bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE EFFECT OF SHORT DURATION BED REST AND TYPE 2 DIABETES MELLITUS ON ARTERIAL STRUCTURE AND FUNCTION IN OLDER ADULTS
Authors: Masterova Kseniya , Moro Tatiana , Volpi Elena 
Published: December 2022

Abstract
Type 2 diabetes mellitus (T2DM) and inactivity individually accelerate changes related to vascular aging. These changes increase cardiovascular risk and contribute to morbidity and mortality in the elderly. It is unknown if T2DM and bed rest have an additive, deleterious effect on vascular structure and function in older adults. The objective of this study is to determine the magnitude of the effect of bed rest on vascular structure in older adults with T2DM compared to healthy controls and determine if resistance exercise is protective of this effect. So far, we have recruited T2DM (n=9) and healthy control (n=17) subjects (age: 67.0 ± 6.7 years) to undergo five days of bed rest. During bed rest, subjects were randomized to receive intensive bedside resistance exercise physical therapy or standard of care in-bed passive physical therapy. On bed rest days 1 and 5, popliteal artery diameter, area, blood velocity, and blood flow were measured using Doppler ultrasonography. Our preliminary data show that the T2DM, non-exercise group had significantly greater decreases in popliteal artery diameter (-0.59 mm ± 0.18) than the control, non-exercise group (-0.17 mm ± 0.11). Resistance exercise did not prevent artery size changes in either controls or T2DM. Resistance exercise showed a trend in preventing blood velocity and flow reduction in both T2DM and control groups. These preliminary data suggest that older adults with T2DM had greater structural popliteal artery changes compared to controls. Resistance exercise appears to help maintain blood flow by maintaining/increasing popliteal artery blood velocity, but not size.
UNTREATED OBSTRUCTIVE SLEEP APNEA INCREASES HOSPITALIZATION RISK IN MEDICARE BENEFICIARIES 65+ WITH HEART DISEASE
Authors: Kirk Jennifer , Wickwire Emerson , Somers Virend , Albrecht Jennifer 
Published: December 2022

Abstract
Cardiovascular disease (CVD) is a leading cause of death and disability in the United States and worldwide. Untreated obstructive sleep apnea (OSA) is common among older adults with CVD and may increase their risk of hospitalization. However, prior research has been limited by smaller samples of participants undergoing diagnostic sleep testing. Our objective was to estimate the effect of untreated OSA on the risk of hospitalization among older Medicare beneficiaries with CVD age 65+. Using a 5% sample of Medicare administrative claims data from 2006 to 2013, beneficiaries were identified as cases diagnosed with OSA or controls without any sleep-related diagnoses. Then, we restricted only to beneficiaries with a CVD diagnosis by the index date (i.e., OSA diagnosis date or matched date in controls). Next, we assessed the risk of hospitalization, counting only one per beneficiary, during the year before the index date. Because OSA is typically present long before it is diagnosed, the year before OSA diagnosis was assumed to represent a period of untreated OSA. Covariates were balanced between cases and controls using inverse probability of treatment weighting (IPTW). Then using logistic regression, we estimated the risk of hospitalizations the year prior to the index date. Of the 142,893 beneficiaries with CVD, only 19,390 were diagnosed with OSA. In the IPTW model, beneficiaries with untreated OSA were more likely to be hospitalized (odds ratio, 1.82; 95% CI 1.77–1.87). Results suggest screening for OSA among Medicare beneficiaries with CVD may identify older adults at increased risk of hospitalization.
HEALTHCARE UTILIZATION IN OLDER ADULTS (≥70 YEARS) UNDERGOING CELLULAR THERAPY FOR HEMATOLOGIC MALIGNANCIES
Authors: Snider Christina , Budhwani Hina , Logue Melissa , Goyal Parul , Pugh Kelly , Murff Harvey , Kassim Adetola , Jayani Reena 
Published: December 2022

Abstract
Increasingly, older adults are receiving hematopoietic cell transplant (HCT) and chimeric antigen receptor T-cell therapy (CAR-T), intensive therapies for treatment of hematologic cancers which typically require prolonged hospital admissions. Older adults are at high risk of increased healthcare utilization and complications of prolonged hospitalization [Mudge, J Am Geriatr Soc, 2019]. We identified patients age ≥70 years who received HCT or CAR-T in a primary outpatient transplant program at Vanderbilt University Medical Center between 1/1/19 and 12/31/20. Healthcare utilization, including all visits and admissions, was captured from the start of conditioning chemotherapy through early post-therapy. Thirty-eight patients met inclusion criteria; 26 (68%) received autologous HCT (autoHCT), 7 (18%) allogenic HCT (alloHCT), and 5 (13%) CAR-T. Twenty-four patients (63%) had high HCT-Comorbidity Index (HCT-CI). Eighteen (69%) autoHCT, 6 (86%) alloHCT, and no CAR-T patients had at least one unplanned admission. The median number of total hospital days (LOS) was 7.5 (2-14), 8 (4-62), and 9 (7-9) days, respectively. One-year mortality was 12% (3) in autoHCT, 43% (3) in alloHCT, and 0% in CAR-T. Low performance status and high HCT-CI did not correlate with LOS (p=0.58 and p=0.16, respectively) or number of outpatient visits (p=1, p=0.19). In conclusion, most patients who received auto- or alloHCT in a planned primary outpatient setting experienced at least one unplanned admission. LOS duration varied widely with shorter LOS among autoHCT patients. Further research is needed to identify factors among older adults (≥70 years) at risk of increased healthcare utilization during HCT or CAR-T.
OLDER DYADS USING A WEARABLE PERSONAL SLEEP MONITORING DEVICE FOR SLEEP SELF-MANAGEMENT
Authors: Jacelon Cynthia , Torrisan Maral , Fiske Sarah 
Published: December 2022

Abstract
Normally occurring changes in sleep patterns can affect behavior, safety, and function in older individuals. In addition, altered sleep of one partner can affect the functioning of the other. We tested a novel intervention using an off the shelf, wrist-worn actigraph as a personal sleep monitoring device (PSMD) with dyads comprised of individuals who were 70 years old or older, and slept in the same house. Aims included: 1) Establish the feasibility of sleep self-monitoring using PSMDs, as a self-management strategy. 2) Establish the feasibility of PSMD data sharing among members of the dyad to improve sleep self-management and improve sleep quality; and 3) Evaluate the usability of PSMDs and data sharing for dyads of older individuals. Over the course of a five-week trial, we used a mixed methods approach. Data were comprised of daily sleep diaries, data from the PSMD, weekly questionnaires regarding sleep patterns and function, and qualitative interviews focused on sleep, self-management within the dyad, and the usability of the PSMD. Data were analyzed using qualitative or statistical methods. The use of the PSMD increased awareness of sleep patterns at the individual and dyadic levels, but the limitations of the PSMD were frustrating. Participants valued having a graphic image of how their daily activities affected their sleep patterns. The dyadic approach was effective in improving sleep patterns for older individuals, and using over the counter activity monitoring devices provide a relatively inexpensive way to assist older adults to improve their sleep self-management.
CHANGES IN PATTERNS OF FORMAL AND INFORMAL HELP AND UNMET NEEDS AMONG KOREAN OLDER ADULTS
Authors: Lee Seoyeon , Cha Seung-Eun , Kim Kyungmin 
Published: December 2022

Abstract
Despite the consistent expansion of social long-term care insurance (LTCI), informal care by family members is still dominant in Korea. This study aims to examine how older adults in need utilized formal and informal sources of help and how patterns of help and unmet needs changed over time, since LTCI has been introduced in 2008. Community-dwelling older adults (65+) from the Korean Longitudinal Study of Ageing (N = 2,501) reported their I/ADL limitations and who helped them—if they are in need in 2010 and 2018. We grouped older adults’ sources of care into (a) no help, (b) informal help only, and (c) any formal help, and examined the patterns by wave and gender. Among older adults with I/ADL limitations, formal help use increased between waves (1% to 12%), suggesting the impact of LTCI expansion. Changes in the patterns of help and unmet need differed by gender. The proportion of older men with no help dramatically decreased (41% to 27%); more men received informal or formal help in 2018. In contrast, the proportion of older women who did not receive any help remained similar (33% to 34%); thus, although more women received formal help, less women relied on informal help in 2018. Within the context of LTCI expansion, older men may mobilize support from their family further, which contributes to lowered unmet needs. However, older women’s unmet need did not decrease, while reduced use of informal help. These findings highlight the importance of considering gendered long-term care resources in Korea.
EFFECTS OF PARENTING STYLE IN CHILDHOOD ON MENTAL HEALTH OUTCOMES OF CAREGIVING IN ADULTHOOD: A QUALITATIVE ANALYSIS
Authors: Baumbach Abby , Hughes M Courtney , Derain Lily , Liu Yujun 
Published: December 2022

Abstract
The life course perspective suggests that caregivers of aging parents bring their histories of relationships with aging parents, such as childhood maltreatment, to the care environment. These histories would then impact the dynamics and consequences of caregiving. However, there is a lack of research on the impact of childhood parental interactions on adult relationships with aging parents, particularly in the context of caregiving. The study aims to understand how relationships with caregivers while growing can impact an individual's role as a caregiver later in life. The qualitative study included 47 adult family caregiver survey respondents who care for their parents, with a mean age of 46.7, ranging from 20 to 79 years old. The respondents were asked to reflect on their recent experience of providing care for their loved ones and how experiences with their caregiver growing up may have influenced their current relationship dynamic. The researchers used Dedoose V.9.0.17 to perform a codebook thematic analysis. Themes from the survey analysis linking childhood to current experience included reciprocating good care, performing obligatory care, and stopping the generational transference of negative care. When focusing on specific parental genders when receiving care in childhood, levels of presence and affection stood out as important aspects of their father’s caregiving. Themes associated with maternal caregiving included good relationships, strained relationships, and nurturing. Knowledge about the impact of childhood experiences can help program designers develop interventions to help lessen caregiver burdens that consider childhood care receiving experiences and the challenges and opportunities they present.
IMPACTS OF CAREGIVING ON WELL-BEING AMONG SPOUSAL CAREGIVERS TO OLDER ADULTS USING COARSENED EXACT MATCHING
Authors: Liu Ruotong , Chi Iris , Wu Shinyi 
Published: December 2022

Abstract
Spousal caregivers to older adults may be at increased risks of negative health outcomes because they are also dealing with their own aging and health issues. Estimating the impacts of caregiving without controlling for caregivers’ own aging and aging-related health decline could exaggerate the negative health consequences of caregiving, whereas focusing on caregivers only could face the risk of selection bias where healthier individuals enter and/or remain in caregiving. In this study, we used coarsened exact matching to compare outcomes in wellbeing between spousal caregivers and spousal non-caregivers. Pooled panel data from Wave 8 to Wave 13 in the Health and Retirement Study was utilized with two consecutive waves of data for each spousal caregiver. The sample included 203,162 person-wave observations from 5,162 unique individuals, among whom 3,577 were spousal caregivers. Variables used for matching were classified into three categories: care obligations, the willingness to provide care, and the ability to provide care. Outcome of interest was depressive symptoms measured by CES-D 8. A total of 2,741 (81.01%) spousal caregivers were matched with 18,043 observations of spousal non-caregivers. Regression analysis indicated that being a spousal caregiver was statistically significantly associated with a 0.27 unit increase in depressive symptoms in the subsequent wave, after controlling for other potentially confounding variables such as caregiver’s race/ethnicity, length of current marriage, etc. Our results highlighted the elevated needs to address mental health among spousal caregivers, and indicated that long-term care program and policy should take into consideration the mental health among spousal caregivers.
MEANING FOCUSED COPING: IMPLICATIONS FOR FAMILY CAREGIVER BURDEN AND POSITIVE ASPECTS OF CARE
Authors: Dieker JoAnna , Qualls Sara 
Published: December 2022

Abstract
The Stress Process Model (Pearlin et al., 1991) posits that different styles of coping influence both positive and negative psychological outcomes in family caregivers. Meaning-focused coping is hypothesized to promote positive psychological experiences, but presently it is unclear how meaning-focused coping is related to caregiver burden. The present study tested the associations among meaning-focused coping, indicators of burden, and positive aspects of care in adult child and spousal caregivers of older adults with dementia. An online sample of caregivers ranging in age from 30-68 (n = 219) completed a measure of meaning-focused coping (COPE-PRG; Carver et al., 1989) and the Caregiver Reaction Scale (CRS; O’Malley & Qualls, 2016) which assessed overload, role captivity, personal growth, and competence. Regression analyses indicated that meaning-focused coping predicted less role captivity and predicted greater personal growth and competence. However, meaning-focused coping did not account for significant variance in perceived overload. The findings extend prior research by demonstrating that meaning-focused coping strategies may faciliate positive aspects of care during chronically stressful experiences such as caregiving. Findings highlight that meaning-focused strategies may be more helpful for coping with role captivity (e.g., feeling unable to participate in work or family roles outside of caregiving) and less helpful for coping with subjective overload (e.g., a sense of overwhelm) in caregivers. Results inform clinical interventions that promote meaning and reduce burden in caregivers.
INFLUENCES ON CUSTODIAL GRANDCHILDREN'S RECEIVING TREATMENT FOR DISTRESS
Authors: Hayslip Bert , Montoro-Rodriguez Julian 
Published: December 2022

Abstract
Little work exists regarding the difficulties facing grandchildren raised by their grandparents, where previous research suggests such children to be especially at risk for psychological difficulties and that they often have limited access to potentially efficacious psychosocial interventions. The present study integrates these two perspectives in examining multiple sociodemographic, family-related, and grandchild-specific factors differentiating custodial grandchildren who were being treated for a variety of emotional and behavioral difficulties (N = 80) and those who were not (N = 157), as reported by the custodial grandparent. A MANOVA (F 23, 176 = 9.74, p &lt; .01, eta2 = .56) indicated that custodial grandchildren who were receiving treatment came from larger grandfamilies, were older, were having a greater variety of grandparent reported psychosocial difficulties, and were experiencing more emotional, behavioral, attentional, and relationship problems. The grandparents of such grandchildren experienced more parental strain, reported less social support, were less resilient, were less satisfied with the grandparent role, and reported poorer health. They also reported being less strongly attached to the grandchild and expressed more negative affect toward him/her. However, they also reported more openness regarding a variety of difficulties that might be addressed by mental health professionals. A subsequent discriminant analysis reflecting a weighted linear combination of the above factors (X2 19 = 132.09, p &lt; .01, Wilks’ Lambda = .498) correctly classified 86.1% of cases based upon treatment status. These findings provide a basis for understanding the determinants of custodial grandchilden’s receiving needed psychosocial interventions crucial to their well-being and adjustment.
WAYFINDING DESIGN IN LONG-TERM-CARE COMMUNITIES: EVALUATION OF COMPLEXITY
Authors: Davis Rebecca , Calkins Margaret 
Published: December 2022

Abstract
Wayfinding, the ability to find one’s way, is a significant problem for many older adults; especially those with cognitive impairment. Long term care communities (LTCC) are often fraught with challenges for wayfinding. Those who cannot find their way are at risk for decreased engagement and loss of independence. A critical need is to assess architectural and design features that promote effective wayfinding in an objective way. This study describes the results of a wayfinding design evaluation of 12 LTCC (4 Assisted living; 2 Independent Living; and 6 mixed residency). We measured space syntax axial integration (SSAI; a measure of the visual connectedness) and a Revised Wayfinding Checklist. The results showed low integration values in all communities, ranging from an R3 of 1.43-2.03, indicating low connectedness (and increased wayfinding complexity). The Checklist score totals ranged from 23 – 34 (M = 27.45) out of a possible total of 17 – 51. Results showed that the buildings were overall complex, all had long corridors (&gt;100 feet), over half used multiple elevators to get to common areas; and over 60% had complex, multi-building layouts. Design wise, visibly accessible restrooms were not present; over half of the LTCC had insufficient lighting; and signage color/contrast and letter size was less than recommended. All sites had few directional signs at decision points. Thus, the review of these LTCC showed that most buildings were very complex, with low connectedness, and had room to improve design features like signage and lighting to support wayfinding ability for the residents.
INVOLVEMENT IN CARE DECISION-MAKING AND ADVERSE OUTCOME ONSET IN COMMUNITY-DWELLING CARE RECIPIENTS IN JAPAN
Authors: Komatsu Ayane , Nakagawa Takeshi , Noguchi Taiji , Saito Tami 
Published: December 2022

Abstract
The involvement of older adults in care decision-making may enhance their daily life motivation and quality of life. Furthermore, it could contribute to their better prognosis in long-term care. We examined the association between decision-making involvement and the onset of adverse outcomes, such as institutionalization and death, among older adults under long-term care. This study used two-year longitudinal survey data of Japanese community-dwelling care recipients aged 65 and above. The participants were followed regarding the onset of institutionalization and deaths. The status of involvement in decision-making was assessed based on one item and the selection among the following response options: “very much involved,” “fairly involved,” “not very involved,” “never involved,” “unclarified wishes,” and “absence of person supporting decision-making.” A multivariable logistic regression analysis estimated the odds ratios (OR) and 95% confidence intervals (CI) for the onset of adverse outcomes, composite of institutionalization and death. A total of 707 participants with no severe cognition disabilities (MMSE&gt;12) and no missing variables at the baseline were included and responded to the follow-up survey. At the baseline, 36.5% reported being very much involved in decision-making. The onset of adverse outcomes was observed in 17.5% of participants (institutionalization, 5.1%; death, 12.4%). Compared to those with very high involvement in decision making, those who were not involved were more likely to have adverse events, even after adjusting for covariates (OR=2.86 [95% CI: 1.21-6.76], p=0.016). Our findings show the importance of decision-making involvement in daily care regarding better prognoses in long-term care.
FAMILY MEMBERS’ COMMUNICATION WITH LONG-TERM CARE PROVIDERS AND ITS INFLUENCE ON RESIDENT WELL-BEING
Authors: Falzarano Francesca , Cimarolli Verena , Siedlecki Karen 
Published: December 2022

Abstract
Considerable research has examined communication dynamics among family members and staff in nursing homes (NHs) and has demonstrated that better communication is associated with more optimal psychosocial outcomes in both family caregivers and formal care providers. However, the literature on how communication dynamics influence resident functioning is limited, and it has yet to be determined how communication impacts residents across other care contexts, such as Assisted Living Facilities (ALFs). Thus, using data from the National Health and Aging Trends Study and the National Study on Caregiving, the purpose of this study was to examine family perceptions of communication with formal care providers (i.e., frequency, availability, and helpfulness of communication) and its influence on resident outcomes in two samples of long-term care residents (n=337 in ALFs, n=112 in NHs) and their family caregivers, and to compare how results differ across care setting. When examining the full sample of long-term care residents, findings showed that better communication was associated with lower depressive symptoms and negative affect. When investigating differences across care settings, we found that those residing in NHs exhibited higher levels of depressive and anxiety symptoms compared to ALF residents. Further, better communication was associated with lower levels of depressive symptoms only among ALF residents. Our findings provide insights into how interpersonal dynamics between family and formal care providers influence resident functioning and underscores the importance of enhanced communication among all members of the primary care team – that is, healthcare providers, residents, and their family members.