bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE ROLE OF CAREGIVERS DURING DISASTERS
Authors: Wyte-Lake Tamar , Haverhals Leah 
Published: December 2022

Abstract
The COVID-19 pandemic laid bare the critical role caregivers play in supporting the older adult population, and how easily care structures can fall apart under the stress of a disaster event. As our population rapidly ages, it is imperative to better understand how to support caregivers to ensure relationships between caregivers and older adults remain robust and guarantee everyone’s safety. Therefore, this symposium focuses on the roles of formal and informal caregivers during disasters, primarily the COVID-19 pandemic. Dr. Richard Chunga will present findings from a survey of homecare aides, exploring drivers of high turnover rates and describing how employers can improve job satisfaction. Dr. Lindsay Peterson will describe barriers and facilitators to disaster preparedness among caregivers, using interviews with caregivers from diverse backgrounds in Florida. Ms. Jessica McLaughlin (PhDc) will share experiences of informal female caregivers, derived from interviews across the United States (US). Chelsea Manheim (LCSW) will describe adaptations to care provision for rural Medical Foster Home (MFH) Veterans from interviews conducted with MFH care providers from across the US. Dr. Carrie Wendel-Hummell will share data around the strengths and challenges of the self-directed care model for home-based long-term care, drawing on interviews with consumers, caregivers, workers, and providers in Kansas. As a whole, these presenters will provide insights into experiences of caregivers as they navigated challenges associated with the COVID-19 pandemic and generate forward thinking on how to inform future disaster response. Sponsoring SIGs: Paid Caregiving, Family Caregiving, Assisted Living, Disaster and Older Adults
MOMENTARY VARIATION IN SUBJECTIVE AGE, PERCEIVED STRESS, AND PHYSIOLOGICAL REACTIVITY IN LATE MIDLIFE
Authors: Tingvold Maiken , Borgmann Lisa , Kornadt Anna 
Published: December 2022

Abstract
The age people feel, their subjective age, can vary on both daily and momentary levels. Previous longitudinal and daily-diary studies have shown that hormonal and self-reported measures of stress covary with subjective age. Our study aims at exploring momentary fluctuations in subjective age and their relation to objective and subjective measures of stress assessed in people’s daily lives. 54 participants aged 50 – 62 years (Mage = 56.1 yrs, 75% female) wore sensors recording their physiological reactivity and reported on perceived stress and subjective age six times per day for one week. We found that a lower subjective age was related to a greater heart rate variability and less perceived stress on a momentary level. Our findings confirm and expand studies showing the association of stress and subjective age and their importance for aging processes in late midlife.
2022 IRVING S. WRIGHT AWARD
Authors: Gill Thomas 
Published: December 2022

Abstract
Dr. Gill is a leading international authority on the epidemiology and prevention of disability among older persons. His nomination for the Wright Award lauded his groundbreaking research on the mechanisms underlying and interventions targeting functional decline and disability among community-living older persons., He collaborates with investigators throughout the country, is a leader of multisite clinical trials, and is a devoted mentor. He has published more than 350 original reports and has been continuously funded by the National Institutes of Health (NIH) and multiple foundations since 1997. Dr. Gill is the Humana Foundation Professor of Medicine (Geriatrics) and Professor of Epidemiology (Chronic Diseases) and of Investigative Medicine; Director, Yale Program on Aging; Director, Claude D. Pepper Older Americans Independence Center; Director, Yale Center for Disability and Disabling Disorders; and Director, Yale Training Program in Geriatric Clinical Epidemiology and Aging-Related Research.
DOES DISTANCE CARE MAKE A DIFFERENCE IN THE STATUS OF CARE RECIPIENTS OVER AN 18-MONTH PERIOD?
Authors: Wakui Tomoko , Kai Ichiro , Awata Shuichi 
Published: December 2022

Abstract
Aging in place is a priority for policy makers and individuals, and the continuity of care provided at home is one of the major concerns. Co-resident caregiving has been a dominant caregiving arrangement in Japan; however, the solitary residence of older care recipients has become more frequent. This study thus examined the impact of distance care on the status of care recipients over an 18-month period. Longitudinal data were collected from family caregivers of older adults in 17 municipalities of north-central Japan beginning in 2010. The status of care recipients after 18 months was categorized as receiving care at home, being institutionalized, deceased, hospitalized, moved out from the community, recovered, or untraceable. Care recipients’ age, gender, activities of daily living, dementia symptoms, and caregivers’ age, gender, health status, economic status, and caregiving burden were measured. We analyzed data of 2280 care recipients–caregiver dyads. Care recipients’ mean age was 84.7 (SD=7.3), and 66.7% were women. Of those, 65.0% had some dementia symptoms. Multivariate logistic regression models predicting the status of care recipients after 18 months showed that distance care had significant effects on care recipients’ status. Those who received distance care were more likely to be moved out, institutionalized, and deceased after 18 months, even after controlling for their care needs and caregiving situations. There were no significant effects on being hospitalized. This study suggests that the more difficult situation pertaining to staying at home is experienced by care recipients who received distance care, and support is required.
RACIAL AND ETHNIC DIFFERENCES IN HEALTH OF SPOUSES OF COGNITIVELY IMPAIRED OLDER ADULTS
Authors: Cantu Phillip , Samper-Ternent Rafael , Chen Lu 
Published: December 2022

Abstract

Introduction
A large body of research in the U.S. shows that non-Hispanic black (black) and Hispanic older adults have higher rates of cognitive impairment and dementia compared to Whites. Little research has examined how cognitive life courses differentially affect spouses of cognitively impaired older adults.

Objectives
This paper will describe the different life courses of spouses of cognitively impaired older adults by race and ethnicity in the U.S.

Methods
Using data from the 2010 Health and Retirement Survey, we examine differences in the health of spousal dyads where one partner becomes cognitively impaired over follow up, by 2016. Spousal dyads are limited to Hispanic (n=464 dyads), i black (n=345 dyads), or white (n=2,409 dyads) couples who were both cognitively normal at baseline and had cognition information at follow up.

Results
Hispanic and Black dyads were more likely to have at least one partner become cognitively impaired over the follow up period despite being younger than White dyads. A total of 23% of Hispanic dyads, 26% of Black dyads and 16% of White dyads were N/CI at follow up. Despite fewer chronic conditions at baseline, a higher proportion of Hispanic dyads with no chronic conditions had at least one member become cognitively impaired (20%) compared to Whites (6.28%).

Conclusion
Our results show that health of couples changes differently by race and ethnicity. A higher proportion of Hispanic and Black dyads have partners with cognitive impairment and the cognitive impairment happens earlier in life.
LONGITUDINAL CHANGE IN LIVING ARRANGEMENTS AND COGNITIVE IMPAIRMENT
Authors: Kim Jiwon , Cantu Phillip , Angel Jacqueline 
Published: December 2022

Abstract

Objective
To examine changes in living arrangements and cognition in the U.S. and Mexico.

Methods
Latent class analysis to document the joint progression of cognitive impairment and changes in living arrangements using the Hispanic -EPESE and the Mexican Health and Aging Study (MHAS)

Results
In the H-EPESE, vital status analyses reveal that those who died were more likely than survivors to report likely dementia and co-morbid physical conditions and one third of older adults lived alone. Almost one-fifth of the H-EPESE sample suffered a decline in cognition over time. Despite declines in cognitive function, there is a great deal of stability in living alone across waves. We expect even greater stability and change in living alone in the event of cognitive decline in the MHAS given cultural traditions and fewer options in care and a lower propensity to live alone in Mexico.
MHEALTH DESIGN AND IMPLEMENTATION IMPLICATIONS TO PROMOTE PHYSICAL ACTIVITY IN OLDER HISPANICS/LATINOS WITH MCI
Authors: Perez G Adriana 
Published: December 2022

Abstract
Addressing physical inactivity for older Hispanics/Latinos with mild cognitive impairment (MCI) is a public health priority, since MCI increases the risk of developing Alzheimer’s Disease and related dementias (ADRD). Compared to non-Latino Whites, Hispanics/Latinos are 2X more likely to develop ADRD. One promising approach to promoting physical activity includes use of mobile health (mHealth) strategies that may deliver Spanish-language information and culturally relevant motivational messages to enhance intrapersonal/interpersonal factors for health behavior change. The purpose of this study is to test mHealth strategies as a mechanism to deliver booster sessions for reinforcing physical activity goals/progress among older Latinos with MCI who complete the Tiempos Juntos intervention treatment. Our hypothesis is that culturally adapting mHealth strategies may improve efficacy and maintenance of physical activity effect; as well as cognitive health outcomes (6 months post-intervention). Results among the first wave of participants will be discussed, including challenges and opportunities for future research. While the use of mHealth is not new, these approaches commonly exclude individuals with limited-English proficiency and thus, designing interventions that center the needs of older Hispanics/Latinos with MCI/ADRD and other historically excluded communities, is an important first step in promoting physical activity and advancing cognitive health equity.
LIFE EVENTS AND CARDIOVASCULAR DISEASE EVENTS: THE STUDY OF WOMEN'S HEALTH ACROSS THE NATION
Authors: Koffer Rachel , Thurston Rebecca , Matthews Karen 
Published: December 2022

Abstract
Cardiovascular disease (CVD) is the number one cause of death for women, and major life events across midlife may contribute to CVD risk. The present study aimed to test whether greater exposure to major life events across nearly two decades of longitudinal follow-up would be associated with higher risk of clinical cardiovascular disease events. 3,222 middle-aged women from the multi-ethnic Study of Women’s Health Across the Nation reported and provided up to 15 years of major life events, non-fatal incident CVD events, traditional biobehavioral and sociodemographic factors, and death certificates. Cox proportional hazards models were used to test the association between average annual life events and incident fatal and nonfatal CVD events. Each additional major life event was associated with a 1.16-fold (95% CI: 1.08-1.23) increase in CVD events. CVD risk will be discussed considering evidence of racial/ethnic disparities in exposure to major life events.
PREDICTIVE MODEL OF 30-DAY HOSPITAL READMISSION FOR PATIENTS WITH ALZHEIMER’S DISEASE
Authors: Mahmoudi Elham , Najarian Cyrus , Wu Wenbo , Aikens James , Bynum Julie 
Published: December 2022

Abstract
Hospitals are insufficiently equipped for patients with Alzheimer’s disease and related dementia (ADRD). Thus, 30-day hospital readmission is higher and costlier among ADRD patients than the general population of older adults. Our objective was to develop a risk-assessment tool for hospitalized patients with ADRD. We used 2016-2019 electronic medical record (EMR) data from the University of Michigan health system and applied machine learning techniques to develop a readmission risk-assessment tool. We identified 2,899 individuals with ADRD who had at least one index hospital admission. All data features available in EMR – demographics, lab results, prior counts of healthcare use, and characteristics of index hospitalization – were included in our predictive models. Additionally, we geocoded the street address of patients using the National Neighborhood Data Archive using the U.S. Census tract-level information to include two composite measures of socioeconomic status: disadvantage and affluence. The readmission rate for ADRD patients was 22% versus 17% for the general population. The best predictive model was the Random Forest (area under the receiver operating characteristic curve=0.66; sensitivity=0.64; specificity=0.61). The accuracy of our model (0.61) was 42% higher than the LACE score (0.43), which is currently used by the hospital for all patients. The top 5 predictors of 30-day readmission among people with ADRD included length of hospital stay, frailty index, living in a disadvantaged neighborhood, and total prior-year healthcare charges. Our risk-assessment tool identifies ADRD patients at high risk of readmission and why they are at higher risk. The tool enables better decision-making before discharge.
THE INCREMENTAL EFFECTS OF DEMENTIA ON HEALTHCARE USE AND ECONOMIC STATUS IN THE US: A QUASI-EXPERIMENTAL APPROACH
Authors: Choi HwaJung , Langa Kenneth , Norton Edward , Cho Tsai-Chin , Connell Cathleen 
Published: December 2022

Abstract
This research is to assess the impact of dementia on healthcare use and economic status over the course of dementia. We used a nationally representative, longitudinal study of older adults, specifying two propensity-score matched samples: 1) 3,476 adults aged 55+ at baseline who would have dementia in two years (hereafter “dementia group”), and 2) 3,476 adults who had never transitioned to dementia but had similar baseline sociodemographic and health status (hereafter “control group”). In two-year follow-up, the total care hours from unpaid helpers (44 hours per month vs. 20) and other in-home medical care (24% vs. 15%) were substantially higher with vs. without dementia. In the dementia group, the percentage of using nursing homes increased from 4% at the baseline to 27% at 8-year follow-up, compared to the increase from 3% to 10% in the control group. There was little change in OOP costs in the control group but a substantial increase in the dementia group over time (from $4,443 at baseline to $11,806 in an 8-year follow-up). The percent having Medicaid increased from 17% at baseline to 33% in 8-year follow-up in the dementia group. By using a quasi-experimental approach with longitudinal data, the study clarifies the incremental effects of dementia on health care and economic status. The effects of dementia on both home-based and facility-based care are substantial, with major changes occurring at the onset. Dementia exacerbated financial resources with increasing OOP medical costs, which may have profound impacts on families and society.
PALLIATIVE CARE FOR NURSING HOME RESIDENTS: APPLYING LESSONS LEARNED FROM COVID-19
Authors: Unroe Kathleen 
Published: December 2022

Abstract
Many people receive care near or at the end of life in nursing homes, including 70% of people with Alzheimer’s Disease and Related Dementias (ADRD). Studies have documented unmet needs for symptom management and frequent transitions of care for nursing home residents. Despite this, access to palliative care for nursing home residents is inconsistent. The COVID-19 pandemic both highlighted and exacerbated inequities in access to care, including in US-based nursing homes, as well as globally. COVID-19 specific guidance for nursing homes at state and federal levels, while designed to protect residents, contributed to increased social isolation and functional decline. Drawing upon data from an ongoing study to advance palliative care for residents living with ADRD, this presentation will highlight promising practices and opportunities to deliver palliative care in this setting.
CAUSAL ANALYSES OF PALLIATIVE CARE OUTCOMES USING OBSERVATIONAL DATA: A REVIEW OF CURRENT LITERATURE
Authors: Kim Narae , Jiang Jingjing , Garrido Melissa , Jacobson Mireille , Mockler David , May Peter 
Published: December 2022

Abstract
People with serious medical illnesses disproportionately account for health care spending, and the last year of life is typically the most costly. Economic evidence to inform improvement efforts in care for this population is long recognized as thin relative to policy importance. Palliative care studies rely heavily on routinely collected data since conducting randomized controlled trials with subjects nearing the end of life is particularly challenging; however, observational studies face high risk of bias. We conducted a systematic review of the peer-reviewed and grey literature to identify quasi-experimental studies evaluating palliative care’s effect on costs and health care utilization. Eligible study designs were those that controlled for unobserved confounding using causal inference methods (e.g. difference-in-differences). Eligible outcomes were costs, health care use, and quality-of-life. Among 806 search results, we included 17 studies: seven used difference-in-differences methods, five used interrupted time series analysis, and five used instrumental variables. Reporting quality was variable. Studies reported a general pattern of improved outcomes associated with palliative care. However, the incidence of studies finding a significant difference was lower than cohort studies that don’t attempt to control for unobserved confounding. Studies that don’t control for unobserved confounding may be overestimating true effects due to bias. Given the large volume of routine data collection in end-of-life care, there exists clear potential to increase the application of the causal inference methods to palliative care research. Such studies would strengthen the evidence base on an understudied topic and potentially inform other types of economic analysis in palliative care.
PROFILE OF DECEDENTS FROM A NATIONAL COHORT OF ASSISTED LIVING RESIDENTS
Authors: Belanger Emma , Rosendaal Nicole , Wang Xiao (Joyce) , Teno Joan , Gozalo Pedro , Dosa David , Thomas Kali 
Published: December 2022

Abstract
An increasing number of older adults reside in assisted living (AL) toward the end of life, and it remains unclear if this trend represents an additional place of care and end-of-life transition before eventual nursing home admission. Our objective was to examine the characteristics and healthcare utilization of AL residents who died during a two-year follow-up. We conducted a prospective cohort study of Medicare beneficiaries residing in large AL communities (25+ beds) in January 2017, and followed them until the end of 2018 using a variety of administrative healthcare claims data. The national population of Medicare beneficiaries in AL included 273,722 fee-for-service (FFS) beneficiaries, and 143,258 Medicare Advantage beneficiaries. From 2017 to the end of 2018, 23.7% of residents died. Of the 66,605 FFS Medicare beneficiaries who died during follow-up, 77.0% were 85 years old or older, 72.2% were diagnosed with Alzheimer’s disease and related dementia (ADRD) and 80.8% were diagnosed with heart failure or chronic obstructive pulmonary disease. Most FFS decedents (97.3%) resided in AL during their last 12 months of life, with 23.0% leaving AL before the last month of life. Half of FFS decedents died in AL, while another 24.1% died in a nursing home. AL communities represent an increasingly common place of end-of-life care for dying Medicare beneficiaries. These findings point to the need for state and federal policies to protect a growing population of frail and vulnerable AL residents.
THE EXPERIENCES OF OLDER PEOPLE IN ENGLAND DURING THE COVID-19 PANDEMIC: EVIDENCE FROM ELSA
Authors: Zaninotto Paola 
Published: December 2022

Abstract
In this session we will present results from the English Longitudinal Study of Ageing (ELSA) Covid-19 substudy. Data were collected during the pandemic at two separate occasions to capture the experiences of older people and to compare them to pre-covid periods. The session will include results among people with cognitive impairment, people who contracted infections and explore the consequences on their mental health, well-being and health in general
UNDERSTANDING SOCIAL AND CULTURAL DIVERSITIES AND AGING FOR HEALTH AND WELL-BEING IN KOREAN AND KOREAN AMERICANS
Authors: Hong Seunghye , Hong Michin , Braun Kathryn 
Published: December 2022

Abstract
Guided by the socio-ecological model and the cultural diversity perspective, this symposium aims to enhance the understanding of critical issues in health and well-being among Koreans and Korean Americans with three primary focuses: aging, social-ecological and multilevel factors, and identifying social and cultural contexts. Five studies examined multilevel factors—individual, relational/interpersonal, community, and societal—that are associated with health and well-being, conducted in Korea as well as in the United States. Study 1 examined psychological well-being among older Koreans, specifically its association with intergenerational relationships and social support using longitudinal multilevel modeling to estimate depression trajectories. Study 2 examined childhood experiences and midlife cultural engagement associations among middle-aged Korean couples, considering the influences of their spouses’ experiences and cultural resources. Study 3 explored the experiences of the nature-based virtual reality program among older Korean Americans, using in-depth interviews and providing an innovative approach using technology as a therapeutic tool. Study 4 examined social determinants of health associated with Korean American immigrants’ willingness for end-of-life discussions and the factors affecting willingness (awareness of hospice, communication with family/doctors, and social isolation). Study 5 examined health insurance coverage and its association with immigration-related factors (English proficiency, generational status, and age at immigration) among Korean Americans using national data. The various health, mental health, and well-being issues in Koreans and Korean Americans will be discussed from contextually responsive approaches. This symposium will provide implications for practices, education, research, and policy to promote health, mental health, and well-being in the Korean and Korean American populations.
HEALTH INSURANCE COVERAGE, AGE, AND IMMIGRATION-RELATED FACTORS AMONG KOREAN AMERICANS
Authors: Hong Seunghye , Park Ki Tae , Lee Yeonjung , Park Mei Linn , Park Nan Sook 
Published: December 2022

Abstract
The purpose of this study was to examine health insurance coverage and its association with demographic and immigration-related factors (English proficiency, generational status, and age at immigration) among Korean Americans (KAs, n=11,462). Data were drawn from the 2017 American Community Survey. KA older adults aged 65+ had significantly higher odds of having any health insurance compared to those aged 41 to 64. KAs who speak English well or only speak English were more likely to have any health insurance compared to those with limited English proficiency (i.e., don’t speak English well or at all). First-generation KAs had lower odds of having any health insurance compared to those born in the U.S. Those who immigrated after 41 years of age were less likely to have health insurance compared to those born in the U.S. These findings underscore the need to consider immigration-related factors in efforts to increase healthcare accessibility for KAs.