bluuebunny/crossref_metadata_2025_split huggingface dataset:
ORGANOCHLORINE EXPOSURES AND COGNITIVE FUNCTION IN OLDER LIFE: THE ROLE OF RACE/ETHNICITY
Authors: Chanti-Ketterl Marianne , Aranda Maria , Plassman Brenda 
Published: December 2022

Abstract
Organochlorines (OCs) are persistent pesticides that remain in the environment and body for extended periods after exposure. Little is known about their long-term impact on cognition in later life. Some studies, but not all, have shown that higher levels of selected OCs are associated with lower cognitive function (CF). Using weighted linear generalized estimating equations, we explored whether the association between lipid-adjusted levels of 8 OCs and global CF is modified by race/ethnicity in 985 adults age 60+ from the National Health and Nutrition Examination Surveys (2011-2014). Adjusting for covariates, results indicated that higher levels of grouped-OCs are not associated with lower CF (p=0.121), but higher levels of specific OCs were associated with lower CF: Mirex[p=0.029]; Oxychlordane[p=0.036]; p,p’-DDE[p=0.009]; p,p’-DDT[p=0.003]; and trans-Nonachlor[p=0.023]. These associations did not differ by race/ethnicity. Disentangling the complex impact of OCs on late-life cognition—whether in combination or singularly—may lead to more equitable environmental health policies.
EXPLORING THE LIVED EXPERIENCE OF RACIALIZED AGEISM AMONG OLDER ADULTS: A PHENOMENOLOGICAL STUDY
Authors: Steward Andrew , De Fries Carson , Dunbar Annie Zean , Trujillo Miguel , Zhu Yating , Nicotera Nicole , Hasche Leslie 
Published: December 2022

Abstract
Ageism is a prevalent, insidious social justice issue which has harmful effects on the health of older adults. Preliminary literature explores the intersectionality of ageism with sexism, ableism, classism, and ageism experienced among LGBTQ+ older adults. To our knowledge, the intersection of ageism with racism, or racialized ageism, is largely absent from the literature. This qualitative study explored the following research question from a phenomenological perspective: “What is the lived experience of racialized ageism among diverse older adults?” Twenty participants 60+ years of age (M=69) in the U.S. Mountain West identifying as Black, Latino(a), Asian-American/Pacific Islander, Indigenous, or White engaged in a one-hour interview between February and July 2021. A three-cycle coding process used constant comparison methods. Five coders independently coded interviews, engaging in critical discussion to resolve disagreements. An audit trail, member checking, and peer debriefing enhanced credibility. Six umbrella themes and 20 sub-themes were identified. In this paper, the following six sub-themes are highlighted with direct implications for practice:1) compounding oppression, 2) being avoided or categorized due to others’ discomfort, 3) increased disrespect, 4) microaggressions, 5) acts of hate, and 6) cultural values/respect for elders as a protective factor. Implications include informing how practitioners may enhance support for older adults in preventing and coping with experiences of racialized ageism. Enhanced understanding of racialized ageism should also inform existing anti-ageism initiatives at the community level. Future research should focus on the experience of racialized ageist microaggressions and the relationship between racialized ageism and specific health outcomes.
PHYSICAL RESTRAINTS AT HOME AND THEIR FACTORS: A ONE-YEAR LONGITUDINAL SURVEY AMONG HOME CARE SERVICE USERS IN JAPAN
Authors: Yamamoto-Mitani Noriko , Numata Hanako , Fukui Chie 
Published: December 2022

Abstract
We conducted a one-year survey of homecare service users aged 75 years and older. Data from 769 clients were examined. Altogether 47 (6.1%) received physical restraint at least once among the five survey points conducted over a one-year period. Among them, 27 (57.4%) received restraint only at one point, and only 2 received restraint in all five points. In the bivariate analyses, the factors associated with the use of physical restraint were: diagnosis of neurological disease, unstable general condition or terminal stage, high level of care required, medical treatment, and family burden. When those who were released from the restraint at 12 months (n=30) were compared with those who were not (n=17), not having stroke, not receiving suctioning, and not having home-visit medical care were significant factors. Physical restraints at home were not common but we must be careful when we serve clients with significant factors of prolonged restraints.
EAST MEETS WEST: MODELS OF "AGING IN COMMUNITIES": DEMENTIA, CAREGIVING, AND ACTIVE AGING BETWEEN THE US AND TAIWAN
Authors: Kuo TsuAnn , Torres-Gil Fernando 
Published: December 2022

Abstract
As countries around the world are entering the super aged societies, aging in place will need to be planned not only as an individual but also as a multi-disciplinary and age-friendly community. Many models are built based on the concept of "Aging in communities" in order to consider the multi-levels of needs and interests that older adults face when living in the same area. With Asia being the next fastest aging continent, innovative models and programs are also developed in Taiwan as it tries to promote healthy aging, combating dementia and supporting family caregivers. This symposium will include 4 papers by introducing a national program for frailty prevention, a community friendly model for people with dementia and a collaborative network to prevent family caregivers from being burned out. In addition, the village model developed in the U. S. will be compared to show how east meets west to demonstrate communities meeting the needs of older adults.
LONG-TERM PSYCHOLOGICAL CONSEQUENCES OF PARENTAL BEREAVEMENT PRIOR TO MID-LIFE: VOLUNTEERING HELPS
Authors: Huo Meng , Kim Kyungmin 
Published: December 2022

Abstract
Losing a child prior to midlife may be a uniquely traumatic event that continues to compromise parents’ well-being in later life. This study compared psychological well-being between bereaved and non-bereaved parents, and examined whether volunteering protects bereaved parents. We analyzed a pooled sample of parents aged 50+ (N = 12,023) from the Health and Retirement Study, including parents who lost a child prior to 50 and those who never lost a child. Bereaved parents reported more depressive symptoms and lower life satisfaction than non-bereaved parents, which was more evident among parents with fewer children alive. Among bereaved parents, volunteering, particularly volunteering 100+ hours/year, was associated with better well-being at baseline; yet, volunteering 1–99 hours/year led to a larger increase in life satisfaction over time. This study adds to our understanding of lasting effects of parental bereavement and suggests volunteering as a potential intervention aimed at helping bereaved older parents.
REIMAGINING DISASTER AND EMERGENCY PREPAREDNESS IN LONG-TERM CARE: EXAMPLES FROM FLORIDA AND TEXAS
Authors: Peterson Lindsay , Andel Ross , Bell Sue Anne 
Published: December 2022

Abstract
A thread common to all disasters is the effect on human health that results when the health care infrastructure and delivery of health services are disrupted. This view has reinforced the importance of an all “all-hazards approach” to preparedness, whereby disaster response planning incorporates principles common to all events and can be adapted to specific contingencies. Preparing for and responding to a disaster in long-term care (LTC) requires a broad view of multiple events that can disrupt daily life and needed services for LTC residents (e.g. hurricanes, pandemics). This symposium will examine the effects of varied emergency events on older adults residing in nursing homes (NHs) and assisted living communities (ALCs) using quantitative and qualitative methodologies. The first presentation will discuss morbidity and mortality of NH residents exposed to Hurricane Harvey (Texas). The second is an investigation of NH direct care staffing during the recent Winter Storm Uri (Texas). The third presentation qualitatively explores the challenges of providing care to residents living with dementia during the COVID-19 pandemic, based on interviews with Florida NH and ALC administrators. The fourth quantitatively and qualitatively explores issues related to resident-to-resident contact restrictions in Florida ALCs. Finally, we will discuss the application of the 4Ms Age Friendly framework (What Matters, Medication, Mentation, and Mobility) to disaster preparedness in LTC. This symposium will provide information that can be used to develop or revise public policies to improve preparedness for and response to a range of emergency events in NHs and ALCs.
FEDERAL ACTIONS TO SUPPORT FAMILY CAREGIVERS UNDER THE BIDEN ADMINISTRATION
Authors: Tell Eileen 
Published: December 2022

Abstract
Family caregivers are the glue holding together the delivery and financing of long-term care. Replacing family care with paid care would cost roughly $470 billion each year. But family caregivers are struggling. They face many challenges – most notably the financial stress and the need for services and supports. Other challenges include lack of respite care, need for caregiver training, and lack of access to quality paid workforce. In order to address these challenges, Congress authorized the RAISE Family Caregiving Advisory Council. The RAISE (Recognize, Assist, Include, Support and Engage) Family Caregivers Act directs the Secretary of Health and Human Services to develop a national family caregiver strategy. This session presents the findings of two years of focus groups and interviews with family caregivers and hundreds of stakeholder organizations that support them, providing concrete input to the Biden administration on how to deliver on the broad objectives of the RAISE Act.
AGING COUPLES’ SATISFYING RELATIONSHIPS AND WE-TALK PROMOTE CARDIOVASCULAR HEALTH DURING CONFLICT
Authors: Shrout M Rosie , Wilson Stephanie , Renna Megan E , Madison Annelise A , Kiecolt-Glaser Janice K 
Published: December 2022

Abstract
Marital conflict poses health risks that intensify as couples grow older. Dyadic stress theories suggest spouses’ marital satisfaction and communication patterns alter cardiovascular function, a key pathway from troubled relationships to poor health. Despite these risks, older spouses are more likely to have a strong couple identity where they think and talk in relational terms. This communication pattern, termed we-talk, is shown when spouses use words like “we” rather than “you” or “me,” reflecting that they are thinking about resolving conflict as a couple rather than as two separate individuals. We examined how both spouses’ relationship satisfaction and we-talk reduced conflict’s cardiovascular toll, and if the health benefits were greatest when both spouses were satisfied and used we-talk. Married couples (n=107) ages 40-87 engaged in a 20-minute conflict discussion while wearing heart rate monitors to assess heart rate variability (HRV), a measure of cardiac flexibility. Couples’ conflicts were transcribed to measure we-talk, or the proportion of first-person plural pronouns, such as we, us, and our. Results showed a person’s HRV was higher and thus healthier when both spouses were satisfied and their partner used we-talk more often. In contrast, HRV was lower and less healthy when neither or only one spouse was satisfied and their partner used we-talk less often. Thus, a couple’s mutually satisfying relationship along with a partner’s we-talk provided a health advantage during conflict. Talking in relational terms may help reduce conflict’s biological toll in aging couples, particularly when their relationships are satisfying.
DEATH FEARS AND ANXIETY ACROSS THE LIFE COURSE: IMPLICATIONS FOR DEATH REFORM
Authors: Thompson Amber , Utz Rebecca 
Published: December 2022

Abstract
Western culture is experiencing a movement for death reform which includes aspects such as death acceptance and supporting individual choice concerning how one wishes to experience end-of-life (EOL). The underlying goal of this reform is to foster natural curiosity about death and dying in order to soothe death fears and anxiety. Over the past few decades in the U.S. there has been an increase in public support for the EOL option of medical-aid-in-dying (MAID), or legally prescribed pharmaceuticals intended to cause death. There have been mixed findings regarding the effects of age on attitudes and perspectives towards death and dying. The aim of this study was to determine the relationship between age, death fears and anxiety, values and perspectives, demographic characteristics, and approval of MAID at EOL in a U.S. nationally representative sample (N = 1994), using a partially latent structural equation model (SEM). Results show that age has a curvilinear effect on death fears and anxiety, and that as death fears and anxiety increase support for MAID decrease. This suggests that the ability to provide person-and-family-centered care at EOL must address the biopsychosocial aspect of death fears and anxiety across the life course. These findings demonstrate the need for more research documenting changes in attitude and perspectives towards EOL for different populations (i.e., ages). The potential benefits of this approach provide a basis for expanding education and awareness of both death and dying in general, and EOL needs and wants for older adult populations.
FAMILY DECISION-MAKING IN SERIOUS ILLNESS SCENARIOS: ACCURACY AND PERCEIVED ACCURACY OF ADULT CHILD SURROGATES
Authors: Hahne Jessica , Carpenter Brian 
Published: December 2022

Abstract
Adult children often help older adults make important decisions in serious illness situations, but previous research suggests adult children are not uniformly accurate in predicting parents' preferences. In this project we examined the accuracy with which adult children (N= 68; M age= 45; 69.1% female) were able to predict medical preferences of their parents (N= 34; M age= 75; 94.1% female). Parents expressed their preferences in four serious illness scenarios, and children predicted parents' preferences. Parents and children also estimated the accuracy of children's predictions and the frequency of communication about medical care. On average across all scenarios, children predicted parents' preferences accurately 42.3% of the time. Parents were willing to take more risk with treatment for more severe disease, as their children predicted, although children generally overestimated parents' willingness to live with increasing disability (M difference = 9.77%). Overall, children were poor at predicting their own accuracy (Rs = -.017, p= .893). Parents were slightly more insightful about their children's accuracy (Rs= .261, p=.034), but there was no association between accuracy and parent or child estimate of frequency of conversations about medical preferences (Parent Rs= .067, p=.586 ; Child Rs= .164, p= .182). These findings suggest that neither are adult children highly accurate at predicting parents' medical preferences, nor do they or their parents have a precise sense of their accuracy. Results from this study may inform interventions to help families communicate about advance care planning.
ENGAGING ADULTS LIVING WITH COMMUNICATION CHALLENGES IN RESEARCH: EXAMPLES AND PRACTICAL TIPS
Authors: Douglas Natalie , O'Sullivan Roger 
Published: December 2022

Abstract
This symposium contends that the engagement of older adults living with a variety of communication challenges in research about interventions designed to support them results in better translation and adoption of research findings. While engaging older adults in research often takes time, effort, and systematic tools, the benefits have been recognized by multiple stakeholders including policy makers, funding agencies, practitioners, older adults, and their families. Adults living with communication challenges may have difficulty expressing or comprehending language; however, that does not preclude their engagement in research activities, especially when this research involves interventions that concern them. This symposium will illustrate three exemplars of engaging adults living with communication challenges in research activities across international initiatives. First, qualitative data from 25 interviews from a project designed to engage persons living with stroke-based aphasia in friendship programming with be discussed. Then, mixed methods data from a community-based approach to support adults living with stroke-based aphasia, mild cognitive impairment, and traumatic brain injury will be described including the process of developing and using a multi-stakeholder advisory board. Finally, involving adults living with Frontotemporal Lobar Degeneration (FTLD) in research with a focus on building trust, staying connected between meetings, being transparent about expectations and applying a narrative approach will be described. Our discussion led by Dr. Roger O’Sullivan will focus specifically on the ethical implications of engaging adults living with communication challenges in research.
ASSOCIATION OF LIVER STIFFNESS BY TRANSIENT ELASTOGRAPHY WITH MOBILITY DIFFICULTY IN OLDER ADULTS WITH NO CIRRHOSIS
Authors: Chaves Paulo H 
Published: December 2022

Abstract
Growing experience with non-invasive ultrasound transient elastography (TE) offers now a major opportunity to improve understanding about the functional impact of non-advanced, asymptomatic liver dysfunction. We assessed the relationship of liver stiffness measurement (LSM) and controlled attenuation parameter (CAP) obtained by TE, surrogates for liver fibrosis and steatosis, respectively, with mobility difficulty, an early stage of the disablement process. Cross-sectional study utilizing National Health and Nutrition Examination Survey 2017-2018 data. Analytic sample (n=1,203) included participants aged 60 years and older without known cirrhosis with available LSM and CAP. Logistic regression assessed the odds of mobility difficulty (walking ¼ mile or climbing stairs) according to LSM and/or CAP, with adjustment for demographics, diseases, metabolic syndrome, body mass index, aminotransferases, gamma-glutamyl transferases, albumin, and platelets. LSM and CAP were linearly, positively associated with the probability of mobility difficulty. In the fully adjusted model, LSM, though not CAP, remained strongly associated with mobility difficulty. Those with LSM in the top (&gt;7 kilopascals [kPa]) and intermediate quintiles (4-7 KPa) had higher odds of mobility difficulty; i.e., odds ratio (OR): 1.81; 95% confidence interval (CI): 1.15-2.86; p=0.01) and OR:1.45; 95%CI: 1.01-2.08; p=.046), respectively. LSM was independently associated with early mobility disability in older adults without known cirrhosis. A direct effect through sarcopenia promotion pathways might be speculated. Whether TE screening could be useful to identify adults with non-advanced liver fibrosis who might benefit from preventive interventions – e.g., diet and exercise for non-alcoholic fatty liver disease patients vis-à-vis mobility disability prevention remains to be tested.
HOME-BASED TRANSCRANIAL DIRECT CURRENT STIMULATION AND CLINICAL PAIN IN OLDER ADULTS: A RANDOMIZED CLINICAL STUDY
Authors: Ahn Hyochol , Martorella Geraldine , Mathis Kenneth , Miao Hongyu 
Published: December 2022

Abstract
Knee osteoarthritis (OA) is one of the leading causes of pain in older adults. Previous studies indicated clinic-based transcranial direct current stimulation (tDCS) was effective to reduce pain in various populations, but no published studies have reported the efficacy of home-based self-administered tDCS in older adults with knee OA using randomized clinical study. Thus, the purpose of this study was to evaluate the efficacy and safety of tDCS on clinical pain intensity in adults with knee OA pain. One hundred twenty participants aged 50–85 years with knee OA pain were randomly assigned to receive fifteen daily sessions of 2 mA tDCS for 20 min (n = 60) or sham tDCS (n = 60) over 3 weeks with remote supervision via telehealth. Clinical pain intensity was measured by asking participants to rate their knee pain using a numeric rating scale from 0 (no pain) to 100 (worst pain imaginable). Participants (68% female) had a mean age of 66 years and the mean body mass index in the sample was 32.59 kg/m2. There have been no adverse events. Active tDCS significantly reduced pain intensity compared to sham tDCS after completion of the fifteen daily sessions (t = 6.57, df = 110, p &lt; .001). We demonstrated that home-based self-administered tDCS was safe and reduced clinical pain intensity in older adults with knee OA, which can increase its accessibility. Future studies with multi-site randomized controlled trials with various populations are needed to validate our findings.
HOSPICE UTILIZATION AND PLACE OF DEATH BY DEMENTIA DIAGNOSIS AND RACE/ETHNICITY
Authors: Jarrín Olga , Lin Haiqun , Wu Bei , Duberstein Paul , Lopez Maria , Zafar Anum 
Published: December 2022

Abstract
Timing of hospice referral is critical to patient’s and family’s quality of life and satisfaction with hospice care. This study examined racial/ethnic variation in hospice use and factors associated with death at home among Medicare beneficiaries aged 50 years and older who died in 2018 (n=1,998,282). Hospice use was most frequent among non-Hispanic white beneficiaries (55.8%) followed by Hispanic (46.2%), Asian American (44.5%), Black (42.7%), and American Indian (42.1%) beneficiaries. Among decedents diagnosed with dementia, initiation of hospice prior to the last day of life was significantly associated with death at home among all racial/ethnic groups: non-Hispanic white (OR=2.62), Black (OR=2.04), Hispanic (OR=2.17), Asian American (OR=2.54), and American Indian (OR=2.76). Among decedents not diagnosed with dementia, initiation of hospice prior to the last day of life was less strongly associated with death at home: white (OR=1.33), Black (OR=0.83), Hispanic (OR=1.32), Asian American (OR=1.69), and American Indian (OR=1.56).
PLACE OF DEATH AND CARE SATISFACTION AMONG THE HEALTH AND RETIREMENT STUDY DECEDENTS
Authors: Malatyali Ayse , Rahemi Zahra , Cidav Tom , Dye Cheryl , Jarrín Olga , McMahan Christopher 
Published: December 2022

Abstract
The place of care at the time of death can influence the satisfaction, type, and cost of end-of-life care. This study investigated factors associated with place of death among older adults in the Health and Retirement Study (Exit files 2002-2018) with cognitive impairment (n=3,102). Black and Hispanic participants were more likely to die in the hospital (OR=1.80, 1.47) and less likely to die in a nursing home (OR=0.54, 0.37) than white and non-Hispanic participants. Hispanic participants were also 50% more likely to die at home than non-Hispanics. Compared to other places, participants who died at home were 43% more satisfied, and participants who died at nursing homes were 32% less satisfied with the care they received. There was no significant effect of ethnicity on the relationship between place of death and satisfaction with care. Investigating the moderating role of other demographic factors can shed more light on this relationship.