bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE PRESCRIPTION DRUG LANDSCAPE OF ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Authors: Bangerter Lauren , Clark Callahan , Jarvis Megan , Coates Emma , Sheils Natalie , Wong Alyssa , Cohen Ken 
Published: December 2022

Abstract
Alzheimer’s Disease and Related Dementias (ADRDs) are debilitating conditions that impact cognition and function of nearly 5 million adults in the U.S. This study describes the landscape of prescription drugs to treat cognitive and behavioral symptoms of ADRD among Medicare Advantage Part D enrollees with ADRD (Dementia, Alzheimer’s Disease, Parkinson’s, Frontotemporal Dementia, Lewy Body, Vascular Dementia, or Mild Cognitive Impairment). We assessed prevalence of prescription fills in the years pre- and post-ADRD diagnosis. Prescription fills to manage cognitive symptoms, were assessed by acetylcholinesterase inhibitors and NMDA receptor antagonists. Prescription fills to manage behavioral and psychological symptoms of dementia were assessed by antipsychotics, mood stabilizers and anticonvulsants, antidepressants, sedative-hypnotic z-drugs, and benzodiazepines. The final sample (N=161,368) consisted of 79.2% white, 62.2% female with median age 83 (IQR 77-89). Most drug fills increased from pre-diagnosis year to post diagnosis year including Acetylcholinesterase inhibitor (15.3% to 35.5%), NMDA Receptor Antagonists (5.8% to 16.6%), mood stabilizers and anticonvulsants (15.8% to 18.2%), and antidepressants (19.4% to 24.2%). Benzodiazepine use remained stable (13.0% to 13.6%) as did Sedative hypnotic z- drugs (1.9% 1.8%). Results reveal polypharmacy (median of 11 prescriptions post-ADRD diagnosis) and high healthcare utilization (median of 10 specialty types visited post-ADRD diagnosis). This study shows discrepancies between real-world pharmacologic ADRD management and evidence-based practices. This work highlights the need for innovative care models that simultaneously address polypharmacy and optimally coordinated care for people with ADRD.
ACCEPTABILITY OF A TAILORED MUSIC LISTENING INTERVENTION FOR SLEEP IN OLDER ADULTS WITH DEMENTIA
Authors: Geisser Sophia , Ciccone Isabella , Sefcik Justine , Hodgson Nancy , Petrovsky Darina 
Published: December 2022

Abstract
There is a lack of non-pharmacological interventions aimed at improving sleep disturbances among persons living with dementia (PLWD). In this randomized clinical trial, we examined the acceptability of a tailored music listening intervention on sleep disturbances in PLWD. We recruited 33 PLWD age &gt;60 and their care partners (‘dyad’); 30 dyads completed the study. Dyads were randomly assigned to a wait-list control or intervention group, which included listening to tailored sleep-inducing music 30 minutes every night for 4 weeks. Acceptability outcomes included a questionnaire of perceived benefits and satisfaction with study participation; and a single item examining the PLWD’s level of enjoyment while listening to music. In addition, we conducted semi-structured exit interviews. We used descriptive statistics and conventional content analysis to examine the qualitative data. Most PLWD and care partners identified themselves as female, Black and non-Hispanic. One third responded that the study benefited care partners (n=11, 36.7%) and helped improve PLWD quality of life (n=11, 37.9%). The majority (n=28, 93.3%) felt that this study was clearly explained to them, while a third felt that the study required too much work (n=10, 33.3%). Most dyads enjoyed listening to music that was selected for them (n=38, 93.3%) and reported that the intervention and music selection was acceptable. We identified four themes regarding the music selections: music was relaxing, enjoyable, promoted sleep, and brought back memories. Overall, this intervention shows promise for decreasing sleep disturbances among PLWD. Future studies involving music interventions for sleep should examine the mechanism of action.
DIFFERENCES IN NEUROPSYCHIATRIC SYMPTOMS AMONG RACIAL AND ETHNIC GROUPS LIVING WITH DEMENTIA IN HOME HEALTHCARE
Authors: Lassell Rebecca , Convery Kimberly , Fletcher Jason , Chippendale Tracy , Lin Shih-Yin , Jones Tessa , Durga Aditi , Brody Abraham 
Published: December 2022

Abstract
The relationship between dementia and neuropsychiatric symptoms is well documented. Yet, little is known about the prevalence of neuropsychiatric symptoms among diverse homebound persons living with dementia. Guided by an intersectionality framework we asked: 1) Is there an association between the presence of individual neuropsychiatric symptoms and racial and ethnic groups? 2) If so, do these symptoms differ by dementia stage among groups? We conducted a cross-sectional study of n=190 receiving skilled home healthcare in Utah, New York, and New Jersey and enrolled in the DSM-H trial. We prospectively measured symptom prevalence with the Neuropsychiatric Inventory Questionnaire and dementia stage using the Quick Dementia Rating System. We performed Chi-square tests to determine the association of individual symptom prevalence with race and ethnicity and cross tabs to descriptively stratify individual symptom prevalence by dementia stage among groups. Participants were 11.9% Hispanic, 28% non-Hispanic Black, 56.1% non-Hispanic white (white). The prevalence of delusions was significantly higher in Hispanic and non-Hispanic Black groups than whites (41.7% & 41.8% vs. 22.5%) and elation/euphoria in Hispanic and non-Hispanic Black groups than whites (20.8% &12.7% vs. 5.4%). Delusions were most prevalent in non-Hispanic Black groups with mild dementia (53.8%) and Hispanics with moderate dementia (50.1%), while elation/euphoria was most prevalent for Hispanics with severe dementia (33.3%). Other neuropsychiatric symptoms showed no significant differences. These findings expand our knowledge of differences in neuropsychiatric symptoms among racial and ethnic persons living with dementia, which can inform future studies and targeted interventions that address disparities and improve care.
RACIAL DISCRIMINATION IN HEALTHCARE SETTINGS OF OLDER ADULTS: SUBJECTIVE REASONS AND CONTRIBUTORS
Authors: Yi Eun-Hye , Hong Michin , Bolton Cherish 
Published: December 2022

Abstract
Racism is prevalent in the United States; however, literature exploring racial discrimination experienced by older adults is still limited. The current study examined subjective reasons for discrimination and compared race/ethnic groups. Then, we examined the contributors to racial discrimination in healthcare settings. An older adult sample aged 55 or higher was drawn from California Health and Interview Survey 2017 for analysis (N=12,261). African Americans were the highest (13.06%) among five racial-ethnic groups who reported racial discrimination experienced in a lifetime in getting medical care, while Whites were the lowest (1.57%). Perceived reasons for discrimination were significantly different by racial/ethnic group. Only 3.5% of Whites perceived they were discriminated against due to their race, whereas racial/ethnic minorities perceived the main reason for discrimination was their race/skin color (African American: 55.43%, Others: 24.06%, Asian Americans: 20.26%, Hispanics: 18.22%). The weighted logistic regression analyses revealed that being a racial/ethnic minority, economic status, mental health status, citizenship, the length of living in the United States, and age were significantly associated with the experience of racial discrimination of older people. Analyses by race/ethnic groups found different contributors. For example, poverty was the most prominent factor in racial discrimination for Whites, while education was for African Americans. This study identified an apparent gap in lifetime discrimination toward racial/ethnic minority older people. Also, we found racial discrimination experience combined with systematic barriers. The findings of this study support the need for interventions for race/ethnicity-based trauma of older people and anti-racism framework education for healthcare professionals and researchers.
IMPROVING THE PERFORMANCE OF COMMUNITY HEALTH WORKERS IN A BEHAVIORAL LIFESTYLE INTERVENTION FOR OLDER ADULTS
Authors: Liu Xinran , Lin Yuxin , Baumann Sara , Albert Steven 
Published: December 2022

Abstract
Community health workers (CHWs) play essential roles in implementing community-based behavioral lifestyle interventions. This qualitative analysis aimed to explore what program factors and CHW characteristics would help improve CHW performance in the Mobility and Vitality Lifestyle Program (MOVE UP), a community-based behavioral weight-management intervention for improving mobility among overweight or obese older adults. The MOVE UP program was implemented from January 2015 to June 2019 at 23 community-based sites in Pittsburgh, Pennsylvania. Trained and supported CHWs delivered 32 group sessions over 13 months. We collected data from semi-structured interviews with 21 CHWs and 14 community key informants (community site directors or coordinators); seven focus group discussions with participants from 9 sites, and 124 pieces of graduation advice provided by MOVE UP graduates for future participants; onsite CHW performance observation at 18 sites, and 124 meeting memos of support phone calls with CHWs. Interviews and focus groups were audio-recorded and transcribed verbatim. All data were thematically analyzed in a deductive approach, using the CHW generic logic model. Emerging themes were: Trained CHWs still require onsite support by experienced CHWs or training staff to deliver the first session; Participants need a Q&A session by specialists to address their questions beyond CHWs’ knowledge; Desirable CHW characteristics could increase CHWs’ relation and accessibility to participants, such as the same age group, similar weight loss experience, and living or working in the same community. These findings provide important insight as to recruiting and supporting CHWs in a community-based behavioral lifestyle intervention for older adults.
IMPACT OF AN ONLINE EMOTION-FOCUSED COMMUNICATION TRAINING ON STAFF KNOWLEDGE AND SELF-EFFICACY
Authors: Abbott Katherine , Heid Allison , Kelley Megan , Heppner Alexandra , Van Haitsma Kimberly 
Published: December 2022

Abstract
The way we respond emotionally to others can impact how we provide care. Emotional intelligence is vital for care team members whose entire day involves interacting with other people. We have developed an interactive, online, self-paced course for people providing care to others with the specific goal of increasing awareness of emotions and helping to identify emotions in others. The training is supported by research indicating that individuals who can better manage their own emotions are better positioned to manage behaviors and emotions in others. The central concept of the training is to build relationships that enhance person-centered care through increasing care providers’ emotional intelligence. These skills allow care providers to better manage their own behavior and emotions, which results in improved quality of their care work. The purpose of this study was to assess the knowledge, self-efficacy, acceptability, and appropriateness of the online training. The data for this study came from n = 130 individuals (19% direct care worker, 16% activities, 13% health care provider, and 12% case manager) who completed assessments pre-and post-training. Knowledge of emotion-focused communication strategies and self-efficacy in using emotion-focused communication strategies both increased significantly with training (t(129) = -5.40 p &lt; .001 and t(124) = -6.42 p &lt; .001). In addition, high levels of acceptability, appropriateness, and satisfaction were reported. Findings indicate the benefits of online training for emotion-focused communication for caregivers. The discussion will focus on recommendations for practice, policy, and research.
COLORECTAL CANCER SCREENING (CRC) DISPARITIES: A ZIP CODE–LEVEL ANALYSIS
Authors: Singh Roshni , Parraga Carla , Lin Rachel , Tamariz Leonardo , Palacio Ana 
Published: December 2022

Abstract
CRC is the third leading cause of cancer-related deaths among older adults in the US. CRC screening can prevent disease by early identification, yet there are disparities in CRC screening. This study aimed to determine the impact of race, social determinants, and geographic location at zip-codes level on CRC screening.We conducted a retrospective cross-sectional study of CRC screening among different races, evaluating the relationship with the social deprivation index (SDI) and annual income as health determinant factors using the public available data of 2016-2019 CDC 500 cities project and PLACES project 2020 database combined with 2019 American Community Survey for zip code-based analysis. We conducted a multivariate analysis and a confirmatory factor analysis among race, income, lack of health insurance, access to check-up visits and SDI.Increasing SDI tertile increased the likelihood of being Black and Hispanic and having lower median household income (p&lt; 0.01). Lack of health insurance and lower regular checkup visits were less common in the third tertile of SDI (p&lt; 0.01). The multivariate analysis showed that being black, Hispanic, having a lower income, not having health insurance, not having regular check-ups and SDI were related to decreased screening. In the confirmatory factor analysis, the variables most associated with decreased screening are SDI and access to health insurance.Race, SDI, insurance status, socioeconomic status, all impact CRC screenings, but the two most important factors are SDI and access to healthcare. These data may help implement interventions that specifically target these barriers to promote CRC screenings within disadvantaged communities.
PERSON-CENTERED CARE: WHY TAKING INDIVIDUALS' CARE PREFERENCES INTO ACCOUNT MATTERS
Authors: Hawes Frances , Tavares Jane , Cohen Marc , Hwang Ann 
Published: December 2022

Abstract
Person-centered care has been recognized as an integral part of a high-quality health care system. Utilizing the 2014 to 2018 waves of the Health and Retirement Study, we explore trends in person-centered care among those 50 and older by examining the extent to which they feel their care preferences are being taken into account, that is, that they are being heard by providers. We analyze the impact of not receiving person-centered care on health care utilization, health outcomes, and preventative care utilization. One-third of respondents reported that their care preferences were “sometimes” or “never” considered. Findings show that wealth and racial disparities in person-centered care are worsening over time. From 2014 to 2018, the percentage of non-Hispanic White respondents who reported that their care preferences were never taken into account decreased while the percentage for Hispanic and non-Hispanic Black individuals increased. Similar trends were seen for low-income individuals. Having a usual source of care was associated with a greater likelihood of having care preferences considered as well as significantly better control of chronic condition and greater use of preventive care. When care preferences are not being taken into account, there is less utilization of health care services, less preventive care usage, poorer control of chronic conditions, and increased risk for higher health care costs. These findings highlight the importance of assuring that people feel listened to by health care providers and emphasize a need for strategies to advance person-centered care for people of color and low-income populations.
ADJUSTING FOR COUNTRY-LEVEL VARIATION IN DEMENTIA PREVALENCE WITH CLASSIFICATION ALGORITHMS IN SHARE
Authors: Klee Matthias , Langa Kenneth , Leist Anja 
Published: December 2022

Abstract
Background. Population-level dementia prevalence depends on societal factors and individual-level risk and protective factors. To improve our understanding of how these factors interact, we can use cross-national surveys such as the Survey of Health, Ageing and Retirement in Europe (SHARE). However, in absence of validated cognitive assessments, adjusting for underdiagnosis of dementia is needed. The present study sought to explore the usefulness of the Langa-Weir and alternative algorithms to detect probable dementia while accounting for country-level variation in estimated prevalence and underdiagnosis of dementia.Method. Data from 57,880 respondents aged 60 years and older to wave 7 of SHARE (2017) with non-missing data on variables related to sociodemographics and cognition were used. Adaptations of the Langa-Weir classification algorithm were compared to a weighted logistic regression model and an XGBoost classifier applying the synthetic minority oversampling technique. Different specifications of algorithms were tested globally and for individual countries and compared with the World Alzheimer’s Report (2015)’s country-level projections of dementia prevalence for 2018. Results. All algorithms accurately classified self-reported diagnosis of dementia (accuracy = 0.90-0.96), with the Langa-Weir classification based on recall and a cutoff reflecting country-specific prevalence outperforming other algorithms regarding compensation of underdiagnosis. Algorithmically detected probable dementia is associated with newly self-reported dementia diagnosis, drop-out and death two years later. Discussion. Identifying probable dementia through classification algorithms can increase statistical power and improve validity in cross-national investigations. Further research is needed to replicate the findings in validated cognitive assessments and to identify causes of cross-national variation in dementia underdiagnosis.
BA FOR DEPRESSION AND DIABETES MANAGEMENT: EXAMINED VIA SINGLE-CASE DESIGN
Authors: Robertson Anna , Feliciano Leilani 
Published: December 2022

Abstract
Type 2 Diabetes Mellitus (T2DM) is a pervasive, chronic disease whose prevalence increases with age. The most common treatment options for T2DM include medication, dietary changes, and engagement in physical activity, which require considerable lifestyle changes. Further, individuals with T2DM are highly likely to develop physical and mental health comorbidities that can complicate effective T2DM management. In fact, individuals with T2DM and other comorbidities are frequently excluded from behavioral and other interventions in randomized controlled trials due to their comorbidities. Individualized treatment is necessary to address these comorbid diseases and to effectively navigate lifestyle changes. As part of a larger study evaluating an at-home diabetes management program with patients at a Federally Qualified Health Care Facility, the current study utilized a single-case experimental design approach using changing criterion design to evaluate behavioral activation to treat depression and diabetes in a 68 year-old Hispanic woman with cognitive impairment. Across her intake, five treatment sessions, and two follow-up appointments, we collaborated with her to set and achieve behavioral goals while effectively managing her diabetes. By end of treatment, she reported significant improvements in depression and overall well-being, increased engagement in exercises, increased blood glucose tracking, and rated improvement in her overall efficacy in life that maintained through follow-up. Results revealed the effectiveness of behavioral activation in treating comorbidities in a low-income, diverse individual. Attendees will learn about a promising treatment avenue for older individuals with complex medical and psychiatric conditions and the utility of single case design.
UNDERSTANDING THE EXPERIENCE OF EUSTRESS AMONG OLDER ADULTS WITH CHRONIC CONDITIONS
Authors: An Jaesung , Payne Laura , Liechty Toni , Iwasaki Yoshitaka 
Published: December 2022

Abstract
In their longitudinal study of stress and health among adults, McGonigal and colleagues (2013; 2016) suggested that how person perceives stress is a key factor affecting their actual physiological health. This is related to the concept of eustress (i.e., positive response to a given stressor) which has received very little attention in the literature. Besides, older adults with chronic conditions deal with symptoms that are difficult to manage and can contribute to chronic stress, which can then affect their health status and quality of life. Thus, helping older adults to shift their perceptions and interpretations of stressors from distress to eustress, rather than trying to avoid stress seems to be a reasonable approach to help them experience healthy aging. The purpose of this study was to explore the experience of eustress among older adults with chronic conditions in the context of leisure. Sixteen participants were recruited from three settings in a Midwestern city: a retirement community, an assisted living center, and a community senior program. Findings showed that participants’ health conditions were one of their greatest stressors, however, they modified their leisure engagement based on their conditions to enable their engagement in valued leisure activities. In the context of leisure, five themes emerged as facilitators that helped older adults to experience eustress: leisure satisfaction, sense of control, high levels of perseverance, positive attitude, and spiritual belief. Direct quotes and further discussion on how the themes are represented in the stress, leisure, and gerontology literature will be presented.
MARITAL DISSOLUTION AND DEPRESSIVE SYMPTOMS IN MIDDLE AND LATE LIFE: AN ANALYSIS OF THE HEALTH AND RETIREMENT STUDY
Authors: Tucker Julia , Han Sae Hwang 
Published: December 2022

Abstract
Literature to date has long indicated that marital relationships serve as one of the most important sources of health and well-being across adulthood. Despite the well-documented link between marital status and health, however, studies that have examined strict within-person linkages between martial transitions and subsequent health are limited . Drawing from the strength and vulnerability integration theory and the life course perspective, we investigated within-person mental health consequences of two forms of marital dissolution (i.e., divorce and widowhood), and whether the mental health consequences vary depending on the timing of marital dissolution (i.e., midlife vs late adulthood). Data for this study came from 11 waves of longitudinal data from the Health and Retirement Study (1998-2018). Study sample included 22,911 individuals 50 and older (11,429 women, 11,482 men) who were selected at the first wave at which they were identified as married during the observation period and subsequently followed up for up to 14 years (person-wave observations N=127,081). Approximately 4% and 17% of the study sample experienced a divorce and widowhood, respectively, during the observation. Mental health was assessed with an 8-item version of the Center for Epidemiologic Studies Depression scale. Study findings based on multilevel models indicated a robust within-person association between transition to widowhood and higher levels of depressive symptoms, but such association was not found regarding divorce. For women only, the mental health consequences of widowhood experienced during midlife were more detrimental compared to late-life widowhood. The findings are discussed in the context of intervention strategies.