bluuebunny/crossref_metadata_2025_split huggingface dataset:
DEMENTIA AND HEARING LOSS: A DOUBLE HIT ON PATIENT-PROVIDER COMMUNICATION?
Authors: Powell Danielle , Reed Nicholas 
Published: December 2022

Abstract
Hearing difficulty may adversely impact patient-provider communication and be exacerbated by the presence of other conditions like dementia. We examined the association between reported Alzheimer’s disease/dementia and reported difficulty communicating with providers. Using the 2019 Medicare Current Beneficiary Survey, we included participants were aged ≥65 years who reported functional difficulty hearing. Exposure was the presence of reported Alzheimer’s disease/dementia. Our outcome is reported difficulty communicating with medical providers. Multivariate logistic regression was used for association between the added presence of dementia and reported difficulty communicating with healthcare providers. Among 5,535 beneficiaries reporting hearing difficulty, diagnosis of Alzheimer’s disease or another dementia showed 2.76(95%CI:1.97-3.87) times greater odds of reporting difficulty communicating with providers compared to not reporting dementia. In summary, older adults with reported hearing difficulty and dementia may have increased difficulty communicating with medical providers. Findings suggest hearing management may aid in improving health outcomes for adults with dementia.
THE EXPERIENCE OF THE COVID-19 PANDEMIC AMONG OLDER ADULTS IN PUERTO RICO
Authors: Burnette Denise , Haidar Yamile Martí 
Published: December 2022

Abstract
Older age groups and racial and ethnic populations are more likely to have medical conditions that increase their risks for illness, hospitalization and death from COVID-19. Puerto Rico has a high prevalence of acute and chronic health conditions and the lowest percent of people reporting good / excellent health of all U.S. states and territories. The effects of poor health on the island have been compounded in recent years by economic and political instability and by major natural disasters; yet, as of February 2022, 95% of persons aged 65 and older had received at least one vaccination and 88% were fully vaccinated. This symposium comprises five papers based on a study of personal, social, physical health, and mental health factors associated with COVID-19 in a community sample of 213 adults aged 60 and over in Puerto Rico. The first paper will introduce the study, including its purpose, theoretical framework, and methodology. Next, we will address methodological and ethical challenges of conducting research with older adults during the pandemic and strategies we used to overcome these. The third paper will report on the core focus of the project: to assess the knowledge, attitudes, and practices of older Puerto Ricans toward COVID-19. The fourth paper will focus on mental health effects of loneliness and loss, two of the most challenging exigencies of the pandemic for older adults. Finally, we will consider participants’ responses to open-ended questions about how they have coped with the pandemic and made meaning of their experiences.
FACTORS ASSOCIATED WITH HOME CARE AIDES' JOB SATISFACTION DURING COVID-19
Authors: Chunga Richard , Cimarolli Verena , Bryant Natasha , Boerner Kathrin , Stone Robyn 
Published: December 2022

Abstract
The COVID-19 pandemic has pronounced already high turnover rates among home care aides (HCAs). High turnover negatively affects home care quality. Job satisfaction among HCAs is a major driver of turnover, but little is known about factors associated with HCAs’ job satisfaction during COVID-19. Using survey data, the purpose of this study was to identify variables associated with job satisfaction among HCAs during the pandemic (N=114). Correlational analyses show that lower job satisfaction is associated with experiencing financial hardship, lack of PPE and employer protocols/guidance, understaffing, lower quality of employer communication related to COVID-19, and HCAs’ lower perceived preparedness to care for clients with COVID-19. In a regression analysis, experiencing financial hardship and lower quality of employer communication remained significant predictors. Findings underscore the importance of employer supports in HCAs’ job satisfaction and provide important lessons for how employers can support HCAs during the pandemic and beyond.
WORKING WITH COMMUNITIES TO INCREASE DIVERSITY, EQUITY, AND INCLUSION IN GERONTOLOGICAL RESEARCH
Authors: Chow Stephanie , Rooks Ronica 
Published: December 2022

Abstract
Gerontological researchers are encouraged to include older adults from underrepresented populations in their research and to think broadly about how they conceptualize diversity, equity, and inclusion (DEI) efforts in their work. This includes not only research on older adults from minority racial and ethnic communities, but also lesbian/gay/bisexual/trans*/queer+ (LGBTQ+) communities, as well as other cultural, religious, and socioeconomic groups. One of the most successful ways for reaching older adults in these populations is through community-based participatory research (CBPR). CBPR is a partnership approach to research that equitably involves community members, organizational representatives, researchers, and others in all aspects of the research process, with all partners in the process contributing expertise and sharing in the decision-making and ownership. Two papers in this symposium use CBPR to identify and include older adults from minority populations in their studies. A third paper reports on working with a Community Advisory Board to recruit bereaved dementia caregivers for research. The final paper walks us through steps to increase DEI efforts by meticulous research question development and thoughtful determinations regarding literature review terminology, recruitment efforts, data collection, and reporting and dissemination techniques.
SEX-DIMORPHIC REGULATION OF INNATE IMMUNITY DURING AGING
Authors: Benayoun Bérénice 
Published: December 2022

Abstract
Aging is accompanied by striking changes in chromatin and gene expression across cell types and species. Yet, how chromatin landscapes change with age and regulate transcription, and how epigenomic changes in turn influence aging in response to external or internal cues, is largely unknown. In addition, accumulating evidence indicates that sex hormones play a key role in driving aspects of cellular and molecular sex-dimorphism. In parallel to sex hormones, karyotypic sex (i.e. XX vs. XY) is also likely to have important impact outside of gonadal sex determination. A key compartment whose activity can be actively modulated by sex-dimorphic mechanisms throughout life is the immune system, whose function declines sharply with aging and may be actively modulated by sex. Indeed, aspects of the immune responses differ between sexes, with a more robust immune response in females and an increased susceptibility to infection in males. Thus, our main cell models of study are key components of the innate immune system and the inflammatory response: macrophages, which accomplish key tasks such as phagocytosis, antigen presentation and cytokine production, and neutrophils, the most abundant leukocyte type serving as a “first line of defense” against infection. Excitingly, we and others have observed strong sex-related differences in the transcriptional and functional phenotypes of these cells and have observed sex-dimorphic “omic” trajectories for these cells with aging. Based on our data and published literature, it is likely that mechanisms involving both gonadal hormones and sex chromosomes may fine-tune different aspects of immunity and, thus, overall health and lifespan.
MEXICAN AMERICAN CAREGIVER HEALTH AND TURNOVER: THE ROLE OF STRESSORS, RESOURCES, AND BACKGROUND FACTORS
Authors: Rote Sunshine , Angel Jacqueline , Markids Kyriakos 
Published: December 2022

Abstract
The purpose of this study is to explore the role of caregiver background, stressors, and resources for Mexican American caregiver turnover and depressive symptoms. Using two waves of the Hispanic Established Epidemiologic Study of the Elderly Caregiver Supplement (H-EPESE CG, 2010/2011-2016 N=333) and informed by the sociocultural caregiver stress process model, we estimate logistic and OLS regressions of caregiver turnover and caregiver depressive symptoms over five years. Neuropsychiatric expressions of dementia were significantly associated with caregiver turnover and relative to caregivers who were adult children of the care recipient, grandchildren caregivers and other kin and non-kin caregivers were more likely to experience caregiver turnover. While depressive symptoms were relatively low at both waves, there was a greater increase in depressive symptoms for caregivers who completed the interview in Spanish, which was partially explained by lower caregiver resources (e.g., support from others). The findings demonstrate the need for dementia care supports for Mexican American caregivers, improving support systems for Spanish-speaking caregivers, and supporting Mexican American caregivers who may be entering the role unexpectedly (e.g., grandchildren or non-kin).
DEPRESSIVE SYMPTOMS AND MULTIMORBIDITY IN CONTEXT: INTERPERSONAL, SOCIOCULTURAL, AND TEMPORAL EFFECTS
Authors: Mindlis Irina , Revenson Tracey 
Published: December 2022

Abstract
Among older adults with multimorbidity (MM), disease-related stressors (e.g., pain) are associated with greater depressive symptoms. However, the contextual factors influencing this relationship remain understudied. We explored the moderating effects of interpersonal, sociocultural, and temporal factors as buffers of this relationship. Adults ≥ 62 years with MM (n=366) recruited through a national health volunteer registry and an online panel platform completed validated scales assessing diagnoses, disease-related stressors (pain intensity, subjective cognitive function, physical function, somatic symptoms), depressive symptoms. Potential moderators: age, expectations regarding aging, perceived social support, and difficulty affording medications (proxy for SES). Data were analyzed with structural equation modeling. Participants were 62-88 years old and living with many illnesses (M = 3.5; range: 2-9); 15% reported moderate-to-severe depressive symptoms. Among those with low social support, the effect of disease-related factors on depressive symptoms was greater (B = .70, SE = .06, p &lt;.001) than for those with high social support (B = .46, SE = .06, p &lt; .001)]. The negative effect of disease-related factors on depressive symptoms was stronger for those with worse expectations of aging (B = .68, SE = .07, p &lt;.001), compared to those with more positive expectations (B = .47, SE = .06, p &lt; .001). Age and difficulties affording medications were not significant moderators. Among older adults with MM, garnering social support and addressing low expectations for old age may be key to preventing the detrimental effect of MM on mental health.
MEALS ON WHEELS UTILIZATION AND THE RISK OF HOSPITALIZATION AMONG MEDICARE ENROLLEES OVER TIME
Authors: Weaver France , Walsh Sarah , Chubinski Jennifer 
Published: December 2022

Abstract
Meals on Wheels (MOW) services provide nutritional and social support for clients and may influence acute care use as a result. This study estimates the associations between MOW utilization and the risk of hospitalization for Medicare enrollees aged 65 and over, according to the degree of home-boundness (an eligibility criterion for MOW access). Attention is paid to the heterogenous role of MOW according to gender, race, and ethnicity. The analysis uses the 2014-2020 National Health and Aging Trends Study (NHATS) and includes 17,345 person-year observations. The study uses longitudinal complex survey Probit models of the likelihood of hospitalization, including interaction terms between lagged MOW usage and the extent of home-boundness. Control variables include sociodemographic indicators, living arrangements, health status, region and time fixed effects. Over the study period, the mean probability of hospitalization for Medicare enrollees aged 65+ is 20.5 percent, and the proportion of MOW users is 5.2 percent. Some 11.4 percent report being partially homebound and 5.6 percent mostly/fully homebound. Results reveal that MOW utilization is associated with a lower risk of hospitalization for those who are partly homebound (p= 0.058). This negative association is the largest and statistically significant for males (p=0.034) and whites (p=0.035) only. Further investigations will assess whether these associations are explained by differences between MOW and non-MOW users. The findings suggest that MOW services may delay or limit, to some extent, hospitalizations among partly homebound Medicare enrollees.
IMPACT OF COVID ON PERSON AND FAMILY ENGAGEMENT IN ASSISTED LIVING
Authors: Beeber Anna 
Published: December 2022

Abstract
Advancing person-centered care in assisted living (AL), while minimizing safety risks (e.g., injury, elopement, or medication errors), requires effective partnerships among residents, family members, and staff. The COVID-19 pandemic adversely affected capacity across and within AL settings to establish and nurture these relationships, ultimately affecting and changing person and family engagement in care. Using data from qualitative interviews, we will report findings about person and family engagement in the safety of AL from the perspectives of 104 residents, families, and staff. Particular attention will be given to examining the effect of COVID-19 on person and family engagement for residents at increased risk for disparities in assisted living, including residents who are living with mild cognitive impairment or dementia. The presentation highlights both challenges and promising practices that emerged from the COVID-19 pandemic. Implications for AL are presented to support the transition from pandemic to endemic.
BEFORE A NEUROCOGNITIVE EVALUATION: ROLES AND COMPETENCIES OF BEHAVIORAL HEALTH PROVIDERS
Authors: Steffen Ann , Allen Rebecca 
Published: December 2022

Abstract
Neurocognitive disorders are among the most stigmatized medical conditions in the USA and across the globe. Cultural beliefs about cognitive aging also impact how individuals, families and healthcare teams respond to concerns about cognitive impairment. GSA’s revised KAER Toolkit for Primary Care Teams (Fall, 2020) provides useful information for the early stages of this process, including kickstarting the conversation about brain health concerns and conducting screenings. This presentation outlines additional competencies for behavioral health clinicians involved in patient, family, and health care team discussions regarding cognitive health concerns. Culturally responsive strategies and resources are suggested to help clinicians explore the decision for a formal evaluation and shape the nature of the referral question(s).
GSA’S CONGRESSIONAL UPDATE
Authors: Lindberg Brian 
Published: December 2022

Abstract
This popular annual session will provide cutting-edge information on what the 117th Congress has and has not accomplished to date, and what may be left for the lame duck session to address. Speakers will discuss key issues such as Social Security, Medicare, Medicaid, Older Americans Act, Build Back Better Act, social isolation, serious illness care, and funding. Predictions for the 118th Congress may be provided.
HOUSING AND COMMUNITY PARTNER VIEWS ON THE BENEFITS OF THE R3 PROGRAM
Authors: Miller Edward , Simpson Elizabeth , Nadash Pamela , Shellito Natalie , Lin Yan , Jansen Taylor , Cohen Marc 
Published: December 2022

Abstract
Housing with services programs have potential to benefit residents and operators of affordable senior housing communities. This study aimed to understand housing and community partner views on the benefits of the R3 program. Data derived from 31 interviews with R3 program managers and wellness team members, executives and direct service staff at the intervention sites, and community partners. Overwhelmingly positive overall assessments of the R3 program were reported. Concrete benefits to residents included receiving additional attention and support; connecting with family and health care resources; enhancing group programming; preventing ambulance transports; helping with transitions; and improving health and quality of life. Psychosocial benefits to residents included: empowering program participants; providing socio-emotional support; and alleviating psychosocial distress. Benefits to housing sites included augmenting staffing levels, skills, and capabilities; proactively tracking and responding to resident needs; lowering resident turnover; and learning from and adopting procedures and processes underlying the R3 philosophy.
TARGETING PARTICIPANTS AT HIGH RISK FOR ADVERSE HEALTH OUTCOMES IN THE R3 PROGRAM
Authors: Cohen Marc , Miller Edward , Nadash Pamela 
Published: December 2022

Abstract
The R32 program seeks to ensure that individuals at high risk for adverse health outcomes are identified, engaged, and linked to needed services. The program pays particular attention to identifying individuals with risks related to mental health, memory, nutrition, food insecurity, and emergency department or inpatient hospitalizations. Key performance indicators were tracked, including the number and proportion of participants whose needs were addressed by R32. Results indicate that the program has succeeded in engaging the vast majority (&gt;90%) of individuals with specific risk factors and connecting them with needed services. Viewed in the context of managed care plans, this level of performance is noteworthy and would earn the program a 5 Star rating – the highest rating available. Findings underscore the strong advantage offered by having a wellness nurse and wellness coordinator embedded on site in senior housing and using this platform to manage prevention and care services to residents.
ON THE THRESHOLD: CREATIVITY IN MID-LIFE
Authors: Adams-Price Carolyn , O'Neill Desmond 
Published: December 2022

Abstract
While late-life creativity has attracted significant scholarly inquiry, it is not clear that the same focus has applied to creativity in midlife and its relationship to creativity across the lifespan. Allied to a proposed symphonic concert by the Indianapolis Symphony of works from late midlife creativity with gerontologically-themed pre-concert talks occurring alongside GSA 2022, an activity curated by the Humanities, Arts and Cultural Gerontology Advisory Panel of GSA, this symposium will provide insights into a relatively under-explored aspect of creativity and aging, that of midlife creativity and its relationship to creativity at other stages of life. For many artists the most significant breakthroughs in style and critical reception are found in the works of midlife, and the symposium will explore the phenomenology and underlying themes of midlife creativity. This will include a review of the literature, a focus on midlife breakthrough and development in the creativity of Brahms and Janacek, interaction with the program of the parallel symphony concert, and a focus on arts and crafts creativity in people newly undertaking arts and crafts in mid-life. This will be complemented by a review of creativity and well-being from the age of 50 onwards.
RACIAL DISPARITIES IN THE ASSOCIATION BETWEEN VISION IMPAIRMENT AND FOOD INSECURITY IN THE US
Authors: Varadaraj Varshini , Kumar Priyanka , Brinson Jessica , Wang Jiangxia , Samuel Laura , Scott Adrienne , Swenor Bonnielin 
Published: December 2022

Abstract
We examined racial disparities in household food insecurity among low-income Americans with and without vision impairment in the National Health Interview Survey, years 2011-2018. Among 257,620 U.S. adults below a threshold of 150% poverty, 15% of White, 16% of Black, and 8% of Asian Americans, and 18% of American Indians and Inuits reported vision impairment. In analyses adjusted for sociodemographic variables, vision impairment was associated with &gt;100% greater odds (95% CI=2.01-2.31) of 30-day food insecurity, as compared to no vision impairment. Further, odds of household food insecurity were higher among Black Americans (OR=1.37, 95% CI=1.29-1.47), and American Indians and Inuits (OR=1.38, 95% CI=1.15-1.66) than White Americans, while Asians had lower odds (OR=0.45, 95 %CI=0.36-0.57). These findings highlight that low-income adults with vision impairment and racial minorities experience food disparities and dietary inadequacy, an area of disadvantage that can influence overall health, in a nationally representative sample in the U.S.
DEPRESCRIBING IN ASSISTED LIVING
Authors: Zarowitz Barbara , Brandt Nicole 
Published: December 2022

Abstract
Deprescribing is defined as the thoughtful process of “tapering, stopping, discontinuing, or withdrawing drugs, with the goal of managing polypharmacy and improving outcomes.” There are multiple clinical issues that deprescribing can address such as: antibiotic resistance caused by inappropriate and excessive use, the ongoing opioid epidemic, as well as over treatment particularly at the end of life. Networks have been established to address deprescribing across settings including assisted living nationally and internationally. Fourteen key informants from these networks were interviewed including different disciplines. From the interviews, six major themes across two domains were identified. The two domains included regional resources and knowledge gaps and the six themes included: (a) network structure, (b) public perception, (c) policy implications, (d) implementation, (e) challenges, and (f) recommendations. Overall, the importance of collaboration among interprofessional team members will be critical to the success of deprescribing as this clinical issue moves ahead.
Vector unmixing of multicomponent palaeomagnetic data
Authors: Tonti-Filippini Justin A D , Gilder Stuart A 
Published: December 2022

SUMMARYPalaeomagnetic investigations often encounter multiple magnetization components, where secondary processes have obscured, partially overprinted or completely replaced the original (primary) remanent magnetization. Identification and separation of primary and secondary magnetizations are generally carried out with principal component analysis of stepwise demagnetization data. However, rocks may contain multiple generations of magnetic minerals with overlapping unblocking ranges that complicate the discrimination of components when applying best-fitting line procedures. Developing a method to differentiate and quantify contributions of overlapping magnetic components using directional data is therefore highly desirable. This paper presents a method to unmix stepwise demagnetization data using an inverse modelling approach. We show that the method is capable of accurately resolving two or three magnetic components with overlapping or superimposed unblocking spectra as well as quantifying absolute component contributions. The method depends on accurate identification and selection of end-member components prior to analysis; in doing so, the method can help palaeomagnetists understand how magnetization components combine to explain their data. We show that the dilution of one component by more than ca. 25 per cent from another component can result in linear demagnetization curves that decay to the origin on orthogonal plots, but whose best-fitting direction can significantly deviate from both end-members. The efficacy of the method is demonstrated through examples of demagnetization data from hematite and/or magnetite-bearing sandstones from China. This method can be broadly applied to all multicomponent magnetization problems in palaeomagnetism.