bluuebunny/crossref_metadata_2025_split huggingface dataset:
SELF-DIRECTED CARE IN HOME-BASED LONG-TERM CARE DURING THE PANDEMIC: POLICY AND PRACTICE IMPLICATIONS
Authors: Wendel-Hummell Carrie , LaPierre Tracey , Sullivan Darcy , Babitzke Jennifer , Swartzendruber Lora , Olds Danielle 
Published: December 2022

Abstract
The COVID-19 pandemic highlighted strengths and challenges of the self-directed care model for home-based long-term care. We discuss policy and practice implications drawing on interviews with over 50 home-and-community-based-services consumers, caregivers, workers, and providers in Kansas. Low-pay, lack of benefits, rising wages in competing sectors, enhanced unemployment and COVID-19 concerns exacerbated workforce shortages that compromised consumer safety and well-being. The lack of budget authority for self-directed consumers in Kansas limited their ability to address these issues. Furthermore, the self-directed model was excluded from emergency funding sources that would have enhanced pay and benefits for workers, including sick pay for quarantine, pointing to the need for targeted funding. Emergency flexibility allowing paid family caregivers addressed care needs for some but is temporary and should be expanded. In the managed care model, MCOs still kept their capitated payment despite significant unfilled care hours, and thus pay-for-performance incentives need to be revisited.
THE EXPERIENCE OF SUBJECTIVE AGE DURING EVERYDAY LIFE
Authors: Touron Dayna , Hughes Matthew 
Published: December 2022

Abstract
Empirical work has shown that subjective age is susceptible to momentary fluctuation throughout the day, and in certain contexts like challenging cognitive evaluations. We propose and test a contextual model that describes how momentary experiences impact subjective age, which in turn impacts daily activities and well-being. Using an experience sampling approach, 200 participants were asked to complete 6 surveys per day for a week. Questions asked about the task they were engaged in, including mental, physical and social engagement, challenge, motivation, confidence, and enjoyment. Participants also completed a manipulation of mental challenge and reported their momentary subjective age. Preliminary multilevel models show that certain momentary factors, such as whether participants were enjoying a task or found the task engaging, predict fluctuations in subjective age. We will also discuss moderators, subjective age domains, time of day effects, and the cross-lagged influence of cognitive stressors over time.
BREAKING GROUND IN TRANSLATIONAL GEROSCIENCE: FROM BIOMARKERS TO CLINICAL TRIALS
Authors: Justice Jamie 
Published: December 2022

Abstract
The geroscience hypothesis posits that common biological mechanisms of aging drive susceptibility of aged individuals to functional decline, multi-morbidity, and death. The promise of geroscience is that some of these mechanisms may be intervenable, thereby preventing or delaying declines, and providing new therapeutic opportunities for hard-to-treat chronic diseases. This is supported by specific examples of translational research models, and interventions that are at the point of entering human clinical trials. This award presentation will review how we are reimagining existing resources and creating new translational frameworks to test the geroscience hypothesis in humans.
SEX DIMORPHISM IN AGING
Authors: Benayoun Bérénice 
Published: December 2022

Abstract
In this symposium, the speakers will discuss how sex can influence aging trajectories using complementary perspectives and approaches across multiple biological scales and systems. Indeed, accumulating evidence across species has revealed that aging is a highly sex-dimorphic process. On the one hand, women outlive men consistently across populations, and most supercentanarians are women. On the other hand, especially after the onset of menopause, women are at increased risk for most age-related diseases (e.g. Alzheimer’s disease, osteoporosis, etc.). However, the molecular pathways underlying such sex-differences in aging and longevity are still largely unexplored and poorly understood. Dr. Austad will discuss how compatibility between the mitochondrial and nuclear genomes during aging is influenced as a function of sex. Dr. Dubal will discuss the impact of sex chromosome complement on cognition with aging in mouse models, and how sex chromosomes may underlie sex-differences in brain aging. Dr. Ucar will discuss work from her lab revealing that the genomic signatures of immune aging in humans are specific to sex. Finally, Dr. Benayoun will discuss how aging of innate immune cells (e.g. macrophages or neutrophils) is regulated by the female vs. male milieu, with sex-specific age-related trajectories remodeling the immune compartment in mice.
INCREASING RISK FOR ELDER MISTREATMENT? A QUALITATIVE STUDY OF CAREGIVER EXPERIENCES DURING COVID-19
Authors: Marnfeldt Kelly , Estenson Lilly H , Marinez Julia , Gassoumis Zach , Wilber Kathleen 
Published: December 2022

Abstract
Family caregivers (CGs) of community-dwelling older adults faced unprecedented psychosocial challenges in the face of the COVID-19 pandemic. Social isolation, lack of social support, truncated care networks, financial hardship and other factors put many older adults at risk for elder mistreatment (EM). Even in normal times, incidents of EM are only identified and formally reported in about one out of every 24 cases. Social distancing restrictions in the caregiving context, including decreased access to healthcare providers, rendered older adults with higher dependency needs inordinately vulnerable to abuse and neglect. We collected qualitative data on the experiences of 24 CGs receiving telephonic support sessions between March 2020 and February 2021. Data from 100 distinct post-session case notes were analyzed using thematic content analysis to generate codes and themes. Caregivers reported rapid deterioration of care receiver’s (CRs) physical health, resulting in higher levels of dependency. Declines in mental health and cognitive impairment, including behavioral issues, were an indicator of stress for both CR and CG. CGs reported lack of access to services and social supports, fractured care networks, and increased feelings of isolation. Preliminary content analysis indicates that serious risk factors for EM were present across all 13 months of the study, and those risk factors continued or worsened over time. Findings suggest that the unintended consequences of the public health response to COVID-19 may have amplified the risk for EM in vulnerable community-dwelling older adults.
CAREGIVING AND COGNITIVE IMPAIRMENT IN MEXICO AND THE US
Authors: Cantu Phillip , Rote Sunshine , Gaugler Joseph 
Published: December 2022

Abstract
Dementia is one of the most common causes of disability and dependence in the world. The growing dementia population in Mexico is exemplary of many low- and middle-income countries (LMICs). While the U.S. has a highly developed formal long-term care system, the use of institutional care among Latinos has been low. Mexico lacks a publicly financed long-term care system, and it does not have a national-level mandatory registry of institutions, compulsory standards of care, nor a regulatory body to oversee management, quality of care standards for services, or the accreditation and evaluation of service providers. There are no policies, public programs, or services to provide dependency care, including support for people living with dementia and their family caregivers. As in other LMIC’s, there is limited public support for the aging population in Mexico, leaving families with the main responsibility of providing care and economic security for older adults. “Informal” and family caregivers for older adults with cognitive impairment are critical components of how older adults with cognitive impairment are able to remain in the community. This symposium will reflect the broad spectrum of caregivers and care context in the U.S. and Mexico to shed light on sources of care for older adults living with cognitive impairment.
CLARK TIBBITTS AWARD AND HIRAM J. FRIEDSAM AWARD PRESENTATIONS AND LECTURES
Authors: Dassel Kara 
Published: December 2022

Abstract
The Clark Tibbitts Award Lecture will feature an address by the 2022 award recipient Laura M.K. Donorfio, PhD, FAGHE, of The University of Connecticut. AGHE's Clark Tibbitts Award was established in 1980 and named for an architect of the field of gerontological education. The award is given each year to an individual or organization that has made an outstanding contribution to the advancement of gerontology and geriatrics education. The Hiram J. Friedsam Award Lecture will feature an address by the 2022 award recipient Rona J. Karasik, PhD, FGSA, FAGHE, of Saint Cloud State University. Hiram J. Friedsam was the professor, co-founder, and director of the Center for Studies in Aging and dean of the School of Community Service at the University of Northern Texas. Dr. Friedsam was an outstanding teacher, researcher, colleague, and mentor to students, faculty, and administrators, as well as a past president of AGHE. The purpose of this award is to recognize those who emulate Dr. Friedsam's excellence in mentorship.
COGNITIVE AGING IN LOW- AND MIDDLE-INCOME COUNTRIES
Authors: Zhang Yuan , Saenz Joseph 
Published: December 2022

Abstract
Cognitive aging is a highly complex, dynamic, and context-dependent process; and is influenced by individual and community characteristics and experiences across the life course. Low- and middle-income countries (LMICs) are critical components of the international dementia research community because the burden of dementia is rapidly rising in LMICs, and low-resource settings may have unique social and economic determinants of cognitive health. However, little population-based research focuses on these regions. The papers in this symposium use high-quality population survey data from Mexico, Brazil, South Africa, and China to study critical social determinants of cognitive function in countries across the globe. These papers cover a range of social and economic factors, including food insecurity, education, household material resources, and urban-rural settings and policy. First, Saenz will present findings on how food insecurity, throughout life, relates with cognitive function among older Mexican adults. Next, Farina will present evidence on both indirect and direct pathways from education to cognitive function among older Brazilians. Third, Kobayashi will present longitudinal data evaluating level and change in household resources in relation to subsequent cognitive function in South Africa. Finally, Zhang will present evidence on the interplay of rural/urban residence and household registration system across the life-course in creating cumulative advantage/disadvantage in cognitive aging using longitudinal data from China. The papers in this symposium provide new insights into social determinants of cognitive health in diverse contexts and have significant policy implications for improving cognitive health in LMICs across the globe.
TRENDS IN HOUSEHOLD MATERIAL RESOURCES AND COGNITIVE HEALTH IN A LONGITUDINAL COHORT STUDY OF AGING IN SOUTH AFRICA
Authors: Kobayashi Lindsay , Kabudula Chodziwadziwa , Kabeto Mohammed , Yu Xuexin , Tollman Stephen , Kahn Kathleen , Berkman Lisa , Rosenberg Molly 
Published: December 2022

Abstract
Material resources that affect daily living conditions may be salient for cognitive aging in low-income settings, but evidence is limited on this topic. We investigated relationships between long-term trends in household material resources and subsequent cognitive function among 4,580 adults aged ≥40 in a population-representative cohort in Agincourt sub-district, South Africa, from 2001-2015. Household material resources (dwelling materials, water, sanitation, sources of power, modern amenities, and livestock) were assessed biennially from 2001-2013. We evaluated mean resources, volatility in resources, and change in resources over this period in relation to cognitive function in 2014/2015. Higher mean household resources and larger improvements over time in resources were positively associated with subsequent cognitive function, independent of confounders. Findings were largely driven by modern amenities for food preparation, transportation, and communication outside of the household. Access to these amenities may support cognitive aging through boosting nutrition and cognitive reserve and should be investigated further.
DEVELOPING AND RAPIDLY SCALING AN MHEALTH APP IN A 25-SITE PRAGMATIC TRIAL OF ALIVIADO DEMENTIA CARE IN HOSPICE
Authors: Brody Abraham , Durga Aditi , Ford Ariel , Lin Shih-Yin 
Published: December 2022

Abstract
Following stakeholder engagement in our pilot phase of a large-scale 2-phase NIA funded pragmatic clinical trial in hospice (HAS-QOL Trial) of Aliviado Dementia Care, we utilized a co-design process to develop over a 6-month period and rapidly scale an mHealth application to assist clinicians in performing best practices in care for persons living with dementia receiving hospice. Throughout the 36 months of intervention period, the app has been utilized by at least 6,580 hospice team members, both to complete training, receive mobile push notification nudges, and: 1) perform 6,682 clinical assessment such as the PAINAD for pain and NPI-Q for behavioral symptoms; 2) develop 2,204 symptom specific care plans; and 3) Review specially developed education materials to 15,128 caregivers and send them to 671 directly. This session will also discuss the process of implementation and scaling, including the technological hurdles in working with a workforce with sometimes limited technical skills.
DIVERSITY MATTERS: INTERSECTIONAL INEQUITIES IN HEALTH AND WELL-BEING THROUGH AGING
Authors: Koffer Rachel , Drewelies Johanna , Carr Deborah 
Published: December 2022

Abstract
Different positions within social hierarchies receive unequal access to resources, leading to health disparities in later life (Agenor, 2020). Research addressing inequities must increasingly account for the many social categorizations (e.g., race, gender, socioeconomic status) that affect individuals‘ lived experiences. This symposium examines the role of intersecting social contexts on health and well-being across the life course. Surachman and colleagues use the U.S.-based National Growth and Health Study to examine the intersectionality between early life socioeconomic context and race on women’s metabolic syndrome severity. Their findings have implications for societal factors leading to accelerated aging across young adulthood and early midlife. Koffer and colleagues use the U.S.-based Study of Women’s Health Across the Nation to demonstrate differential midlife exposure to types and number of major life events across race/ethnicity and education. They subsequently find that major life events increase risk of cardiovascular disease events, indicating the importance of studying the life experiences of diverse women across midlife. Drewelies and colleagues use the Germany-based Berlin Aging Study II to look at the associations among multidomain identity and social background factors on physical, cognitive, and psychological aging. Implications from their work demonstrate the interplay of diversity on health and well-being in older adulthood. Conjointly, findings indicate that intersectional identities play an important role in shaping key outcomes of human functioning across adulthood and aging. Dr. Deborah Carr will critically discuss the three contributions from a life course perspective and provide considerations for future research and policy promoting equity for diverse older adults.
USING ADJUSTED MULTIPLE CORRESPONDENCE ANALYSIS TO EXPLORE LATENT VARIABLES FOR THE DEMPOL-Q
Authors: Hoffmann Anna-Louisa , Bergmann Johannes-Michael , Holle Bernhard , Roes Martina , Palm Rebecca 
Published: December 2022

Abstract
Nursing home administrators are responsible to operationalize dementia-specific person-centred care into their care practice, e.g. by internal policies. To assess the degree of existence of internal policies on person-centred care for dementia-specific care in German nursing homes, we developed the Dementia Policy Questionnaire (DemPol-Q). After pretesting, the instrument consists of 19 dichotomous items. We aimed to explore the construct validity of the DemPol-Q. We used a secondary data set of a national survey with a representative sample of 134 nursing homes. For data analysis we conducted an Adjusted Multiple Correspondence Analysis. Results show that nine items of the DemPol-Q were significantly assigned to two latent variables. Since the items per latent variable vary in their content, they cannot be explicit denominated with a specific sub-dimension of dementia-specific person-centred care. Nonetheless, Adjusted Multiple Correspondence Analysis is an uncommon but appropriate exploratory data reduction procedure for nursing science.
A MIXED METHODS EVALUATION OF PROJECT TRIP: KEY FINDINGS AND EXPANSION
Authors: Schwartz Abby , Richman Alice , Scott Mallary , Liu Haiyong , White Weyling , Doherty Caroline 
Published: December 2022

Abstract
Project TRIP is an innovative individualized transportation program for low-income adults in rural eastern North Carolina (eNC), that aims to increase access to healthcare and reduce health disparities. This paper presents results from a 3-year grant which sought to evaluate TRIP and expand it to a neighboring eNC county. The concurrent mixed methods findings from the process/implementation, outcome/effectiveness, and economic evaluation, and qualitative interview data with TRIP stakeholders (N=40) will be presented. Findings include relationships between pre and post TRIP enrollment health data indicating improvements in health outcomes and decreases in health care utilization, including estimated costs savings of Project TRIP. Qualitative interview data will be discussed in substantiating the quantitative evaluation data. Interviews with stakeholders in the TRIP replication and expansion county site will also be presented including pilot test data in that county. The presentation will conclude with implications for sustainability and further expansion of TRIP.
TIME TO EMBRACE HETEROGENEITY IN INTERVENTIONAL STUDIES OF OLDER ADULTS
Authors: Xue Qian-Li 
Published: December 2022

Abstract
Adopting evidence-based medicine in clinical care of older patients is challenging because the “best” evidence available may not be directly applicable due to exclusion or underrepresentation of older adults in clinical trials. Interventions shown to be beneficial in trial populations therefore often exhibit heterogeneous treatment effects (HTEs) in older adults, particularly among the most vulnerable. This talk will review the concept, causes, and estimation of HTEs. We distinguish clinical heterogeneity from methodologic heterogeneity, defined respectively as the variation in biological mechanisms leading to similar aging phenotypes and variation in study design, measurement, and analysis. We use examples drawn from geriatric medicine to introduce novel study designs and data analytics used to study HTEs. This talk highlights the importance of moving beyond post-hoc subgroup analysis to an approach that integrates theories, observational and experimental data, and data science in the study of HTEs.
THE LOOMING POST-ACUTE REORGANIZATION: IMPLICATIONS FOR OLDER ADULTS TRANSITIONING FROM THE HOSPITAL
Authors: Bucy Taylor , McHugh John , Cross Dori 
Published: December 2022

Abstract
Post-acute volume plays an important role in the care of millions of older adults transitioning from a hospital stay. To help reduce the total cost of care, many hospitals have been shifting more volume from institutional skilled nursing care to less expensive home health care. In fact, in 2017, home health volume eclipsed skilled nursing facility volume as the preferred post-acute destination for the first time. The COVID-19 pandemic further exacerbated this trend with many older adults preferring to avoid institutional care. Using 2016-2019 MedPAR data, we explored changes over time in hospital discharges to skilled nursing facilities versus to home health. We regress the ratio of home health to skilled nursing facility volume on a month-year variable. We find that the ratio of discharges to home health versus to skilled nursing facility increases by .07 percentage points per month (coefficient = .00073, 95% CI [.00063 to .00084]). This translates to a nearly one percentage point change in the ratio of home health to skilled nursing volume per year. These trends vary by patient characteristics (e.g. hospital diagnosis), organizational characteristics (e.g. hospital market relationships), and indicators of market capacity of post-acute services. This growing trend has implications on vulnerable older adults; health system leaders need policy guidance and incentives to invest in value-oriented care practices across this changing post-acute landscape.
PHYSICAL INTIMACY IN DAILY LIVES OF OLDER ROMANTIC COUPLES: LINKS WITH MOMENTARY AFFECT AND DAILY CORTISOL LEVELS
Authors: Kolodziejczak Karolina , Drewelies Johanna , Pauly Theresa , Ram Nilam , Hoppmann Christiane , Gerstorf Denis 
Published: December 2022

Abstract
Physical intimacy is assumed to benefit well-being through stress-buffering and mood-improving processes. Although partnered older adults often report wishing for and experiencing physical intimacy, inquiries about how intimacy is linked to affect and stress in older couples’ daily lives remain scarce. We examined self-report and salivary cortisol data from 120 German couples (Mage= 71.6, SDage= 5.94) obtained up to seven times per day over seven consecutive days. In moments when participants experienced more physical intimacy, women reported less negative affect, and men more positive affect. Experiencing more overall physical intimacy was associated with more positive affect and less negative affect in women, and lower daily cortisol in men. More overall intimacy wished was related to more negative affect in women and men, and to higher daily cortisol in men. We conclude that physical intimacy relates to indicators of well-being in older couples’ daily lives and consider routes for future inquiry.
FEELING BLUE WITH YOU: AGING COUPLES' REACTIVITY TO UPSETTING PERSONAL MEMORIES AND MARITAL CONFLICT
Authors: Wilson Stephanie , Shrout M Rosie , Kiecolt-Glaser Janice K 
Published: December 2022

Abstract
Reactivity to marital conflict has long been considered a critical mechanism linking marriage to health and well-being. Yet, developmental theories suggest conflict may subside with age. To compare mood and cardiovascular responses to two novel contexts—both partners’ upsetting personal experiences—with marital conflict reactivity, 107 couples ages 40-87 recounted a difficult personal memory to the partner, discussed a marital problem, and provided baseline and post-task mood, blood pressure (BP), and heart rate (HR). Although older adults relived their upsetting personal memories with less emotional intensity, negative mood and systolic BP increased most after this task. Compared to disagreement, the spouse’s upsetting memory triggered larger increases in negative mood, HR, and among older adults, SBP. Results suggest that both partners’ upsetting personal experiences are as relevant for mood and cardiovascular activity as marital conflict in aging couples, and that spousal distress may grow increasingly important with older age.