bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMMUNICATION WITH HEALTHCARE PROVIDERS DURING THE PANDEMIC: EXPERIENCES OF OLDER ADULTS
Authors: Sweeder Logan , Sillner Andrea , Boltz Marie , Van Haitsma Kimberly 
Published: December 2022

Abstract
The COVID-19 pandemic introduced many societal changes, including the need to use technology to communicate with healthcare providers. For many this was a new form of communication. This study examines (1) who older adults identified as healthcare providers and (2) reflected on how communications with formal healthcare providers changed during the pandemic. This data is a subset of a cross-sectional descriptive survey that was distributed electronically to a sample of community-dwelling older adults aged 65 years and older (N=323). Qualitative data was analyzed using thematic analysis. Quantitative data was analyzed using descriptive statistics. Participants averaged 72.7 years of age and 74.5% were retired. Just over ¼ of the sample identified nurses as part of their formal healthcare team; however, participants who identified nurses as formal healthcare providers had fewer negative themes regarding telehealth communication with healthcare providers compared to those who did not. They were also more likely to support in-person and technology driven communication models in the future. Telehealth remains an evolving form of primary healthcare that was utilized throughout the COVID-19 pandemic. Many older adults in our study considered it a resource that requires further optimization while others were staunch opponents to its continued employment in healthcare settings. Nurses are a vital part of our healthcare system and frequently interact with patients and families to coordinate care. Further research should examine how different scopes of nursing practice can support the implementation of telehealth to improve care delivery among community-dwelling older adults.
TURNING REAL-WORLD DATA INTO ACTIONABLE EVIDENCE FOR HEALTHCARE INTERVENTIONS IN NEURODEGENERATION
Authors: Poulsen Rachel , Chang Jun Ha , Bhatti Danish , Rizzo Matthew , Merickel Jennifer 
Published: December 2022

Abstract

Background
Age-related neurodegenerative disorders, including Alzheimer’s disease and Parkinson’s disease (PD), progressively reduce mobility and quality of life (QoL). Real-world mobility from actigraphy predicts PD disease severity. This pilot analysis assessed utility of actigraphy to screen early physical function-related QoL decline in PD. Method: Mobility was monitored for 4 weeks using wrist-worn ActiGraph recordings in 27 participants with idiopathic PD (age = 67.78 ± 5.64, 19 males). Days with &gt;600 mins of wear time during non-sleep times were analyzed (µ = 29.78 days ± 3.78). Typical activity was quantified as average steps per hour. Participants completed demographic and health assessments. Disease severity and physical function QoL were measured using the clinically-validated Unified PD Rating Scale (MDS-UPDRS) and Short Form-36 (SF-36), respectively. Disease severity, QoL, and typical activity were compared using Spearman correlations.

Results
Lower typical activity from actigraphy was associated with more severe motor symptoms (MDS-UPDRS; r = -0.40, p = 0.04) and with increased impairment in physical function QoL (r = 0.50, p &lt; 0.01). Daily activity from actigraphy did not predict symptom severity of non-motor and motor-related complications. Discussion: Pilot results show utility of actigraphic metrics for indexing real-world mobility and QoL declines in neurodegenerative disorders, in line with broader efforts to turn real-world data into actionable evidence for healthcare interventions. Ongoing discovery in larger populations should yield robust, clinically-relevant indices of daily activity in aging and neurodegenerative impairment.
RACIAL/ETHNIC DISPARITY IN 4M-BASED PRIMARY CARE DELIVERY VIA TELEHEALTH IN PROVIDER SHORTAGE AREA
Authors: Lee Rain , Kim Yi Hyun , Kim Laurie , Yoo Ji Won , Maxi Andrea , Hong Chelin 
Published: December 2022

Abstract

Background
Telehealth is a promising alternative to primary care delivery in provider shortage areas. The purpose of this study was to evaluate the implementation of the 4Ms (i.e., Medication, Mentation, Mobility, What Matters) framework in telehealth-based primary care in provider shortage areas by ethnic status.

Methods
This study was a retrospective analysis of 184 older adults (60+) representing 5% of the total sample at urban primary care in ethnically and racially diverse populations. Data were retrieved from July 2020 to September 2021. 14 trained primary care providers participated in this study and provided the 4Ms as following: 1) Medication (e.g., deprescribe or reduce high-risk Medication); 2) Mentation (e.g., depression and cognition assessment with brief counseling); 3) Mobility (e.g., mobility and home safety assessments); 4) What matters (e.g., advance care planning). The current study measured components of the 4Ms per telehealth visit by ethnic/race status (white vs. non-white).

Results
Overall, advance care planning (i.e., what matters) was the most discussed via telehealth (79%), followed by mobility (46.2%), Medication (16.8%), and Mentation (14.7%). To examine the disproportion of accessing telehealth by patients’ racial background, the independence test of chi-square showed that non-white populations were less likely to have access to telehealth than white patients (p = .02).

Conclusion
There was an ethnic and racial disparity in the 4M framework application via telehealth in an urban primary care clinic. To sustain telehealth for patients in a healthcare shortage, ethnically and culturally specific training is needed, and linguistically diverse curricula are recommended.
CROSS-NATIONAL DIFFERENCES IN ATTITUDES TOWARD FAMILY AND GOVERNMENTAL SUPPORT FOR ELDER AND CHILD CARE
Authors: Avni Elinore 
Published: December 2022

Abstract
Population aging in wealthy western nations has raised concerns about who will provide care to older adults. At the same time, the rise of single parenthood and dual-career families has heightened the need for childcare. As governments and families face challenges in meeting these dual needs, this study compares responses to the question of “who should primarily provide” eldercare and childcare across three countries: the US, Germany and Israel. Analysis of 2012 International Social Survey Programme data reveals that while persons in the US endorse family as care providers to both older adults and children, Israelis endorse government as eldercare providers yet family as the source of childcare provision. German respondents prefer both government and family as childcare providers, yet believe the government should provide eldercare. The paper discusses how cross-national differences in attitudes toward care are associated with cultural and socio-economic characteristics, and highlights implications for policy and practice.
CANCER CARE IN ELDERLY: CHALLENGES AND REQUIREMENTS OF INFORMAL CAREGIVERS
Authors: Chakravarty Esha , Chakravarty Indrani 
Published: December 2022

Abstract
The affect of Covid -19 and changes in healthcare has shifted most of cancer care of elderly to home settings. Calcutta Metropolitan Institute of Gerontology (CMIG), Regional Resource and Training Centre in Ageing studied the daily tasks, requirements and emotional burden of caregivers in West Bengal, India. Caregivers of lung cancer, liver cancer and colorectal cancer patients (n=500) completed questionnaires provided by CMIG. The mean age of cancer patients was 72.5 years. CMIG found that 47% of the caregivers were the spouses of elderly patients, 33% were their adult children and 20% were other family members. Forty six percent of the caregivers were found to care for patients with metastatic disease, 33% cared for co morbidities, 63% cared for those undergoing chemotherapy or radiotherapy. Ninety eight percent of the caregivers provided assistance with Activities of Daily Living, 75% in administering medicine, 47% helped in pain management, 39% helped in hospital visits or deciding to call doctor. Twenty one percent of the caregivers reported poor health and 16% were not confident of the quality of care they provided. Sixty six percent reported suffering from stress and perceived cancer as a family disease, 45% thought they lacked social support. Of the adult children who provided care, 78% resported they needed more training to provide quality cancer care and transitioning to formal care would improve results.This study will help influence State policies for allocation of resources for training for cancer caregivers, build support groups for stress management and create cancer care helplines.
POTENTIAL PREDICTORS OF HEALTH LITERACY IN OLDER ADULTS
Authors: Rubinstein Stephanie , Fennell Gillian , Zelinski Elizabeth 
Published: December 2022

Abstract

Objective
Being able to effectively communicate health care needs and understanding health-related information is particularly important as people grow older. In this study, we sought to identify the factors related to subjective health literacy among older adults.

Methods
We examined eight potential predictors of health literacy: subjective memory, cognition, objective health literacy, self-rated health, age, sex, race, education, depression. Our data was derived from a large sample (N=1,272) of participants aged 50 and older who took part in the Health and Retirement Study (HRS; 2008 wave and 2009 internet survey).

Results
Controlling for all other variables, subjective memory (b = .15, p = .02) was positively and self-rated health (b = -.09, p &lt; 0.001) was negatively associated with subjective health literacy. Neither objective health literacy, cognition, nor age were significantly associated with subjective health literacy. Women reported better health literacy than did men (b = .09, p = 0.01). The predictors in this model explained 9% of variation in subjective health literacy. Discussion: These findings may be better understood as we take into consideration the interplay between health literacy, cognition, education, and subjective memory established in extant literature. We discuss the implications of our findings as they relate to healthcare decision-making as well as plans for future research.
LONGITUDINAL EFFECTS OF HYPERTENSION ON COGNITIVE PERFORMANCE IN OLDER ADULTS
Authors: Moll Allison , Woodard John L 
Published: December 2022

Abstract
Hypertension impacts many older adults, but it is still not clear whether it has a negative effect on cognitive performance in older adults. The purpose of this study was to assess the longitudinal effect of hypertension on cognition in older adults (Mage=75.6 years, SD=8.3). Participants came from the National Alzheimer’s Coordinating Center database. The cognitive assessment included the MoCA, Digit Span, Trail-Making Test A and B, WAIS-R Digit Symbol, Category Fluency, and Letter Fluency. Linear mixed effects modeling examined the random and fixed effects of clinician-assessed hypertension, months since first study visit, sex, age, and the interaction between hypertension and time since first visit on cognitive performance across five annual study visits. Results showed that hypertension had a significant main effect on Category Fluency, Trails B, Letter Fluency, and Digit Span–Forward and Backward. However, effect sizes were quite small (ηp2 range: 3.93x10-4 – 1.73x10-3). Main effects of age and months since first visit were significant predictors of all cognitive measures, such that older age was associated with worse cognitive performance and more months since the first visit was associated with better cognitive performance. This positive association is perhaps suggestive of practice effects across study visits. A significant interaction between hypertension and months since first visit for Category Fluency and Trails B showed that hypertensives and non-hypertensives performed differently at the initial visit but similarly by the last visit. However, effect sizes were small (ηp2 range: 3.86–9.64x10-4). These results suggest hypertension effects on cognition in older adults are minimal.
LIFE COURSE CONDITIONS AND COGNITION IN A NATIONALLY REPRESENTATIVE SURVEY OF OLDER ADULTS
Authors: Iveniuk James , Compernolle Ellen , Gupta Riddhi , Hanis Jen , Hawkley Louise 
Published: December 2022

Abstract
By the time people reach older adulthood, their cognitive function may be conserved, or in decline, in part due to their social experiences over their entire life course. Researchers have gained a greater understanding, over recent decades, of the importance of life-course events for cognition in later life. Nevertheless, our understanding of many of these factors, especially in childhood, remains limited. Drawing upon Round 2 of the National Social life, Health, and Aging Project (NSHAP; N=3,377), and data linked to the 2010 census, the 1940s census, and air pollution data, we undertake a whole-life-course approach to understanding the determinants of cognitive function in older adults. Building on the work of the Lancet Commission on risk factors for dementia, we considered health conditions, low education,incarceration, and brain injury (ever); poor health behaviors and low social contact (current); and air pollution (average over past five years). We also considered adverse childhood experiences,, and home conditions in 1940. Similar to other studies, we found that female gender, identifying as white, and being born in the US were significantly associated with better cognitive function. Higher depression and lower social contact were associated with worse cognition. There were no significant associations between cognition and early childhood factors - with the exception that growing up in an urban area was associated with better cognitive function. Experiencing jail time was also negatively associated with cognitive function. Findings point towards the need for a more expansive consideration of life course conditions, as they impact cognition in late life.
THE RELATIONSHIP BETWEEN SKIPPING BREAKFAST AND DEMENTIA: A RETROSPECTIVE COHORT STUDY IN OSAKA
Authors: Chikama Hitomi , Kanaya Reiko , Takeya Yasushi , Toki Hiroshi , Yamamoto Ryohei , Yamakawa Miyae 
Published: December 2022

Abstract
In Japan, annual medical checkups are carried out to prevent lifestyle diseases. Studies have found that skipping breakfast is a risk factor for diabetes, and potentially also dementia. This retrospective cohort study aimed to evaluate the relationship between skipping breakfast and dementia in people with diabetes. The eligible cohort was anyone on the National Health Insurance Database of Osaka who had a checkup in FY 2013 and had diabetes (N = 283,410). The cohort was divided into two groups, those who skipped breakfast more than three times a week (7.38%) and those who did not. The database does not allow individuals to be identified. People with diabetes were defined as those prescribed diabetes drugs in the year before the checkup or with HbA1c of 6.5% or higher at the checkup. People with dementia were defined as those prescribed anti-dementia drugs between April 2014 and December 2017. Data also included body mass index (BMI), smoking, sex , age, and prescription of hypolipidemic or blood pressure drugs. Logistic regression analysis was used, with odds ratio (OR) and 95％ confidence interval . Being male, younger, smoking, having lower BMI or HbA1c levels, and drug prescriptions were associated with skipping breakfast. Skipping breakfast was associated with dementia (OR 1.26, 1.14–1.41), as was lower BMI and being older. For people with diabetes, skipping breakfast is a risk factor for obesity and dyslipidemia, which are associated with dementia. This study therefore provides evidence for a health behavior approach to eating breakfast in people with diabetes.
ASSOCIATION OF SUBJECTIVE AND OBJECTIVE COGNITION WITH DISEASE AWARENESS: EVIDENCE FROM BLOOD BIOMARKERS DATA
Authors: Lin Zhuoer , Fu Mingqi , Chen Xi 
Published: December 2022

Abstract
Impaired cognitive ability and its misperception contribute to poor decision-making of older adults; yet their impact on health-related decisions is less known. We examined how self-perceived and actual cognition were associated with chronic disease awareness using a nationally representative sample of Chinese older adults. Blood biomarkers data were collected in 2015 to identify participants’ dyslipidemia and diabetes status. Among participants with identified dyslipidemia or diabetes, disease awareness was defined as self-reported diagnosis of the conditions as of 2018. Objective and subjective cognition were respectively assessed using the Mini-Mental State Examination and self-rated memory. The associations of subjective and objective cognition with chronic disease awareness were determined by weighted logistic regressions. Among 4,578 adults aged 60 and older with complete measurements, 1,442 and 759 individuals were identified having dyslipidemia and diabetes, with proportions of disease awareness being 38.0% and 58.1%, respectively. Individuals with mild (Odds Ratio [OR]=0.63; 95%CI: 0.45-0.89) or severe cognitive impairment (OR=0.46; 95%CI: 0.29-0.72) had lower odds of dyslipidemia awareness; and those with severe cognitive impairment had lower odds of diabetes awareness (OR=0.43; 95%CI: 0.23-0.79) than cognitively intact counterparts. However, adjusting for objective cognition, older adults with better subjective cognition had lower odds of dyslipidemia (OR=0.80; 95%CI: 0.63-1.02) and diabetes (OR=0.71; 95%CI: 0.55-0.92) awareness. Such associations were stronger for individuals with rural status, lower education, or living without children. Our findings highlight the great challenges deteriorated cognitive function and misperception may pose to chronic disease awareness, as well as the importance of targeted supports particularly for those more disadvantaged.
DETECTING NARCISSISM FROM DAILY LANGUAGE USE: A MACHINE LEARNING APPROACH
Authors: Zhang Shiyang , Gao Sibo , Fingerman Karen 
Published: December 2022

Abstract
High-quality social contacts are important for older adult’s emotional well-being whereas narcissism, characterized by self-centeredness, may undermine the quality of personal relationships. Narcissism may be associated with poorer quality relationships because narcissistic adults are more self-centered in their daily social interactions. The current study examined the associations between linguistic features of conversation throughout the day and narcissism using a machine learning approach. Older adults aged 65–89 (N = 281, Mage = 74.07) wore an unobtrusive electronically activated recorder (EAR) throughout the day for 4 to 6 days. The EAR was activated 30 seconds every 7 minutes to capture conversations occurring in a natural setting. The sound files that contained participant’s speech (N = 28,243) were transcribed verbatim. We used Linguistic Inquiry and Word Count (LIWC) to extract linguistic features from the transcriptions (nfeature = 81; e.g., function words, affective processes). Linguistic features were analyzed using random forest algorithm which is a supervised machine learning method that can evaluate features’ performances in predicting older adult’s narcissism. The model reached an accuracy of 62% and results showed that total word count, more auxiliary verbs (e.g., will), more swear words (e.g., damn), and less assent (e.g., agree) were the most powerful predictors of narcissism. Drawing on sound files collected from real-life interactions, findings indicate higher usage of aggressive and disagreeable words among more narcissistic individuals, which probably leads to poorer quality relationships with social partners. Interventions aiming to improve contact quality and emotional well-being may consider individuals’ word use in daily interactions.
CAN YOU HEAR ME? A MEDICAL STUDENT-LED QUALITY IMPROVEMENT INITIATIVE FOR HOSPITALIZED PATIENTS WITH HEARING LOSS
Authors: Rennke Stephanie , Warren Rachel , Sims Wynton , Menon Shreya , Binford Sasha , Rathfon Megan , Wallhagen Margaret 
Published: December 2022

Abstract
In acute care settings hearing loss (HL) is associated with impaired patient-provider communication, increased length of stay, and increased mortality. COVID-19 has exacerbated this problem with the widespread use of masks and eye shields which muffle speech and prevent lip reading. Our 800-bed tertiary care medical center lacked a standardized approach to identify patients with HL and address communication barriers. Three first year medical students spearheaded the initiative as part of a health systems improvement curriculum with support from a faculty coach and a faculty researcher. From September 2020 to October 2021, the students met with stakeholders, leadership and champions and unit staff, identified the current state and completed a gap analysis through interviews, surveys, and direct observation. The pilot in May 2021 included two week-long PDSA cycles on one hospital unit to: 1) screen patients aged 65 and older using the validated 10-item HHIE-S questionnaire, 2) implement an education and awareness campaign with bedside signage, posters, and conferences and 3) provide a personal amplifier (purchased in bulk by the medical center) with verbal and written instructions. A total of 29 patients screened positive and were given personal amplifiers. Post-pilot interviews reported increased provider awareness and knowledge around best communication practices. Patients and staff reported limited amplifier use due to poor sound quality, small dials, poorly fitting ear buds and a short battery life. Based on these results the team recommended discontinuing the personal amplifiers and identifying other communication tools including higher quality personal amplifiers and speech to text applications.
INVESTIGATING THE CONNECTION BETWEEN AGEISM AND ELDER ABUSE
Authors: Burnes David , Pillemer Karl , MacNeil Andie 
Published: December 2022

Abstract
Elder abuse is recognized as a pervasive public health problem with detrimental consequences for older adults and society. Although considerable research has examined elder abuse risk factors at the individual level, there is a growing call for the field to move beyond proximal causes and consider broader socio-cultural and structural factors that influence elder abuse. Illustrating this shift, organizations, advocacy groups and researchers have proposed a connection between ageism and elder abuse. However, despite the assertion that ageism is a causal factor for elder abuse, there is a scarcity of research to demonstrate this relationship, and a coherent theoretical framework linking ageism to elder abuse remains to be articulated. The purpose of the current study was to examine the conceptual pathways and limited empirical research connecting ageism and elder abuse, and to develop a conceptual model that links ageism and elder abuse. We conducted a comprehensive review and synthesis of the ageism/elder abuse literature, as well as research from other domains of interpersonal/family violence. Based on this synthesis, the proposed model includes plausible mediators (social isolation, devaluation, depersonalization, infantilization, powerlessness, blame) and moderators (intersection with socio-cultural identities, internalized ageism, policy/social norms) that could be targeted as mechanisms of change in interventions designed to address the issue. As such, it provides a framework for hypothesis-testing and future research on the topic. This study informs a research agenda to bring conceptual clarity and empirical evidence to the study of the connection between ageism and elder abuse.