related to interpersonal and systemic trust, independent research, and bodily autonomy. Implications of this research for public health and practitioners working with older adults will be discussed.
DAY-TO-DAY VARIABILITY BETWEEN AFFECT AND LEISURE ACTIVITY ENGAGEMENT IN BLACK ADULTS
Authors: Sardina Angie , Gamaldo Alyssa , Allaire Jason , Whitfield Keith 
Published: December 2022

Abstract
This study examined daily variability in affect and leisure engagement, within community-dwelling Black adults (age range=50-80 years). Associations between affect and leisure engagement, and moderating sociodemographic factors, were explored. Fifty adults (78% women; M education=11.62) reported affect and leisure engagement across 8-occasions over 2-3 weeks. Participants averaged 3-leisure activities/day with more engagement in watching TV, walking, reading, and visiting others. Significant within-person variation across daily affect and domains of leisure engagement were observed. Greater negative affect was significantly associated with lower social and total leisure engagement, particularly for adults with lower levels of education (p’s&lt;.05). Results demonstrate within-person changes in the type of leisure engagement among Black adults, with potential factors related to interconnections between affect and sociodemographics (e.g., education). This study reveals promising directions for future research to implement models estimating both between- and within-person effects of daily leisure engagement, within minority populations and across racial groups.
RELATIONSHIPS BETWEEN LEISURE CONSTRAINTS AND MODES OF TRANSPORTATION AMONG OLDER ADULTS IN SUBSIDIZED HOUSING
Authors: Tian Junyan , Tan Shyuan Ching , Sardina Angie , Gamaldo Alyssa , Ross Lesley 
Published: December 2022

Abstract
Transportation needs among lower-income older adults is understudied, particularly regarding how transportation utilization is related to leisure constraints. This preliminary study included 39 adults residing in subsidized housing in North Carolina and Pennsylvania (M=68.03, SD=10.26, female=74.4%) and assessed reported modes of transportation for daily activities and perceived leisure activity constraints. Much of the sample reported driving (57.9%) or relying on others to drive (70.3%) with a significant sample reporting use of public transportation (48.6%). Transportation utilization was differentially correlated with leisure constraints. Perceived difficulties getting to/from activities in the community was associated with greater utilization of having ‘others drive you’ (r=0.43, p=.011), but lower utilization of ‘driving oneself’ (r=-0.40, p=.019). Walking as a mode of transportation was associated with lower (r=-0.41, p=.014) perceived difficulties getting to/from activities in the housing complex. These results indicate the importance of further exploring the association between transportation and leisure needs of these lower-income older adults.
USING HYBRID EFFECTIVENESS DESIGNS TO FACILITATE IMPLEMENTATION: THREE CASE STUDIES IN DEMENTIA CARE RESEARCH
Authors: Gaugler Joseph , Baier Rosa , Fortinsky Richard , Gustavson Allison , Hodgson Nancy , McPhillips Miranda , Sefcik Justine , Gitlin Laura 
Published: December 2022

Abstract
This individual symposium presentation will provide case examples of three “hybrid effectiveness” trials in dementia care in different care settings including community-based and residential long-term care settings, each of which incorporate implementation methods alongside traditional evaluations of effectiveness. We offer considerations related to conceptualization, study design, sampling, data collection, and analysis that may guide gerontologists who aspire to adopt hybrid effectiveness designs in their own work. We conclude with methodological recommendations to incorporate an implementation science lens throughout the lifecycle of gerontological (and/or dementia care) intervention development. By applying key principles from implementation science throughout the intervention development process, a truncated and more efficient implementation pipeline may be achievable in gerontological research. Moreover, incorporation of implementation science methods into standard intervention development and testing methodologies will result in older persons, their families, healthcare providers, and communities having the best evidence available at their disposal.
INTO THE VOID: A CAREER IN INCONTINENCE… AND BEYOND
Authors: Resnick Neil 
Published: December 2022

Abstract
Long-believed inevitable with age, urinary incontinence (UI) --like dementia – has proved neither ineluctable nor untreatable. Moreover, older adults remain continent despite abnormal lower urinary tract (LUT) function! The key is that the LUT is just one risk factor, and incontinence results from contributors at every level: from drugs and diseases beyond the LUT, to problems of brain and physical function, to multiple issues within the LUT itself. Such insights have provided the rationale for a nontraditional diagnostic and therapeutic strategy, one that has not only improved outcomes but also enabled creation of previously-believed heretical approaches that address the LUT last and only if necessary. In addition, this approach enabled development of Medicare’s Minimum Data Set for frail elderly and, more importantly, may facilitate development of scalable ways to raise the floor of care for other geriatric syndromes as well.
ARTS AND CREATIVITY AND THEIR IMPACT ON HEALTH AND WELL-BEING: A SYSTEMATIC REVIEW OF THE EVIDENCE
Authors: O'Sullivan Roger , McQuade Laura 
Published: December 2022

Abstract

Aim
The aim of this mixed method systematic review was to develop a better understanding of the evidence on the impact of arts and creativity on the physical health and well-being of people aged 50+. Method: 73 studies were eligible for inclusion within the review and were appraised using the Mixed Methods Appraisal Tool.

Results
Dance was associated with improved balance, lower body physical strength and flexibility, aerobic fitness. Promising evidence showed that music and singing were associated with improved cognitive function, quality of life, affective states, and a sense of well-being. Preliminary evidence showed that visual and creative arts were associated with reduced feelings of loneliness, improved sense of community and social connectedness. Initial evidence showed that theatre and drama were associated with emotional well-being.

Conclusion
These findings highlight the value of participation in the arts and have implications for both public health and the arts and creativity agenda.
BEST PRACTICES IN COMMUNICATING ABOUT PALLIATIVE CARE TO PATIENTS AND PHYSICIANS
Authors: Kogan Alexis Coulourides , Rahman Anna , Lomeli Sindy , Enguidanos Susan 
Published: December 2022

Abstract
Home-based palliative care (HBPC) programs are proliferating across the U.S, yet face significant, documented challenges in promoting uptake of services and sustaining sufficient patient referrals. There is a tremendous need to understand effective methods for engaging physicians, patients, and caregivers in palliative care. Thus, the purpose of this study was to elicit best practices in how to communicate about HBPC to both healthcare providers and patients/caregivers. Focus groups with nine California-based HBPC organizations were conducted between January and April 2020. Discussions lasted approximately 54 minutes, were guided by a semi-structured protocol, audio recorded, and transcribed verbatim. Thematic analysis was used to identify themes and codes from the data. Twenty-five interdisciplinary HBPC staff members participated in a focus group. Most identified as white (76%), female (76%), and working in their current position for five years or less (56%). Three themes were identified from the data: (1) value of relationships; (2) communication do’s and don’ts; and (3) need for education. Participants discussed actionable recommendations for each theme. Study findings highlight several best practices for HBPC programs to communicate- and foster relationships with healthcare professionals and patients/families about palliative care, with education at the crux. Lessons learned about key words and phrases to say and to avoid are particularly valuable for budding HBPC programs. Our results suggest that HBPC providers exert enormous efforts to increase patient referrals and enrollment through strategic, continuous outreach and education to physicians, patients, and their caregivers; however, palliative care educational interventions are needed.
IMPACT OF SUBSIDY ON THE USE OF PERSONALIZED MEDICINE IN BREAST CANCER
Authors: Chen Cynthia , Lim Jue Tao , Lim Swee Ho , Tan Ern Yu , Tan Veronique Kiak Mien , Tan Su Ming , Tan Tira , Hartman Mikael 
Published: December 2022

Abstract
Advances in adjuvant therapy have led to increased survival rates after cancer prognosis. Herceptin, a targeted therapy, had first been introduced to Singapore in 2006. We aimed to assess whether subsidies for Herceptin from 2012 will lead to changes in uptake among Human Epidermal Growth Factor Receptor 2 (HER2) positive patients by socio-economic groups. Two-level random-intercept logistic regression was used to model diagnostic test and Herceptin uptake using the Singapore Breast Cancer Cohort from 2006 to 2018, adjusting for covariates such as education, housing type and marital status before and after subsidies. Interrupted time series (ITS) analysis was used to evaluate the impact of Herceptin subsidy on treatment uptake. The concentration index was also computed to measure inequality in uptake by ethnicity and education. We found that the odds of diagnostic testing were not associated with socioeconomic factors. However, before subsidies, the highest education attained (OR = 4.57, 95% CI= (1.90, 11.02), P&lt; 0.01) significantly increased the odds of Herceptin uptake. These odds were levelled after the introduction of subsidies to Herceptin treatment in 2012. After subsidy, we also found that Herceptin uptake increased significantly by 11.4% (95% CI= (3.47%, 19.4%), P=0.016). Also, inequality of Herceptin use decreased especially amongst the Indians, where at least 40% were used in the higher educated group prior to the subsidy. Subsidies have lowered the barriers to Herceptin uptake for marginalized individuals. Having targeted subsidies for socio-economically disadvantaged groups may work more efficiently in providing ease of access than a blanket subsidy in Herceptin.
POTENTIAL AND PITFALLS IN THE USE OF EXTENDED REALITY TO SUPPORT OLDER ADULTS
Authors: Boot Walter , Dilanchian Andrew 
Published: December 2022

Abstract
Extended Reality (XR), including Virtual Reality (VR) and Augmented Reality (AR), holds tremendous potential with respect to being able to support older adults' performance of Instrumental Activities of Daily Living (IADLs), activities crucial for independence, and Enhanced Activities of Daily Living (EADLs), activities that promote enjoyment, wellbeing, and quality of life. This presentation will draw from multiple empirical studies conducted within the CREATE Center, and other studies from the literature, on potential barriers older adults may face to obtaining these benefits. In particular, this presentation will focus on the construct of presence, the sense of "being there" in a virtual environment, which has been described as the defining characteristic of successful VR experiences, usability challenges, and challenges related to cybersickness.
PRESIDENTIAL SYMPOSIUM: EMBRACING OUR DIVERSITY IN GERONTOLOGY EDUCATION: PERSPECTIVES ON STRATEGIES AND LEARNERS
Authors: Montepare Joann , Bradley Dana , Baker Tamara 
Published: December 2022

Abstract
Our populations are not only becoming older, but also becoming more diverse on several fronts. Our new social structures call for new strategies for embracing our diversity in how we design and deliver education about aging in and beyond the classroom. In this AGHE Presidential Symposium, educators will discuss innovative and needed ways we can integrate diversity in gerontological pedagogical practices. To begin, Rona Karasik (St. Cloud State University) will discuss the call for integrating anti-racist strategies in classroom practices, and offer examples of several such strategies. Next, Brian Carpenter (Washington University in St. Louis) will discuss shrinking geropsychology pipelines, especially for students from racial and ethnic groups, and will share recommendations for expanding these pipelines. Aaron Guest (Arizona State University) will then discuss the need to extend diversity and education efforts to include LGBTQ individuals and issues. Karen Lincoln (University of Southern California) will discuss the need to move educational efforts beyond our classrooms to diverse learners in our communities. To this end, she will describe a dynamic academic−community partnership that provides aging-focused education to African-American older adults. Dana Burr-Bradley (University of Maryland, Baltimore County) will give the final presentation with a discussion about the need for an international lens that appreciates the global diversity of the aging experience. Tamara Baker (University of North Carolina, Chapel Hill) will serve as the discussant and offer her perspective on how the need to embrace our diversity in gerontology education cuts across all GSA units and connects them with AGHE’s educational mission.
DIVERSIFYING THE PATHWAY: A MULTIFACETED APPROACH WITHIN GEROPSYCHOLOGY
Authors: Carpenter Brian , Ma Flora , Hiroto Kimberly 
Published: December 2022

Abstract
Like other health services disciplines, geropsychology is facing a paucity of diverse intersectional identities within a larger shortage of interest in aging across all levels of training. We need an incisive and comprehensive plan to enhance the representation of historically marginalized groups within geropsychology and address systemic factors limiting entrance into the field. In this presentation, we review the projected need for mental health services attuned to equity, diversity, and inclusion and current trends in the geropsychology pathway. Then we describe several initiatives to expand attention to cultural humility and antiracism. These include the development of foundational competencies that include attention to diverse representations, which can be disseminated to pre- and post-licensure generalists and specialists; diversity-infused offerings within recent conferences and webinars; and efforts to intensify the focus on diversity within psychology’s aging-related professional organizations. Finally, we conclude with additional suggestions to expand and sustain attention to diversity.
THE PSYCHOSOCIAL IMPACT OF COVID-19 ON COGNITIVE AGING ARAB AMERICAN IMMIGRANTS IN MICHIGAN
Authors: Sayed Linda 
Published: December 2022

Abstract
This study examines the psychosocial impact of COVID-19 on cognitive aging Middle Eastern/Arab Americans immigrants and refugees in Michigan. Sociopolitical experiences as an immigrant and/or refugee may have unique effects on late-life cognitive health. Given that social engagement reduces the risk of ADRD, this study sought to examine the consequences of COVID-19 socialization restrictions on familial and communal support systems for aging Middle Eastern/Arab immigrants and refugees. Three focus groups discussions with 8-10 participants each (N=31) conducted at local Arab organizations and religious institutions were conducted followed by inductive analysis. Preliminary results indicate two prominent themes: 1) Social and Familial Hardships; and 2) Isolation. Narratives illustrate the prevalence of psychosocial ADRD risk from COVID-19. Findings are discussed within a stress framework to advance universal and unique elements of Arab immigrant and refugee cognitive aging.
COHORT EFFECTS IN OLD-AGE COGNITIVE AGING: A STUDY OF SOCIAL CONTEXT IN CHILDHOOD IN 140,030 OLDER ADULTS
Authors: Scott Stacey , Shawver Zared , Clouston Sean , Zhang Yun , Voll Stacey , O'Keefe Patrick , Rodgers Joeseph , Hofer Scott M 
Published: December 2022

Abstract
Researchers have reported that later-born cohorts often have higher scores on cognitive tests, potentially indicating that some of the differences normally attributed to cognitive aging may reflect developmental differences. The present study examined the hypotheses that social factors at birth and in early adolescence might partially explain birth cohort effects. This secondary analysis of data collected prospectively as part of four internationally comparable and nationally representative studies of individuals aged 50 and older residing in 17 European countries and the United States (N=140,030). Cognition was prospectively measured longitudinally 360,150 observations spanning, on average, 4.27 (SD=5.12) years allowing us to leverage age/cohort variability. Multilevel longitudinal modeling was used incorporated random intercepts and slopes at the country and individual levels to model lifetime cognition while adjusting for contextual factors. Birth cohort was associated with height (B=0.095, SE=0.002, P&lt; 1E-06), episodic memory (B=0.105, SE=0.001, P&lt; 1E-06), and verbal fluency (B=0.217, SE=0.002, P&lt; 1E-06). Approximately 7.72% (95% C.I.=[7.60-7.86]) of participants were exposed to at least two years of famine in childhood, and were born into countries with moderate levels of income inequality. Multivariable adjustment accounted for 15.10-24.96% of birth cohort effects in episodic memory and verbal fluency respectively. Longitudinal modeling revealed that after adjusting for famine, war, income inequality, educational attainment, and height, these factors explained 81.58-63.65% of the birth cohort effect in episodic memory and verbal fluency respectively. Global research has reported that early life factors can have an impact on development, so this study extends this to suggest these factors have a lifelong impact.
IN THE EYES OF THE BEHOLDER: RACE, PLACE, AND HEALTH
Authors: Velasquez Alfredo , Douglas Jason , Guo Fangqi , Robinette Jennifer 
Published: December 2022

Abstract
Racial and ethnic health disparities are fundamentally connected to neighborhood quality. For example, racial and ethnic minorities are more likely to live in neighborhoods with signs of physical disorder (e.g., graffiti, vandalism), and physically disordered environments have been noted to associate with increased risk for chronic illness. Given that older adults may spend more time in their neighborhoods than younger adults as they transition out of the workforce, examining associations between neighborhood physical disorder and health among older minorities is of critical importance. Using 2016-2018 Health and Retirement Study (HRS) data, a representative sample of US adults aged 51 years and older (n= 9,080, mean age 68 years), we conducted a series of weighted linear regressions to examine links between neighborhood disorder as rated by third parties and both participant-perceived neighborhood safety and self-rated health. Study results indicated that higher neighborhood physical disorder was significantly related to more neighborhood safety concerns among non-Hispanic White and Hispanic residents, but not among non-Hispanic Blacks. On the other hand, neighborhood physical disorder was significantly associated with poorer health among all racial/ethnic groups. These patterns persisted after adjusting for education, sex, age, and census tract concentrated disadvantaged, population density, and racial/ethnic diversity. Our results indicate that community level interventions targeting neighborhood physical disorder may improve community health and minimize racial/ethnic health disparities.