bluuebunny/crossref_metadata_2025_split huggingface dataset:
CONNECTING RURAL OLDER ADULTS WITH DISABILITIES TO HOME MODIFICATIONS WITH A REMOTE HOME ASSESSMENT
Authors: Nabors Emily , Garell Catia , Pynoos Jon 
Published: December 2022

Abstract
Older adults living in rural areas have particular challenges to accessing critical supportive services such as home modifications to promote functioning and safety. Conducting remote home assessments through telehealth has the potential to reduce time spent and overall cost that occur in conducting in-person assessments. During the pandemic, providers turned to telehealth to preserve continuity of assessment services with few research-based practices to guide them. With support from a NIDLRR SBIR grant, Thrive for Life LLC in partnership with the USC Leonard Davis School of Gerontology conducted research to develop a remote home assessment that aims to connect health and home modification providers with rural older adults (65+) with disabilities, a population that may not receive home modifications otherwise. Research included a literature review, key informant interviews with five experts in the field, and individual phone interviews with 30 rural older adults who have disabilities. The literature was analyzed and used to inform the interview questions. Key informant interview responses were analyzed for models, potential challenges, lessons learned, and opportunities to impact priority needs. Consumer interview responses were analyzed for needs, preferences, concerns, and challenges related to technology use. Findings demonstrate common barriers such as lack of access to broadband and smart technology; circumstances in which remote assessments are, and are not, likely to be successful; and the potential value of conducting remote home assessments in rural areas to ensure equity of access to home modifications for older adults with disabilities during the pandemic and beyond.
AGING IN PLACE: TURNING TO THE VOICES OF EXTENSION EDUCATORS
Authors: Koerner Susan , Anderson Brianna , Ju Sehyun 
Published: December 2022

Abstract
Most adults report a preference for aging-in-place (AIP) – remaining safely in their own home and community as they age, even as they become more dependent on others. When attempting to determine options and feasibility for AIP, older adults and/or their families – especially those living in non-metropolitan rural areas and small towns, may turn to Extension educators for information and guidance. For the current study we interviewed seven family-focused Extension educators responsible for 25 counties throughout a Midwestern state to explore the challenges, supports, patterns of experience, and service/policy recommendations that these professionals find relevant to AIP in their regions. The principal investigator (PI) conducted each semi-structured interview by phone; each audio-recorded interview lasted approximately 60 minutes. Two trained research assistants and the PI applied combined deductive-inductive thematic analyses to the transcribed interview data following Braun and Clarke (2012), utilizing MAXQDA, and ensuring trustworthiness during the coding process. Five major categories with sub-themes emerged: Challenges to AIP (e.g., transportation), Supports to AIP (e.g., churches), Most-Challenged Populations (e.g., middle-income families who neither can afford in-home assistance nor are eligible for government aid), Attitudes Toward AIP (e.g., caution against social isolation), and Recommendations for Services/Policies to Facilitate AIP (e.g., government funding, in-home technology assistance). Some variation across counties was apparent with, for example, one county making concerted efforts to retain young adults in its communities (i.e., reducing out-migration), thus enhancing family presence making AIP more feasible, non-isolating. Our findings will be especially noteworthy to social service providers and aging-focused public policymakers.
GEOGRAPHIC PROXIMITY TO NEIGHBORHOOD RESOURCES AND DEPRESSIVE SYMPTOMS AMONG KOREAN OLDER ADULTS
Authors: Lee JuHyeong , Shin Donghee , Kim Yeoju , Kim Giyeon 
Published: December 2022

Abstract
Given the importance of geographic proximity to neighborhood resources especially during the COVID-19 pandemic, this study examine whether the relationship between geographic proximity to neighborhood resources (e.g. hospitals, public transportation, etc.) and depressive symptoms varied by geographic location (i.e., rural vs. urban areas) among older adults in South Korea and whether this relationship was mediated by participation in social activities (e.g. education, club, community, etc.). The nationally representative samples, Korean older adults aged 65 or older, were drawn from the 2020 Survey of Living Conditions and Welfare Needs of Korean Older Persons (N=9,732, Urban=6,975, Rural=2,757). Hierarchical regression models, Baron and Kenny’s steps, and Sobel Test for the mediation effect were conducted. Results showed that geographic proximity was negatively associated with depressive symptoms in urban areas (B=-.041, p&lt;.001), while positively associated in rural areas (B=.034, p&lt;.01). Participation in social activities partially mediated the relationship in urban areas (Z=-2.162, p&lt;.05), while there was no significant mediation effect in rural areas. Additionally, geographic proximity to hospitals or public transportation was significantly associated with depressive symptoms in rural areas. The findings suggest that geographic proximity to neighborhood resources helps older adults reduce social isolation, which may improve mental health of older adults living in urban areas during the pandemic. However, geographic proximity to neighborhood resources could make older adults living in rural areas become depressed, emphasizing that the characteristics of the urban and rural areas need to be considered to create an aged-friendly environment.
NEIGHBORHOOD PREDICTORS OF MENTAL HEALTH OF OLDER AMERICANS: EVIDENCE FROM A 5-YEAR LONGITUDINAL STUDY
Authors: Orekoya Afolabi , Egbuchiem Henry , Olanisa Olawale , Arisoyin Abimbola , Ebili Ujunwa , Adaralegbe Adeleye , Abbasi Khuzeman 
Published: December 2022

Abstract
With increasing dependence on other people in old age, environmental resources become an important asset for older adults to experience healthy aging. Data on the longitudinal relationship between neighborhood and mental health in late life is scanty. This study utilized hierarchical multiple regression model analysis to investigate whether and which neighborhood factors predicted depression and anxiety among older Americans followed up for over five years within the same neighborhood. Two waves of data containing a cohort of 1,731 older adults from the NSHAP project were used. Outcome measures were depression and anxiety. Predictors were four neighborhood factors: Social cohesion (NSC), social ties (NSC), neighborhood problems (NP), and perceived neighborhood danger (PND). We adjusted for demographic and physical health characteristics. The mean age of the respondents was 71.4 ± 6.5 years and were mostly females (55.5%). Lower NSC and a higher PND significantly predicted depression. However, the model only explained 2.8% of the variance in depression. In the covariate-adjusted model, none of the neighborhood factors predicted depression, but the model significantly improved to 32.5%. NP was the only significant predictor of anxiety in the final model and explained 27.8% of the variance in anxiety. Covariates, which are primary determinants of mental health disparity, have a much larger role to play. This study sheds some light on the complexity of the relationship between neighborhood and mental health in older adults. Future policy development and interventions should target improving both physical and social environments to enhancing the mental wellbeing of older adults.
EARLY-LIFE EDUCATION AND COGNITIVE AGING: DOES CONTENT, LOCATION, AND HISTORICAL CONTEXT MATTER?
Authors: Smith Jacqui , Zahodne Laura 
Published: December 2022

Abstract
Life course and cognitive aging theories about the sources of subgroup and individual differences in susceptibility to cognitive impairment frequently highlight the significance of early-life education, defined in research by total years of school and highest degree. A more nuanced approach could shed light on why and for whom education matters for brain aging processes. For example, one year of school in the 1930s may not be the same as one year in the 1960s, or in different school types and states in this historical period. In addition, post- high school training and degrees differ in content. Each paper in this symposium uses early-life education history and late-life cognitive data from the Health and Retirement Study (HRS). Speakers discuss what guided their selection of specific education content, location, contexts and analytic strategy. Williams-Farrelly asks how individuals characterized by privileged high school educational experiences in the period from 1930 to the 1960s benefited in terms of social mobility and later-life cognitive functioning. Nkwata, in contrast, focuses on early-life education experiences that potentially limit the skills acquired together with exposure to family adversity and stress. Yu utilizes sequence analysis to identify and examine the association between late-life cognition and variations in patterns of K-12 education defined by duration and order of racial/ethnic composition. Walsemann and colleagues ask if state-level differences in the timing and implementation of school desegregation policies explain Black-White disparities in the transition to cognitive impairment in the US South. The session concludes with an integrative discussion by Zahodne.
SENIOR HOUSINGS’ ROLE FOR AGING IN PLACE: FOCUSING ON THE NATIONAL PROFILE OF INDEPENDENT LIVING FACILITIES IN KOREA
Authors: Park Sojung , Ryu ByeongJu 
Published: December 2022

Abstract
Understanding the changing preference for alternative housing arrangements is important due to the confluence of a global population aging, increasing cost concern for long-term care, and the desire of older people for aging in place (AIP). To date, little is known about to what extent the current housing models meets the needs of AIP for older people. Guided by the Person-Environment fit perspective, we examined the South Korean case using the first national data on independent living facilities (ILF) for older adults. Employing a convergent mixed-method design, we conducted a quantitative analysis of 277 ILFs and qualitative interviews with executive directors and managers from 10 facilities. We found the majority of the housings serve the low-income, and the residents' health status varies widely (i.e., ranging from fully independent to those homebound). However, the characteristics and nature of services available and staff composition are not adequate to meet the needs of the residents. Notably, privacy issues (i.e., a shared restroom and bedroom) in congregate settings stood out, decreasing the occupancy rate. Our findings suggest that the housing model needs to be diversified corresponding to the resident's needs for health and social care and economic affordability and should respect their privacy needs. We discussed ways to reform the current policy governing the ILFs, including strengthening service coordination programs to alleviate gaps between the residents' needs and the service availability. Our findings provide implications for improving and reforming the existing housing model to age in place in Korea and potentially other aging societies.
LONGITUDINAL ASSOCIATIONS OF SOCIAL CONNECTEDNESS, SOCIAL CONTRIBUTION, SOCIAL ENGAGEMENT, AND LATE-LIFE DRUG USE
Authors: De Main Atami , Powers Daniel , Xie Bo 
Published: December 2022

Abstract
Substance misuse among older adults is a growing and complex problem with implications for society, aging adults, and their families. It is understudied in research and clinical practice. Limited and mixed evidence exists that suggests relationships between changes in older adults’ social environment and their drug use over time. This study addressed this gap by examining potential associations between social environment and drug use among community-dwelling older adults. Data were drawn from 3-waves of the national longitudinal survey of Midlife Development in the United States (MIDUS) (N= 2,020; age range=55-94 years; Mean=63.10, SD=5.66 at Wave 1). We estimated multilevel logistic growth models to assess the relationships between social environment indicators (social connectedness, social contribution, social engagement) and drug use, controlling for age, marital status, race/ethnicity, education level, household income, employment status, and number of chronic conditions. Our findings showed significant odds of drug use over the 20-year period of study, which were increased among older adults with multiple chronic conditions with a 59.5% risk of drug-related problems. Social contribution (feelings of being valued by society) negatively predicted older adults’ drug use whereas social connectedness and social engagement were not significant predictors over time. The models also indicated a moderating effect of social contribution on drug use, showing low changes in drug use over time with low social contribution. Our findings illuminate the differential roles of social environment indicators in drug use. Future research, policy, and practice may particularly focus on the role of social contribution in late-life drug use.
ADDRESSING GAPS IN PRIMARY CARE DIAGNOSIS OF COGNITIVE IMPAIRMENT VIA A NURSE CONSULTATION
Authors: Shin So Young , Bui Nhat Minh , Kiekhofer Rachel , Goode Collette , Dulaney Sarah , Possin Katherine 
Published: December 2022

Abstract

Purpose
This study aimed to identify the concerns and unmet needs of patients and care partners after incident primary care diagnosis of cognitive impairment.

Methods
Primary care providers referred older adults who had newly diagnosed with cognitive impairment for a telephone encounter, the ‘Brain Health Consultation’ (BHC), with a dementia expert nurse. The nurse assessed for questions or concerns regarding immediate needs, cognitive, neuropsychiatric, functional, or other symptoms; cognitive assessment results and the diagnosis; care planning including safety, prognosis, treatments, advance care planning, and community services.

Results
Patients (N=37) and care partners (N=30) completed the BHC. The patients were racially/ethnically diverse; 51% Asian, 18% Non-Hispanic White, 10% Hispanic, 10% Black, 11% other). Most patients (70%) and caregivers (70%) endorsed cognitive concerns, and many patients endorsed mood (65%), sleep or fatigue (49%), and pain (10%) concerns. All patients and care partners had questions about the assessment results and diagnosis, and some patients (11%) and caregivers (13%) expressed concerns about disease progression. Few patients and caregivers expressed care planning needs.

Conclusion
Following incident cognitive impairment diagnosis in primary care, patients and families have unmet needs around understanding their assessment and diagnosis. Care planning may be reserved for a follow-up consultation after the patient and family have had time to understand and accept the diagnosis. While we used a dementia expert nurse to perform the BHC, given the types of concerns identified, a supervised, trained, unlicensed health professional (e.g., a care team navigator) may be appropriate to perform the BHC.
EFFECTS OF SPECIAL NURSING UNITS IN NURSING HOMES: FOCUSING ON HEALTH OUTCOMES AND SATISFACTION
Authors: Cho Eunhee , Yoon YeaSeul , Choi Seonhwa , Kim Eunkyo 
Published: December 2022

Abstract
This quasi-experimental study aimed to evaluate the effectiveness of special nursing units in nursing homes by comparing health outcomes and satisfaction between the general nursing units and special nursing units across nursing homes in South Korea. Surveys—paper, phone, and online—were conducted five times (March, August, and November 2019; June and October 2020) for health outcomes (health pattern changes and the number of residents with new health problems) and four times (March and August–November 2019; June and October 2020) for satisfaction. Descriptive analysis, χ²-test, paired t-test, and McNemar test were performed using the SPSS 25.0 program. The results showed an improvement in the health outcomes of residents in the special nursing units. Regarding health pattern changes, there was a decrease in the number of residents facing problems related to consciousness, cardiovascular function, urination, defecation, and pain and of those with new health problems such as aches, falls, pressure sores, and urinary incontinence. Furthermore, caregivers’ satisfaction in the special nursing units was higher than that of their counterparts in the general nursing units. The results of this study will be used as evidence to expand this special nursing unit’s services in the future.
HEALTHCARE AIDE-FOCUSED INTERVENTIONS TO IMPROVE PAIN MANAGEMENT IN LONG-TERM CARE
Authors: Knopp-Sihota Jennifer , Nuspl Megan , MacGregor Tara , Reeves Jennifer , Saleem Ahsan 
Published: December 2022

Abstract
Pain is endemic for residents of long-term care homes, with many residents experiencing pain daily. Given that healthcare aides provide most daily care for residents, they are ideally situated to deliver timely assessment and non-drug interventions for managing resident pain. In this Cochrane-style systematic review, we searched 7 databases to identify intervention studies that included long-term care residents aged ≥60 years who received interventions to reduce chronic pain. Interventions were either delivered by healthcare aides at the resident level or were directed at healthcare aides to improve their pain management practices. We screened 400 titles/abstracts and 152 full-text articles. Nine studies met inclusion criteria and were included in a narrative review. Due to the limited number of studies and variety of study designs, data were insufficient to perform meta-analyses or thematic analysis. Three studies described pain interventions delivered by healthcare aides at the resident level reporting significant improvement of pain. Six studies described pain interventions delivered to healthcare aides. Results of these interventions were inconsistent; 2 reported significant improvements in pain-related outcomes (e.g., resident pain, monitoring of pain), 3 reported insignificant changes, and 1 reported a positive correlation between measured pain and pain medication use. We concluded that despite the paucity of research in this area, this systematic review provides preliminary support for pain interventions by healthcare aides for long-term care residents. Future research exploring interventions for healthcare aides to take greater roles in pain management could unlock further improvements in resident care.
CHARACTERIZING GENERATIONAL CAREGIVING USING DATA FROM THE BRFSS
Authors: Olivari Benjamin , Reed Nia , Bouldin Erin , Jackson Eva , Omura John , McGuire Lisa , Croft Janet 
Published: December 2022

Abstract
As the proportion of family and friends in the U.S. providing informal care increases, it is important to understand how this may impact certain demographic groups. Millennials and older adults are two generational segments of caregivers of interest given the complexities associated with these groups. Millennials can be sandwiched between a growing older population of parents or grandparents while also raising young children, often providing care for both. Similarly, older adults frequently balance caring for spouses, themselves, and grandchildren. We characterized these two groups of caregivers using 2015-2019 Behavioral Risk Factor Surveillance System (BRFSS) data from the Caregiver Optional Module administered in 44 states, D.C., and Puerto Rico. Among 246,223 Module respondents, 21.3% reported providing care for a family member or friend. Among caregivers, 12.4% were identified as Millennials (aged 18-38 years), and 19.7% were older adults (aged≥65 years). About one-in-three Millennial caregivers reported providing care to a parent and half to another relative, such as a child or grandparent. While less than 4% of Millennial caregivers reported providing care for a spouse, nearly one-in-five older adult caregivers did. Although their care recipients may differ, both groups reported high intensity of care, with 30% of caregivers in each group providing 20 hours of care or more weekly. Caregiving among older adults can be further complicated by their own health difficulties, with over half of older adult caregivers reporting having two or more chronic conditions and one-third reporting a disability. BRFSS data may inform planning efforts pertaining to these caregiving groups.
ASSOCIATION OF CARDIOVASCULAR DISEASE WITH RACE/ETHNICITY IN FAMILY CAREGIVERS OF PERSONS LIVING WITH DEMENTIA
Authors: Baik Dawon , McNair Bryan , Centi Sophia 
Published: December 2022

Abstract
Family caregivers of persons with dementia (dementia FCGs) experience high caregiving burden, and caregiving-related stressors have been linked to cardiovascular disease (CVD). Racially and ethnically diverse FCGs face additional challenges in managing their own health; however, racial/ethnic disparities in caregiving-associated cardiovascular health are understudied and poorly understood. To fill the gap, we evaluated racial/ethnic differences in CVD risk and CVD conditions among dementia FCGs in the U.S. Using 2015-2020 Behavioral Risk Factor Surveillance System data (N = 6,132), we compared CVD risk and CVD conditions in racial/ethnic dementia FCG minorities to non-Hispanic White dementia FCGs. Logistic regression models were used to estimate unadjusted (OR) and adjusted odds ratios (AOR) with 95% confidence intervals (CI) for association of race/ethnicity with CVD risk and CVD conditions, adjusting for potential confounders. Compared to non-Hispanic White FCGs, non-Hispanic Black FCGs (AOR 0.33, 95% CI 0.2-0.53) and non-Hispanic Asian FCGs (AOR 0.16, 95% CI 0.05-0.51) were less likely to have depressive symptoms. Hispanic FCGs (OR 0.69, 95% CI 0.5-0.95), non-Hispanic Black FCGs (AOR 0.6, 95% CI 0.41-0.86), and non-Hispanic Asian FCGs (AOR 0.51, 95% CI 0.28-0.94) were less likely to smoke. Non-Hispanic Black FCGs were less likely to exercise (OR 0.69, 95% CI 0.52-0.91) and more likely to be obese (AOR 1.64, 95% CI 1.14-2.36). The findings confirm racial/ethnic disparities in psychological, behavioral, and metabolic risk factors for CVD among dementia FCGs. Future studies should investigate how dementia FCGs’ caregiving-related conditions affect CVD and how racial/ethnic considerations can inform culturally appropriate prevention-care strategies.