bluuebunny/crossref_metadata_2025_split huggingface dataset:
AGING IN PLACE: THE REALITIES OF OLDER HOMELESS WOMEN NAVIGATING URBAN STREETS AND SHELTERS
Authors: Gonyea Judith , O'Donnell Arden 
Published: December 2022

Abstract
Older homeless women have often been an invisible population; however, this is changing as their numbers grow. Today, women age 50 and older represent 30% of the shelter population. In this qualitative study, we explored the question, What does “aging in place” mean to women in their fifties who are navigating the urban streets and shelter system?” Our study’s purpose was to gain a deeper understanding of the impacts of daily displacement and migration and, through the women’s accounts, engage in a critical analysis of the shelter system’s practices and policies. Fifteen older chronically homeless women were recruited via a flyer posted at a city’s women’s day shelter to participate in an onsite interview about their homelessness experiences. Using a phenomenological approach, in depth semi-structured interviews were conducted, recorded and transcribed verbatim. Our analysis process was inductive and iterative with the culminating phases being theme generation and interpretation. Participants identified challenges centered on six themes: 1) loss of a sense of control, self-determination, and independence, 2) lack of physical security, 3) worsening physical and emotional health, 4) lack of comfort, familiarity, and routine, 5) weakening or loss of social connections, and 6) a diminished sense of self-worth. The findings highlight the links between place, sense of belonging, and identity. The data underscored that shelters were dehumanizing places that further diminished women’s sense of self. We discuss reforms needed to disrupt shelter and housing systems’ practices that further disempower and stigmatize the women and fail to support pathways out of homelessness.
DEEP AGING: THE CONNECTION THAT SURVIVES DEATH AND ITS ROLE IN INCREASING HUMAN–NONHUMAN RELATIONSHIPS
Authors: Park Hong-Jae 
Published: December 2022

Abstract
Ageing is part of life, and so is death. Although death will involve all of us over time, it is often regarded as a taboo topic, and bonds with the dead are seldom acknowledged in contemporary times. The aim of this paper is to present selected insights on the connection that survives death and its role in increasing human/non-human relationships, learned from two indigenous knowledges—whakapapa (genealogical connections in Maori) and filial piety (respect/care for parents and ancestors). Data were collected from semi-structured interviews with 49 key informants (Maori=25; Korean=24) between 2019 and 2021 in New Zealand and South Korea. A modified thematic analysis method was used to analyse the data obtained in a bilingual research context. The research findings show that the connectedness with ancestors or deceased loved ones is a significant part of the participants’ mental and social lives, emphasised in both whakapapa and filial piety/ancestor veneration traditions. Maori participants were likely to consider their natural environment (for example, land and water) as a common good for all generations, while Korean counterparts viewed it (for example, a mountain) as the place where ancestors were remembered and venerated. Participants’ awareness of the post-mortem relationships was associated with their connection with nature and spiritual practices. Overall, this study suggests that there are several possible ways that older people could do ‘something’ prior to death for their remaining families and friends, ranging from activities concerning death talk, end-of-life preparation, legacy building and after-life planning, to connectedness with nature and non-human beings.
WHAT NEEDS TO BE DONE TO PREVENT ELDER ABUSE IN JAPAN?
Authors: Kuo TsuAnn , Anetzberger Georgia 
Published: December 2022

Abstract
This symposium first introduces the Japanese Act on the Prevention of Elder Abuse, including its elder abuse definitions and trends in elder abuse in both institutional and domestic settings. It then describes a recent amendment to operational standards made by ministerial ordinance, which aims to reduce elder abuse. Second, it presents analysis of elder abuse data (N=497) from Matsudo-City in Chiba prefecture, which found that only about 65% of reported elder abuse cases were deemed to meet the legal definition of elder abuse and the rest were excluded due to how the law defines abusers. Findings suggest the definitions in the Act be broadened to encompass a wider set of abuse situations. Third, it presents analysis using the same data, of characteristics of abusers. Findings indicate that about 24% of abusers were caregivers with disabilities, suggesting the importance of supporting caregiver health and welfare to help prevent abuse. The symposium concludes by presenting findings from a longitudinal survey of older adults aged 75+ (N=769) indicating that physical restraints use is associated with “having been diagnosed as intractable neurological diseases,” “unstable general condition or at the terminal stage,” “higher levels of care-need,” “having medical treatment,” and “family members’ long-term care burdens.”
BEREAVEMENT ACROSS THE ADULT LIFE COURSE: VARIATIONS IN EFFECTS ON HEALTH AND WELL-BEING
Authors: Suitor J Jill , Gilligan Megan 
Published: December 2022

Abstract
This symposium considers the consequences of deaths of family members across the life course on psychological well-being, physical health, and mortality in the middle and later years. The first two papers focus on intergenerational losses, using data from the HRS. Donnelly, Lin and Umberson examine the ways in which the impact of parental death on adult children’s health in later life are shaped by children’s ages at loss, social isolation, and race/ethnicity. Next, Huo and Kim investigate the extent to which the effect of child loss on parents’ well-being in mid- and later-life is moderated by volunteering. The third and fourth papers focus on the role of spousal loss in health and well-being. Rodin and colleagues use HRS data to explore whether the association between widowhood and mortality differs depending on the cognitive health of the surviving spouse. Next, Vedder and colleagues provide a systematic review of variations in patterns and predictors of loneliness by marital status in middle and later life. Finally, Miles and Olsen examine the association between recent loss and binge drinking among spouses and adult children who had served as caregivers to the deceased, using data from the Georgia Behavioral Risk Factor Surveillance Survey. This diverse set of studies reveals how the impact of the death of family members on survivors’ health and well-being is shaped by a complex set of structural and socioemotional factors, shedding new and important light on health disparities by sex/gender and race/ethnicity in the middle and later years.
THE WIDOWHOOD EFFECT IN COMPLEX SERIOUS ILLNESS: THE IMPACT OF SPOUSAL DEATH ON MORTALITY IN DEMENTIA
Authors: Rodin Rebecca , Smith Alex , Espejo Edie , Boscardin W John , Gan Siqi , Hunt Lauren , Ornstein Katherine , Morrison Sean 
Published: December 2022

Abstract
Numerous studies suggest that there is an association between widowhood and mortality. This “widowhood effect” may be heightened in patients with dementia, who have high support needs and for whom spouses typically provide extensive caregiving support. Yet there are limited data on widowhood and mortality that account for dementia status. To determine the relative mortality risk of widowhood among those with and without dementia, we conducted a retrospective cohort study among community-dwelling, married/partnered persons, ≥65 years, enrolled in the Health and Retirement Study, 2000-2018. Among the 12,308 persons (n=390 with dementia), widowhood was not associated with increased mortality, after adjusting for age and dementia status, in men or women (adjusted HR 1.04; 95%C.I.(0.95-1.13); HR 0.96; 95%C.I.(0.87-1.95), respectively). These findings suggest that dementia, age, or other unmeasured confounding variables may account for the previous finding of increased mortality following spousal death. Further research is needed to confirm these findings in diverse populations.
THE LONG-TERM LONELINESS OF WIDOWHOOD: A SYSTEMATIC REVIEW OF MARITAL STATUS DIFFERENCES
Authors: Vedder Anneke , Stokes Jeffrey , Boerner Kathrin , Schut Henk , Boelen Paul , Schut Bibi , Stroebe Margaret 
Published: December 2022

Abstract
Loneliness can be prominent in bereavement, possibly leading to compromised mental and physical health. We systematically reviewed the extent of loneliness across marital status groups, examining the prevalence, intensity, risk factors, and correlates of loneliness in widowhood, compared to other marital statuses. Studies that met predefined criteria as well as investigated marital status (comparisons) were included in the review. For reporting, we followed the PRISMA statement. Thirty-eight studies were included. Widowhood was associated with a greater likelihood and intensity of loneliness when compared to other marital statuses, and especially the divorced. Widowers were on average lonelier than widows. Findings suggest that , widowed persons are uniquely vulnerable to loneliness, and that, in the long-term, loneliness may be more pronounced among the widowed than the divorced. However, methodological shortcomings (e.g., heterogenous samples, different measures of loneliness) of available studies must be considered, and future research should aim to overcome these limitations.
MENINGES HARBOR IMMUNE MEMORIES OF LIFE EXPERIENCES
Authors: Herz Jasmin , de Lima Khalil Alves , Salvador Andrea Francesca , Lemieux Mackenzie , Dykstra Taitea , Smirnov Igor , Kipnis Jonathan 
Published: December 2022

Abstract
The adaptive immune system relies on formation of the memory of past microbial challenges to accelerate protective immune responses in the event of reinfection. This memory is accomplished in part by the retention of antigen-specific B and T cells within barrier tissues. As the healthy central nervous system parenchyma is virtually devoid of adaptive immune cells, the meningeal spaces carry out the vital function of coping with environmental threats during aging. We conducted an extensive molecular and functional analysis of meningeal T cells to test the hypothesis that the meninges in the brain sense and respond to internal and external cues throughout life, and that alterations in the meningeal T cell repertoire alter brain function. We found presumably self-reactive tissue-resident T cells in the meninges of naive mice. Using models of pathogen exposure, we describe a neuroimmune axis in which antigen experienced resident Tcell subsets dynamically record immune perturbations, which resulted in behavioral abnormalities that were exacerbated with aging. Our findings elucidate molecular properties of T cells that survey the brain borders under both homeostatic and pathological conditions and provide insights linking CNS immune privilege with memory.
R1p Dispersion in White Matter Correlates with Cognitive Impairment in Older Adults
Authors: Adelnia Fatemeh , Davis Taylor , Acosta Lealani Mae , Puckett Amanda , Wang Feng , Zu Zhongliang , Harkins Kevin , Gore John 
Published: December 2022

Abstract
Alzheimer‘s disease is the most frequent form of dementia in older adults and has a total estimated worldwide cost that rises to $2 trillion by 2030. Much previous neuroimaging research in AD has focused on the roles of amyloid and tau proteins using PET, but there have also been several studies that have implicated microvascular changes as an early indicator of damage related to later dementia. Here, we developed and refined a non-invasive 3D-R1ρ dispersion imaging technique using different locking fields to quantify microvasculature changes within brain tissues in persons with mild cognitive impairment (MCI) compared to healthy controls. The fractional difference in R1ρ comparing different locking fields provides a unique way of characterizing changes in the geometry and structure of microvasculature. After providing informed consent, 40 adults aged 62 to 82 years (n=17MCI) underwent cognitive assessments and MRI scan at 3T. We found the fractional change in R1ρ of the whole brain white matter is significantly greater in persons with MCI, and the correlation remained significant (ß=-0.4, p-value=0.01) after introducing age (ß=0.2, p-value=0.2) and sex (ß=-0.1, p-value=0.5) as covariates. The white matter hypertonicity lesion volume measured from conventional MRI was also correlated with the health status (p-value &lt; 0.05); however, the size of the regression coefficient was substantially smaller (53% lower), and it was no longer significant (p-value=0.14) after adjusting for age and sex. This work establishes a new non-invasive method that can potentially characterize changes in microvasculature anatomy with the progression of cognitive impairment regardless of an age effect.
ASSOCIATION BETWEEN EXPOSURE TO HURRICANE HARVEY AND MORTALITY AMONG NURSING HOME RESIDENTS
Authors: Hua Cassandra , Thomas Kali , Patel Sweta , Dosa David , Jester Dylan , Andel Ross 
Published: December 2022

Abstract
Hurricane Harvey made landfall in Southeast Texas in August 2017, causing catastrophic flooding. We examined the association between exposure to Hurricane Harvey and rates of 30-and 90-day mortality among Texas nursing home residents. Using Medicare data, we compared a cohort of residents exposed to the storm in 2017 (n= 18,693) to a cohort of residents not exposed to the storm in 2015 (n=19,688). We fit generalized estimating equations with a sandwich estimator, adjusting for resident demographic and clinical characteristics. Exposure to Hurricane Harvey was not associated with 30-day rates of mortality. However, it was associated with a 15% increase in the odds of dying at 90 days holding resident characteristics constant (adjusted odds ratio: 1.15 [95% Confidence interval: 1.06, 1.25). Health effects due to severe flooding, such as those related to decreased ability to manage chronic conditions, may not be apparent until several weeks after the storm.
TEXAS NURSING HOMES INCREASED DIRECT-CARE STAFFING LEVELS DURING WINTER STORM URI
Authors: Jester Dylan , Peterson Lindsay , Andel Ross , Dosa David 
Published: December 2022

Abstract
Prior work suggests that nursing homes (NHs) increase their registered nurse (RN), licensed practical nurse (LPN), and certified nursing assistant (CNA) staffing levels in anticipation of a major hurricane. However, less is known about NHs’ ability to increase staffing levels during a winter storm. We examined RN, LPN, and CNA staffing levels in 1,170 Texas NHs during Winter Storm Uri from February 13-20, 2021. This storm was characterized by cold temperatures and snow/ice accretion that affected the Texas power grid. Linear mixed effects models were adjusted for profit status, continuing-care retirement community status, resident census, overall star rating, a weighted deficiency score, number of citations for infection control, number of substantiated complaints, and county fixed-effects. After adjustment, Texas NHs decreased RN (β=-0.005;b=-0.002;p=.004) but increased LPN (β=0.022;b=0.009;p&lt;.001) and CNA (β=0.044;b=0.026;p&lt;.001) staffing levels. NHs face unprecedented challenges during winter storms, including maintaining adequate staffing levels to meet the needs of their residents.
USING THE INSTITUTE OF HEALTHCARE IMPROVEMENT'S 4M FRAMEWORK TO IMPROVE DISASTER PREPAREDNESS FOR NH POPULATIONS
Authors: Dosa David , Jester Dylan , Peterson Lindsay , Dobbs Debra , Brown Lisa , Black Kathy 
Published: December 2022

Abstract
Prior studies have repeatedly demonstrated that exposure to natural disasters such as hurricanes, earthquakes, and flooding events have profound effects on nursing home (NH) residents. Previous efforts to improve disaster preparedness have often been predicated on the decision to evacuate or shelter in place from a disaster. Unfortunately, evacuation of NH residents is often not possible and nursing homes are often required to make difficult decisions to protect the lives of their residents without data. Recognizing that healthcare systems increasingly provide care for complex individuals; the Institute of Healthcare Improvement (IHI) and the John H. Hartford Foundation introduced a framework for evaluating age-friendly healthcare systems based on 4 evidence-based core elements that matter to older adults. We believe that this 4 M’s paradigm: What Matters, Medication, Mentation, and Mobility, provides a step off point for defining a practical approach to disaster preparedness for nursing homes exposed to future disasters.
DEMOGRAPHIC DIFFERENCES IN THE LONGITUDINAL EFFECTS OF SYMPTOMS ON FALLS AND FALL-RELATED OUTCOMES
Authors: Peng Wenting , Miyawaki Christina , Mo Cen , Luo Yuqian , Tang Siyuan , Liu Minhui 
Published: December 2022

Abstract
Research has shown an association between symptoms and falls and fall-related outcomes among older adults. However, this association was primarily drawn from cross-sectional studies or studies with a single symptom. Using the 2011-2018 waves of the National Health and Aging Trends Study, we examined whether 1) prior-wave common co-occurring symptoms predicted later-wave fall-related outcomes and 2) demographics moderated the longitudinal effects of symptoms on fall-related outcomes among community-dwelling older adults. Falls and fall-related outcomes were self-reported falls, multiple falls, fear of falling (FOF), and FOF limiting activity. The number of symptoms (from 0 to 6) was calculated based on the presence of pain, insomnia, breathing difficulty, depressive symptoms, anxiety, and fatigue. Binomial logistic regression was used for data analyses. Our sample consisted of 9,060 participants who contributed 34,327 observations. These observations were aged between 65 and 79 years old (57.7%), female (58.4%), and non-Hispanic White (70.5%). Each additional symptom was associated with an increased risk of falls (Adjusted Odds Ratio [AOR]: 1.13, 95% CI: 1.11-1.15), multiple falls (AOR: 1.15, 95% CI: 1.12-1.18), FOF (AOR: 1.21, 95% CI: 1.18-1.24) and FOF limiting activity (AOR: 1.25, 95% CI: 1.21-1.29). Age, race/ethnicity, education, and living arrangement significantly moderated the relationships between symptoms and falls and fall-related outcomes. However, gender did not moderate the effects of symptoms on any outcomes. These findings suggest that symptoms longitudinally predict falls and fall-related outcomes. Common symptoms assessment and individual demographics should be incorporated into fall risk assessments and interventions.
GENERIC AND TAILORED INTERVENTIONS FOR COMMUNITY OLDER ADULTS WITH CHRONIC COGNITIVE COMMUNICATION DISORDERS
Authors: Saidi Ladan Ghazi 
Published: December 2022

Abstract
Many Community-Dwelling Older Adults (CDOA) live with debilitating chronic cognitive and communication disorders including Aphasia, Mild Cognitive Impairment, and Traumatic Brain Injury, and no longer receive healthcare services. This portion of the symposium will discuss why engaging CDOA and their caregivers with developing and selecting interventions for their cognitive communication disorders is important. Further, we discuss a community-based approach to make generic as well as tailored speech-language pathology services available to CDOA free of charge. The process of developing and using a multi-stakeholder advisory board of clinicians, researchers, CDOA, as well as a diverse advisory board of caregivers will be described, and challenges will be discussed. Further, we will present and discuss some relevant data.
RESOURCE UTILIZATION AMONG FAMILY CAREGIVERS: INDIVIDUAL AND NEIGHBORHOOD CHARACTERISTICS
Authors: Choi Hyojin , Litzelman Kristin , Harnish Autumn , Reblin Maija 
Published: December 2022

Abstract
Resources in the community play a pivotal role in increasing well-being of both care recipients and caregivers and ensuring equitable access to needed resources is a crucial priority for policy and practice. Drawing on the Andersen Behavioral Model, this study explored the longitudinal relationship between individual and neighborhood factors and social resource utilization (i.e., paid caregivers, respite care, support group, training, financial help, or transportation) among family caregivers. Unpaid family caregivers for community-dwelling older adults were identified using data from the National Study of Caregiving and National Health and Aging Trends Study (Time 1: 2015, Time 2: 2017; n=616). Neighborhood characteristics were indicators of the Social Vulnerability Index and provider density at the census-tract level. Poisson regression was used to assess predictors of greater resource use (interpreted as incident rate ratios [IRR] with 95% confidence intervals [CI]). Nearly two-thirds of the sample reported using one or more services at each timepoint. Enabling factors were key predictors of resource use at Time 2, including income above 400% federal poverty level (IRR[CI]=1.53 [1.11,2.09]), better self-rated health (IRR[CI]=1.11 [1.01,1.22]), and resource use at Time 1 (IRR[CI]=1.64 [1.29,2.08]). Need-based predictors included greater frequency of personal care (IRR[CI]=1.13 [1.05,1.22] and longer care duration (IRR[CI]=0.99 [0.98,1.00]). Neighborhood factors were not associated with resource use in this analysis, nor were other need factors including caregiving burden. The findings highlight potential disparities in resource use by income, health status, or experience with systems navigation, with implications for policy and outreach.
TIME-USE AND WELL-BEING IN FAMILY AND OTHER UNPAID CAREGIVERS OF OLDER ADULTS
Authors: Baik Sol , Lehning Amanda , Sacco Paul , Cagle John , Kusmaul Nancy 
Published: December 2022

Abstract
Due to the intensive time commitment for caregiving, caregivers report limited freedom to engage with others, participate in physical activities, pursue leisure activities, and have adequate time for sleep. Few studies have focused on caregivers’ time-use across different activities, particularly how different patterns of time-use are associated with well-being. This study aimed to: (1) identify time-use profiles of family caregivers of older adults and (2) examine associations between identified time-use profiles and caregiver well-being. We analyzed 1,640 family caregivers of community-dwelling older adults by combining secondary data from Round 7 (2017) of the National Study of Caregiving and the National Health and Aging Trends Study. We conducted latent profile analysis to estimate time-use profiles including covariates and outcomes. Three classes of caregivers emerged based on time-use patterns. The High Committed class (20%) spent the longest time in non-eldercare related committed activities, such as household activities and paid work. The High Discretionary class (49%) spent the highest amount of discretionary time, including social activities, physical activities, and other free-time activities. They also spent the least amount of non-eldercare committed time compared to the other two caregiver types. Lastly, the Balanced class (31%) allocated time relatively evenly in all activities. When comparing well-being outcomes between time-use profiles, caregivers in the High Discretionary class had worse self-rated health but lower levels of anxiety than the Balanced class. Research on time-use and caregiver well-being may help identify at-risk caregiver groups based on lifestyle profiles and develop targeted policies to promote better caregiver well-being.