bluuebunny/crossref_metadata_2025_split huggingface dataset:
EMOTION WORD USE AND CARDIOVASCULAR REACTIVITY DURING MARITAL INTERACTIONS
Authors: Meier Tabea , Stephens Jacquelyn , Haase Claudia 
Published: December 2022

Abstract
Cardiovascular reactivity in midlife may predict health problems in later life, but few studies have examined cardiovascular reactivity during marital interactions, as an important interpersonal context, and potentially modifiable linguistic correlates. This laboratory-based study examined emotion word use (i.e., positive and negative emotion words derived using automated language analysis) and cardiovascular reactivity (i.e., heart rate changes from baseline) across two marital interaction contexts (i.e., positive and conflict conversation) in 46 married couples (92 individuals; age: M = 42.6, SD = 8.5). Results showed that (1) spouses who used more negative emotion words during conflict showed higher cardiovascular reactivity. Moreover, (2) when husbands used a more diverse negative emotion word vocabulary during positive conversations, their wives showed higher cardiovascular reactivity and (3) when wives used a more diverse positive emotion vocabulary, their husbands showed lower cardiovascular reactivity. Findings highlight the relevance of couples’ emotion word use for cardiovascular reactivity in midlife.
ANTIPSYCHOTIC MEDICATION USE IN ASSISTED LIVING/RESIDENTIAL CARE: DO ORGANIZATIONAL CHARACTERISTICS MATTER?
Authors: Dys Sarah , Tunalilar Ozcan , Carder Paula 
Published: December 2022

Abstract
This study investigates how assisted living/residential care (AL/RC) and memory care (MC) contexts are associated with the prevalence of antipsychotic medication use (APU). Primary data were collected from a statewide representative sample of AL/RC settings through the Oregon Community-Based Care study from 2017-2019 and combined with publicly available administrative data. Framed by Donabedian’s model of care quality, we examine associations among 90-day prevalence of APU, organizational, care process, and AL/RC resident population characteristics using random intercepts regression models. Every licensed AL/RC setting in Oregon receives an annual mailed survey to provide aggregate resident demographics, health acuity, health service use, payment type and organizational policies. Organizational measures (e.g., profit status, license type, geographic designation) were collected from state websites. The average 90-day prevalence of APU among all Oregon AL/RC settings is 30.7%, though rates differ by MC endorsement (23.9% in AL/RC and 42.7% in MC). Compared to care processes and resident population characteristics, organizational characteristics were associated with larger magnitudes of difference in rates of APU. Nonprofit settings were associated with lower rates of APU in both AL/RC (β= -4.4 percentage points, [95% CI: -8.4, -0.4]) and MC (β= -12.4, [95% CI: -21.2, -3.6]. Compared to low-Medicaid settings, settings with very high proportions of Medicaid residents were associated with higher prevalence of APU, +8.9 in AL/RC (95% CI: 1.7, 16.1) and +11.0 in MC (95% CI: 2.3, 19.8). Policymakers might consider how organizational resource capacity influences APU in AL/RC settings, especially if APU prevalence is treated as a quality indicator.
KEY CONSIDERATIONS FOR EVALUATING REAL-WORLD EVIDENCE IN SUPPORT OF FDA REGULATORY DECISION-MAKING
Authors: Li Jie (Jenni) 
Published: December 2022

Abstract
For decades, FDA has been using RWE to monitor and evaluate the safety of drug products in the post-marketing setting. Under the FDA RWE Program, FDA has accepted RWE in support of effectiveness claims. For example, the approval of tacrolimus (Prograf) for the prophylaxis of organ rejection after lung transplant was based on RWD from a national transplant registry. The key considerations for evaluating RWE for safety and effectiveness assessments include: (1) whether the RWE are fit for use (e.g., data relevance and reliability); (2) whether the study design can provide adequate scientific evidence to answer the regulatory question of interest (e.g., whether the lack of blinding impacts the reporting of the outcome events); and (3) whether the study conduct meets FDA regulatory requirements (e.g., study monitoring and standardization of data collection). FDA has issued draft guidances on EHR/Claims data, registries, data standards, and regulatory considerations, respectively, to detail these key considerations. Carefully designed and analyzed RWE studies can be used to support safety and effectiveness claims.
CAREGIVING NETWORKS OF DIVERSE FAMILIES: CONTEXT AND CULTURE INFLUENCES ON DEMENTIA CARE
Authors: Roberto Karen , Savla Jyoti 
Published: December 2022

Abstract
Older adults living with dementia and their primary caregivers are embedded within larger family and formal care networks that are shaped by cultural and contextual influences. Yet information about diverse caregiving networks is sparse. This symposium focuses on the composition, structure, responsibilities, and influences of caregiving networks in supporting persons living with dementia and their primary family caregivers. Savla and colleagues identify six distinct care networks among dementia family caregivers living in economically diverse areas of rural Appalachia. Networks varied by caregivers’ emotional connectivity with family/friends, caregiver strain, role overload, loneliness, and service attitudes and utilization. Ashida and colleagues focus on changes in rural and urban dementia family caregiving networks during the COVID-19 pandemic. Network members engaging in negative social interactions increased while those engaging in uplifting interactions decreased over time, especially among urban caregivers. Bonds Johnson and colleagues examine shared decision making between African American caregivers and their relative living with dementia. Dyadic analysis revealed that while care recipients were involved in the decision-making processes, their care network’s level of the involvement varied. Angel and colleagues explore the role of caregiver characteristics, stressors, and resources for Mexican American caregivers. Depressive symptoms were significantly associated with dementia caregiver turnover, with adult children and grandchildren caregivers more likely to experience turnover than spouses. Collectively, the findings presented extend prior research on community-based dementia caregiving, broadening the focus from a single caregiver to a network of caregivers and capturing the complexities of place-based context and culture variations in care provision.
TURNOVER AND DEPRESSIVE SYMPTOMS AMONG MEXICAN AMERICAN CAREGIVERS OF PERSONS LIVING WITH DEMENTIA
Authors: Angel Jacqueline , Rote Sunshine , Markides Kyriakos 
Published: December 2022

Abstract
This study explored the role of caregiver background, stressors, and resources for Mexican American caregiver turnover and depressive symptoms. Using two waves of the Hispanic Established Epidemiologic Study of the Elderly (H-EPESE, 2010/2011-2016 N=333) Caregiver Supplement and informed by the sociocultural caregiver stress process model, we estimate logistic and OLS regressions of change in dementia and change in caregiver over five years. Neuropsychiatric expressions were significantly associated with caregiver turnover. Adult children and grandchildren caregivers were more likely to experience caregiver turnover than spouses. While depressive symptoms were relatively low at both waves, there was a greater increase in depressive symptoms occurred for caregivers who completed the interview in Spanish rather than English, which was partially explained by greater perceived stress at baseline. Findings demonstrate the need to provide dementia care supports for Mexican American caregivers, reduce stress for Spanish-speaking caregivers, and support Mexican American grandchildren who unexpectedly become caregivers.
ENDOGENOUS DNA DAMAGE AS A DRIVER OF AGING AND TISSUE DYSFUNCTION
Authors: Yousefzadeh Matt 
Published: December 2022

Abstract
Aging is a complex multifactorial process that enhances stress or impairs the ability to cope with it, whereby increasing the risk of morbidity and mortality. Many factors can contribute to aging, such as macromolecular damage (including DNA damage) that accumulates in a time-dependent manner. DNA damage is also known to induce cellular senescence, a cell fate that is known to play a causal role in aging. To investigate the effects of DNA damage and cellular senescence on aging, animal models lacking Ercc1, an important DNA repair gene, were utilized. Ercc1-deficient mice age faster than wild-type littermates and exhibit the senescent cell burdens that are comparable to that of a naturally aged mouse. To investigate cell autonomous and non-autonomous effects of DNA repair deficiency on senescence and aging, Ercc1 was deleted in mice in a tissue-specific manner. Increased senescent cell burden and dysfunction were present in tissues specifically targeted for Ercc1 deletion. However, enhanced senescence was also present in some non-targeted tissues, suggesting that these occur through cell non-autonomous mechanisms.
COGNITIVE RESERVE AND RISK OF MOBILITY DISABILITY IN OLDER ADULTS
Authors: Holtzer Roee , Zhu Xiaonan , Rosso Andrea , Rosano Caterina 
Published: December 2022

Abstract

Background
Cognitive Reserve (CR) protects against cognitive decline and dementia but its relation to mobility disability has not been established. To address this important gap in the literature, we conducted a longitudinal investigation to test the hypothesis that higher baseline CR was associated with a lower risk of developing mobility disability in older adults.

Methods
Participants were dementia-free older adults who received a brain magnetic resonance imaging and had gait speed assessments during follow-up. Using the residuals approach, CR was derived from the modified-Mini-Mental Status Examination (3MS) total score by removing variance accounted for by measures of structural brain integrity, education and race. Mobility disability was defined using a validated cutoff score in gait speed of 0.8 m/s. Logistic regression models using General Estimating Equations (GEE) were utilized to examine longitudinal associations between baseline CR and the risk of developing of mobility disability across repeated assessments.

Results
Of the participants (n=237; mean age=82ys; %female=56%) who were free of mobility disability at baseline, 103 developed mobility disability during follow-up (mean=3.1ys). Higher CR at baseline was associated with lower risk of developing incident mobility/disability [odds ratio (OR)=.819, 0.67 to 0.98, p=.038 (unadjusted); OR=.815, 0.67 to 0.99, p=.04 (adjusted for socio-demographic variables and depression); OR=.819, 0.68 to 0.88, p=.035 (adjusted for illness history); OR=.824, 0.68 to 0.99, p=.045 (adjusted for white matter hyperintensities); OR= .795, 0.65 to 0.95, p=.016 (adjusted falls history)].

Conclusion
We provided first evidence that higher CR was associated with lower risk of developing mobilitydisability in older adults.
APA GUIDELINES FOR THE EVALUATION OF DEMENTIA AND AGE-RELATED COGNITIVE CHANGE: OVERVIEW AND CLINICAL APPLICATION
Authors: Mast Benjamin , Lichtenberg Peter 
Published: December 2022

Abstract
Dementia is a leading cause of cognitive and functional decline and the number of people living with dementia or involved in caring for another person with dementia continues to rise. There is a growing need for health professionals who are well trained in dementia assessment and intervention. In 2021, the American Psychological Association and its Committee on Aging (CONA) published a revision of the APA Guidelines for the Evaluation of Dementia and Age-Related Cognitive Change with the goal of promoting proficiency and expertise in this growing practice area. This symposium presents an overview of the APA Guidelines and their clinical application in various practice situations and settings. The first presentation (Mast) provides an overview of the guidelines and highlights areas of significant revision, including greater attention to multicultural competence, person-centered principles, and assessment of family caregivers. The second presentation (Steffen) presents the application of the APA Guidelines to working with older adults before formal assessment and diagnosis has been initiated. The third presentation (Allen) describes use of the APA Guidelines in the post-evaluation period and integrates GSA’s revised KAER Toolkit for Primary Care Teams. The final presentation (Bush) presents ethical considerations before, during, and after dementia assessment.
APA GUIDELINES FOR THE EVALUATION OF DEMENTIA: OVERVIEW AND KEY UPDATES
Authors: Mast Benjamin , Levy Shellie-Anne 
Published: December 2022

Abstract
This presentation will provide a historical background and a broad overview of the APA Guidelines for the Evaluation of Dementia and Age-Related Cognitive Change. This will begin with an overview of general and procedural guidelines pertaining to dementia assessment and will be followed by an in-depth discussion of key updates in the 2021 revision. The newly revised guidelines recognize racial and cultural disparities in dementia outcomes, and emphasize the importance of multicultural competence in all aspects of dementia assessment. The revised guidelines also integrate person-centered principles into the assessment process and place greater emphasis on understanding the person living with dementia. New guidelines were included to address (1) the assessment of behavioral and psychological changes in the context of dementia, and (2) the importance of assessing the health and well-being of family caregivers.
AFTER A NEUROCOGNITIVE EVALUATION: ROLES AND COMPETENCIES OF BEHAVIORAL HEALTH PROVIDERS
Authors: Allen Rebecca , Steffen Ann 
Published: December 2022

Abstract
GSA’s revised KAER Toolkit for Primary Care Teams (Fall, 2020) provides useful information for referring individuals and families to community resources following a neurocognitive disorder diagnosis. Mental health practitioners must develop competencies and professional identities within integrated care teams to facilitate this process. This presentation outlines post-assessment suggestions for clinicians across disciplines (psychology, social work, nursing, medicine, pharmacy, +) in building such teams. There may be needs for serial assessment of specific individual capacities, treatment plans to facilitate shared decision-making between individuals and family care partners, and evaluations of the family care partner’s capacity to provide care. Behavioral health providers assist patients, families, and health care teams across a range of residential settings in understanding and implementing treatment recommendations. Emerging science indicates the value of initiating planning discussions with lifestyle modifications to enhance functioning within dyads. Culturally responsive strategies will be suggested for engagement in planning for future care.
AGE AS ONE OF THE DETERMINANTS OF RESILIENCE TO THE COVID-19 PANDEMIC AND ITS IMPACTS ON SEX LIFE
Authors: Berdychevsky Liza 
Published: December 2022

Abstract
Recent research started exploring the impacts of the COVID-19 pandemic on sex life. However, there is a dearth of research on the roles of age in the overall adjustment to the pandemic and its impacts on sex life. The purpose of this study was to address this gap. Data collection was based on the online survey methodology (N=675, age range:18-76yo). Data analysis included one-way ANOVA and multivariate multiple regression. Age differences were found in the participants’ overall ability to adjust to the pandemic-related lockdown conditions, with older adults (51+yo group) adjusting better than the rest of the sample and young adults (18-30yo group) adjusting significantly worse. Resilience to the impacts of COVID-19 on sex life also varied by age. Sexual desire deteriorated the worst among middle-aged participants (31-50yo group); likely, due to increased childcare responsibilities. However, the issues with physical sexual difficulties have worsened the most among older adults. Regression results also showed that age had negative effects on the frequencies of intimate and sexual behaviors (sexual touching and caressing, sexual intercourse, and oral sex) and sexual desire and satisfaction with sex life during the pandemic. While older adults’ overall adjustment capacity to the pandemic’s conditions was the highest in the sample, the pandemic’s impacts on their sex lives and sexual health were the worst. The pandemic has exacerbated existing vulnerabilities and further jeopardized older adults’ sexual wellbeing. This study provides age-specific insights for sexual counseling and age-targeted sexual health education for older adults during the pandemic and its aftermath.
TRENDS IN RISK FACTORS FOR DISABILITY AND REDUCED PHYSICAL FUNCTIONING AMONG US ADULTS DURING THE COVID-19 PANDEMIC
Authors: Andrasfay Theresa , Crimmins Eileen 
Published: December 2022

Abstract
The COVID-19 pandemic has caused widespread societal disruptions that may have impacted risk factors for disability and functional limitations. Current research suggests that physical inactivity, BMI, and smoking increased during the early phase of the pandemic, but less is known about whether these risk factors remained elevated as the pandemic progressed and mitigation measures were less disruptive. In this study, we assess trends in exercise frequency, BMI, and smoking among American adults aged 45 and over during the first year of the COVID-19 pandemic. We use data from the Understanding America Study (UAS) Coronavirus in America study, a nationally representative online survey that followed American adults from March 2020 to July 2021. We find that exercise frequency was highly seasonal throughout the pandemic, increasing during warmer months and decreasing during the colder winter months. Throughout this period, exercise frequency was highest among those with more education and those who were retired. Average BMI remained similar throughout this period, but less educated individuals and those working away from home and those who were unemployed experienced increases in BMI. Consistent with media reports suggesting increased interest in quitting smoking during the pandemic, we find decreases in smoking prevalence and frequency of smoking over this period. Decreases in smoking prevalence were concentrated among less educated individuals, who had higher prevalence of smoking to begin with. In sum, changes in risk factors for disability and reduced physical functioning during the pandemic were mixed and varied by education and employment status.
BLACK PLACEMAKING: THE BODY, HOME, AND PUBLIC SPACE THROUGH THE LENS OF OLDER WOMEN
Authors: Reyes Laurent , Yeh Jarmin , Versey H Shellae 
Published: December 2022

Abstract
African American communities are frequently depicted as victims of urban conditions. However, a rich culture of grassroots community development and organizing, often led and stewarded by Black women, exists. Many of these efforts involve enhancing economic, political, and educational opportunities and centering ethics of care and caregiving. This is the notion of Black placemaking, which is explicitly community-focused, shaping the social fabric of everyday life and allowing for the development of Black vernacular spaces that became vital to African-American culture. This paper examines how Black older women engage in placemaking by presenting three select case studies. Using a narrative inquiry approach, we conducted secondary data analysis of interviews drawn from larger qualitative studies about aging in communities that took place in San Francisco and New York City. Black feminist spatial imagination, embodiment, and intersectionality theory were our guiding frameworks. Our analysis revealed how the aging Black body is a site that is subjected to socio-political regulation and violence and illuminates how Black women are agents of community resilience, creativity, and transformation. Creating and holding space (i.e., placemaking) with bodies and physical structures that center the Black community is an act of care, self-determination, and resistance to white supremacy. These embodied processes of placemaking have wide-ranging implications for the ways Black neighborhoods are framed and discussed in popular media, empirical research, and policy. Furthermore, they invite a shift in our current approach to placemaking in later life, one that centers the strengths, history, and traditions of the Black community.
HOW DO INTERGENERATIONAL RELATIONSHIPS IMPACT THE HEALTH OF ASIAN AMERICAN OLDER ADULTS?
Authors: Nguyen Duy , Lee Yookyong , Liu Rui 
Published: December 2022

Abstract
Intergenerational relationships and filial piety are important values common to many Asian-ethnic groups. While a limited literature exists examining the health outcomes of older adults living with grandchildren in Asian countries, Asians in America have received less attention from researchers and policymakers. This study fills the knowledge gap by using data from the 2015-2019 American Community Surveys to examine the relationship between Asian ethnicity and living with grandchildren on health outcomes. This analysis focuses on respondents aged 65 and over from the six most populous Asian American groups: Chinese, Filipino, Indian, Japanese, Korean, and Vietnamese (n=100,538). Roughly half the sample lived with grandchildren. Weighted, adjusted logistic regression analyses tested for the effects of Asian ethnicity and living with grandchildren on 4 health outcomes: ambulatory, independent living, hearing, and vision difficulties. Multivariate analyses showed Filipino and Vietnamese older adults were more likely than Chinese to report difficulties across health outcomes. Additionally, individuals living with grandchildren were less likely to report ambulatory, independent living, and hearing difficulties. Joint effect analyses revealed Indian, Filipino, and Japanese Americans living with grandchildren reported more difficulties compared to the reference group. Overall, the results suggest that living with grandchildren can be a protective factor for the health outcomes of older Asian Americans, while having different impacts depending on ethnic origin. Future research needs to differentiate the impact of living with grandchildren across Asian ethnic groups. Further, culturally appropriate policy and practices are needed to promote successful aging among older Asian Americans living with grandchildren.