bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE IMPACT OF EARLY CONDITIONS ON THE PREVALENCE OF DIABETES ACROSS THREE COHORTS OF OLDER ADULTS IN MEXICO
Authors: Samper-Ternent Rafael , Zazueta-Borboa Jesús-Daniel , Mehta Neil , González Cesar , Wong Rebeca 
Published: December 2022

Abstract
In low-and-middle-income countries like Mexico the impact of disadvantaged early childhood conditions (ECC) on later-life health in not well known and may be changing across birth cohorts. Our objective is to examine the impact of ECC on the propensity to have diabetes in three different cohorts of older adults aged 60-69 (born in 1930-1939, 1940-1949, 1950-1959). We examine to what extent differences in ECC, sociodemographic characteristics, and lifetime obesity explain the differences in the prevalence of diabetes across the cohorts. We use five waves of data from the Mexican Health and Aging Study (n=10,313). We estimate a series of logistic regression models and use counterfactual analyses to identify the roles of ECC and lifetime obesity on cohort-specific diabetes prevalence and on differences in diabetes prevalence across cohorts. Our results suggest that improvements in ECC would decrease prevalence of diabetes by 12.5% in the 1930-1939 cohort and 10% in the 1950-1959 cohort. However, the rise of obesity at age 50 counters this effect and leads to higher prevalence of diabetes in both cohorts. Our models show that if everyone had a normal weight at age 50, the prevalence of diabetes would decrease by 31.3% for the 1930-1939 cohort, 27.3% for the 1940-1949, and 26.7% for the 1950-1959 cohort. Despite improvements in socio-economic conditions during childhood in Mexico, the increase in lifetime obesity appear to offset the benefits derived from better ECC resulting in higher rates of diabetes.
OLDER ADULT’S PERCEPTION OF PRIMARY HEALTH CARE REFORM IN A LOW-MIDDLE-INCOME COUNTRY (LMIC): IMPACT ON GERIATRIC CARE
Authors: Abah Theresa 
Published: December 2022

Abstract
Health reforms are intended to provide equitable and beneficial care across population groups, it also transforms service delivery. We sought to identify current or potential implementation gaps that divert improvement efforts in service delivery, and practices that prevent holistic approaches in caring for older adults, especially in developing nations. This study examined a major health reform initiative in a LMIC aimed at integrating defragmented health organizations under one management, it also looked at extent to which reform agendas align with primary health care (PHC) principles. Using purposeful random sampling design, this quantitative study obtained participants’ views of care received in 12 sites and 2 states in Nigeria. A total of 218 participants aged 50 years and older in both rural and urban areas. Partial correlations were carried out after accounting for other variables of interest. Findings show there was no significant differences in attributes of primary care received by geography, gender or by state. Although Ondo state scored higher than Federal Capital Territory in previous performance evaluations (66% and 43% in 2015), respondents from both states received only two out of the seven primary care attributes recommended by the World Health Organization. First contact (access to care) and Care continuity, p &lt;.01 and p, 0.5, (d = 0.202 and 0.179) were significant. Overall, our findings suggest that performance improvement at management level dominated reform efforts over service delivery. It is unclear how this aligns with providing older adults with the health care that they need.
BUDGET IMPACT ANALYSIS OF NONPHARMACOLOGICAL INTERVENTIONS FOR COMMUNITY-DWELLING PEOPLE LIVING WITH DEMENTIA
Authors: Jutkowitz Eric , Mendez Mauricio Lopez , Shewmaker Peter 
Published: December 2022

Abstract
Non-pharmacologic dementia care interventions significantly reduce the risk of a nursing home admission for people living with dementia. We used an evidence-based mathematical model to evaluate the budget impact for a healthcare payer that independently implemented four non-pharmacologic dementia care interventions that reduce the risk of transitioning to a nursing home for people living with dementia: 1) MIND, an at-home care coordination intervention; 2) NYU Caregiver (NYUCI), provides caregivers with counseling and ad-hoc support; 3) Alzheimer’s and Dementia Care (ADC) program, a clinic based care coordination intervention; and 4) Adult Day Services Plus (ADS-Plus), an adult day based care coordination intervention. Healthcare payer costs included Medicare and Medicaid expenditures. We simulated a cohort of 302,630 community-dwelling people with dementia, which is the number of people who were diagnosed with dementia in 2018. We applied each intervention’s inclusion criteria to determine the proportion of the cohort that would receive the interventions. Some people may die or enter a nursing home before receiving the interventions. MIND, NYUCI, ADC, and ADS-Plus reduced annual payer expenditures (relative to $25,000, which is the average amount Medicare-Medicaid pay per person with dementia) on average by 0.67%, 0.23%, 0.13%, and 0.58%, respectively over 5 years. Cost savings for the interventions varied by demographics. African American females between ages 95-100 who received NYUCI had the largest cost savings ($2,750.57). White females between ages 65-70 who received ADC had an increase in payer costs ($2,397.07). On average, non-pharmacologic dementia care intervention do not increase a healthcare payer’s budget.
DIFFERENCES IN LIFE COURSE PATHWAYS TO DEMENTIA INCIDENCE FOR BLACK AND WHITE OLDER AMERICANS
Authors: Farina Mateo 
Published: December 2022

Abstract
Black Americans are 2-3 times more likely to have dementia than White Americans. Studies have evaluated how differences in exposures to life course risk factors, such as level of education, may be contributing to this disparity. When using this approach, substantial reductions in cognitive health inequality across race were accounted for, but not completely explained. However, this research assumes an underlying similarity in life course pathways to cognitive impairment risk across race groups. We used longitudinal data from the Health and Retirement Study (2000-2016) to evaluate life course pathways to dementia risk across race groups. We find substantial differences across race groups. Dementia risk for older black adults is greatly shaped by southern birth and education. For older white adults, adulthood factors such as wealth, health behaviors, and cardiometabolic conditions has a greater role. Our findings support calls for a closer examination of within group analysis among minoritized populations.
THE TELLEGACY PROGRAM
Authors: Holloway Jeremy 
Published: December 2022

Abstract
Emerging research displays how social isolation and loneliness (SIAL) before and during the Coronavirus pandemic are linked to health issues caused by SIAL. These issues are estimated to increase the risk of early death by 26 percent, the equivalency of smoking 15 cigarettes a day. The program started soon after the pandemic as an intergenerational program created to combat SIAL among older adults. University students, known as Legacy Builders, connect through virtual or via phone conversations to communicate meaningfully with the older adult. Students are prepared with a curriculum on mindfulness, SMART goal-setting, growth mindset, visualization goal-setting exercises, and reminiscence therapy as well as the skill and art of listening. At the end of the encounters, a legacy book is given to the older adult with a description of the older adult’s life shared during their conversations with the Legacy Builder. The UCLA Loneliness Scale was utilized along with older adult self-reports. Sixteen residents in a memory care facility, ages 58 to 86, with multiple levels of dementia participated in the program of Summer 2021. The UCLA Loneliness Scale revealed that 13 of the 16 residents originally reported that they feel lonely or isolated. After 5 weeks of participation 7 out of the 16 residents report that they felt less lonely. Qualitative analysis showed improved perceptions of aging and an interest in Geriatrics among the student participants. These results also displayed positive older adult perceptions of the younger generation, and similar responses of the younger generation towards older adults.
STAKEHOLDER ENGAGEMENT IN THE DESIGN OF A FALL RISK PREDICTION SYSTEM FOR SOCIALLY VULNERABLE OLDER ADULTS
Authors: Demiris George , Hodgson Nancy , Richmond Therese , Skubic Marjorie , Harrison Sean , Sefcik Justine , Oh Sungho , Cho HanNah 
Published: December 2022

Abstract
Falls and fall-related injuries are significant public health issues for adults 65 years of age and older. Fall-related injuries are among the most expensive medical conditions. Mild cognitive impairment (MCI) and housing conditions are each independent risk factors for multiple falls among older adults and there is increasing evidence of the adverse effect of MCI on balance, stride, gait speed and increasing fall risk. We developed an innovative technology-supported intervention called Sense4Safety to 1) identify escalating risk for falls through real-time in-home passive sensor monitoring (using depth sensors); 2) employ machine learning to inform individualized alerts for fall risk; and 3) link ‘at risk’ socially vulnerable older adults with a tele-coach who guides them in implementing evidence-based individualized plans to reduce fall-risk. The purpose of this study was a) to examine preferences and attitudes of low-income older adults towards an in-home sensor-based system to inform fall prevention strategies; and b) solicit feedback from and validate the intervention protocols by clinical experts in fall prevention, fall risk assessment and geriatrics. We conducted one hour interview sessions with a total of 10 older adults and 10 clinical experts. Sessions were transcribed and analyzed. Findings included perceived benefits and challenges, recommendations for refinement of the intervention (including educational components and different visualization approaches for sensor data) and the role of family members or trusted others in addressing fall risk. We highlight clinical and ethical implications resulting from the use of passive monitoring for socially vulnerable older adults with MCI.
DIGITAL TECHNOLOGY USE AND INTERGENERATIONAL INTEGRATION: THE MEDIATING ROLE OF DIGITAL LITERACY
Authors: Park Hayoung , Choi Bomi , Joo Susanna , Kim Yoon-Myung , Kim Hyoun K 
Published: December 2022

Abstract
This study aimed to analyze the mediating effect of digital literacy on the association between digital technology use and intergenerational integration in later life. The sample included 315 older Korean adults aged 65 and above (M=68.83, SD=4.19, range=65-84) who participated in an online survey in December 2021. The participants’ use of digital technology was measured by the sum of thirteen questions about how often they used each digital technology in their daily lives. Intergenerational integration was measured by the sum of thirty questions concerning awareness of understanding and empathizing with characteristics and cultures between generations to live harmoniously in the times through communication and cooperation. The mediating variable, digital literacy, was measured by the sum of thirty-five questions from the New Media Literacy Scale, asking individuals’ ability to find, evaluate, and communicate information in a digital society. Age, gender, education level, household income, marital status, and living conditions were controlled for to reduce confounding effects. According to the mediation path analysis using SPSS PROCESS macro and bootstrapping, digital literacy significantly mediated the effects of digital technology use on intergenerational integration in later life; the higher the level of digital technology use, the higher the level of digital literacy, and this had a positive effect on the level of awareness of intergenerational integration among older adults. This study is significant in that it confirms the mechanism underlying the link between digital technology use and intergenerational integration and provides a new empirical model to promote intergenerational integration in terms of digital aging.
LEVERAGING VIDEO CONFERENCING TECHNOLOGY TO FACILITATE SOCIAL ENGAGEMENT IN OLDER ADULTS
Authors: Mois George , Lydon Elizabeth , Shende Shraddha , Khamzina Madina , Myers Dillon , Mudar Raksha , Rogers Wendy 
Published: December 2022

Abstract
Social engagement is critical for maintaining well-being and quality of life in older adults. However, typical age-related changes across bio-psychosocial dimensions as well as age-related conditions such as mild cognitive impairment (MCI), pose many challenges for older adults to remain socially connected. The development of technologies, specifically video conferencing, can be leveraged as a tool to facilitate the delivery of social engagement opportunities, both enhancing access and minimizing social isolation. For successful adoption of these tools, the needs and preferences of older adult users must be considered. We employed an iterative research process for designing and developing a social-engagement intervention using a platform called OneClick.chat. We provide community-dwelling older adults with opportunities to engage in casual conversations and reminisce with others on topics of shared interests (e.g., nature, food, hobbies). Our iterative design process involved an interdisciplinary team of engineers, human factors specialists, gerontologists, and neuropsychologists. We also evaluated the system with eight participants (aged 50-64) who provided their insights pertaining to the content, delivery, perceived ease of use, usefulness, and potential adoption of this video-conferencing platform. Based on the feedback received, we have optimized the intervention in preparation for a randomized controlled trial. Furthermore, we provide key insights related to the implementation of social engagement through video technologies with the aim of facilitating social connectivity. Our learnings can be used to guide future work involving video-technology-based interventions to facilitate social connectivity for older adults with varying cognitive abilities.
THE ASSOCIATION BETWEEN SUBJECTIVE AGE AND TECHNOLOGY USE AMONG OLDER ADULTS
Authors: Ikeuchi Tomoko , Wakui Tomoko , Itoh Sakiko , Miwa Hiroyasu , Watanabe Kentaro 
Published: December 2022

Abstract

Background
Subjective age (SA) (i.e., felt age) has been found to be a biopsychosocial marker of aging. This study examined the associations between SA and frequency of technology usage of older adults.

Methods
Data were collected via an online survey conducted in 2020. The study analyzed participants aged 65 to 89 (M = 71.9, SD = 3.91) years resided in Japan (N = 1855, 54.3% women). SA was indexed by asking participants to specify in years how old they felt. Proportional discrepancy scores (PDS) ((SA - chronological age) / chronological age) were calculated to indicate younger or older SAs and used as an independent variable. Participants were asked about the frequency of computer, smartphone, flip phone, and SNS use.

Results
Nearly 90% reported using computers for more than 2-3 days a week, 64.3% smartphones, 22.9% flip phones, and 36.6% SNS. Logistic regression analyses revealed that lower PDS (i.e., feeling younger) was associated with a significantly higher frequency of smartphone use (OR: 0.75; 95% CI: 0.59, 0.96) after adjusting for age, gender, education, and subjective health. No such association was found for computer, flip phone, and SNS use. Implications: Older adults who use smartphones daily may feel younger than those who do not. Since the present study was administered during the COVID-19 pandemic, the daily use of smartphones may have helped older adults stay in touch with friends and family members and obtain information they need. The use of smartphones possibly contributed to better mental health outcomes while practicing social distancing.
CAREGIVING STRESSORS AND MENTAL HEALTH AMONG OLDER DEMENTIA CAREGIVERS: THE MEDIATING ROLE OF LIFE DISRUPTION
Authors: Wang Fei , Irani Elliane 
Published: December 2022

Abstract
Providing care to a loved one with dementia can take a mental toll on older adult caregivers who struggle to balance their caregiving duties and self-care. However, few caregiving studies focus on older adults as caregivers. Further, the extant research mainly investigates stressors directly related to the demands of caregiving without accounting for the disruptions in different areas of life triggered by dementia caregiving. Guided by the Stress Process Model, we examined how life disruption mediates the association between caregiving stressors and caregiver mental health. A total of 360 older adult caregivers (age 65 or above) of individuals with dementia (age 65 or above) in the U.S. were selected from the 2017 National Study of Caregiving. An index of life disruption was created based on seven types of life challenges due to caregiving, such as constriction of social life and job-caregiving conflict. Results from a path analysis show that both objective and subjective caregiving stressors (i.e., care assistance and role overload) were positively associated with life disruption, which in turn, were positively associated with depressive symptoms and anxiety. Caregiver socio-demographics and self-rated health were included in the analysis as covariates. These findings inform a novel clinical assessment framework for practitioners to identify the unique challenges faced by older dementia caregivers in the U.S. Moreover, this study elucidated life disruption as a modifiable factor to mitigate mental health problems in this population. Future research should compare the effects of different types of life disruption on mental health among older dementia caregivers.
CAREGIVING FOR AN OLDER RELATIVE IN YOUNG ADULTHOOD
Authors: Fingerman Karen , Zhang Shiyang , Zhou Zexi , Ng Yee To , Birditt Kira , Zarit Steven 
Published: December 2022

Abstract
Caregivers are typically viewed as midlife or older individuals, but nearly 25% of self-identified caregivers are young adults (aged 18 to 29). We report findings from a small study of Hispanic/Latinx, African American, and Asian American young adult caregivers, using: quantitative and open-ended assessments and weekly diary surveys. We assessed caregiving tasks young adults provide, rewards, and detriments of providing care. In open-ended responses, young adults described their caregiving roles as emotional as well as hands on, and reported filling in for other caregivers who could not help. They reported goal disruptions (e.g., education, romantic ties) associated with caregiving, but felt they were repaying debts to their grandparents through caregiving. Diary data document vicissitudes in weekly caregiving experiences and well-being. Discussion focuses on the unique implications of caregiving ties between young adults and their grandparents when the grandparent incurs physical or cognitive health impairments.
SLEEP IS REQUIRED FOR ODOR EXPOSURE TO CONSOLIDATE MEMORY AND REMODEL OLFACTORY SYNAPSES
Authors: Chandra Rashmi , Farah Fatima , Muñoz-Lobato Fernando , Bokka Anirudh , Benedetti Kelli , Saifuddin Fatema , VanHoven Miri , L'Etoile Noelle 
Published: December 2022

Abstract
Olfactory dysfunction precedes dementia in several neurodegenerative disorders such as Alzheimer’s disease (AD) or Parkinson’s Disease (PD), and AD/PD are associated with progressive sleep abnormalities. However, how sleep affects cognitive performance remains unclear, perhaps due to the complexities of the human nervous system. Here we demonstrate that the transparent model organism C. elegans which has well defined neural connection sleeps after repeated odor trainings. This provides us with a platform to dissect how sleep affects memory at a synaptic resolution. We identified that sleep after training is required for the animal to retain a long-term memory of the odor. We found that if animals do not sleep in the first two hours after training, memory is not consolidated. After identifying the neurons that are required for the memory, we show that the sensory-interneuron connections within the circuit are downscaled after sleep. Therefore, we found a time-specific requirement of sleep that modulates synaptic downscaling to preserve memory. Conversely, lack of sleep post-training erases the long-term memory and destabilizes the synaptic downscaling, indicating that modulating the amount of sleep is sufficient to modulate memory. These results make C. elegans an excellent tool to ask what molecular mechanisms, cell biological processes and circuit level reorganizations are engaged during sleep to promote memory. This understanding will provide insights into the functions of sleep that affects cognitive performance in neurodegenerative diseases.
TRACING THE RELIGIOUS LIFE COURSE: INTER- AND INTRAGENERATIONAL SOURCES OF LATER-LIFE RELIGIOSITY IN BABY BOOMERS
Authors: Silverstein Merril , Yoon Joonsik , Harris RianSimone , Hwang Woosang 
Published: December 2022

Abstract
The development of religiosity in later life has its origins in earlier phases of the life course, yet few studies have investigated the contribution of early religious exposure to religious beliefs and behaviors in old age. This investigation uses multigenerational data from the Longitudinal Study of Generations taken from 385 baby boom children, 16-26 years of age, and their parents in 1971, and follows the children’s religious orientations into midlife and old age. Guided by intergenerational transmission and path dependency perspectives, we found that parents’ religious intensity in 1971 strengthened their children’s cognitive and behavioral religiosity in later life as mediated by children’s early and midlife religiosity. Our results demonstrate both intergenerational transmission followed by temporal stability in religious belief and practice. Evidence suggests that parental influence creates religious momentum in their children that carries from adolescence/young adulthood through the unfolding of their lives into old age.
MULTIMODAL AFFECTIVE ANALYSIS OF FACIAL AND VOCAL EXPRESSIVITY USING SMARTPHONE AND DEEP LEARNING ANALYSIS
Authors: Kim Heejung , Cho Youngshin , Lee Sunghee , Kang Chaehyeon 
Published: December 2022

Abstract
Limited expressivity of emotion is one of the most common symptoms of major depression, particularly in older adults. Although assessing facial and vocal expressivity is very important for accurate clinical evaluation of geriatric depression, research has rarely examined older adults via telehealth technology. This study aims to quantify facial and vocal expressivity via a multimodal affective system with deep learning. A total of 19 Korean adults aged over 65 years with severe depressive symptoms participated in this research. Using smartphone video recording, 1,429 facial and vocal data were collected between July and December 2020. Recorded videos were transmitted automatically to the cloud system. Basic facial movements were extracted using combined video frames and mel spectrogram images. Compared to the AI hub of Korean images from big data, mood status was classified into seven categories (anger, disgust, fear, happiness, neutrality, sadness, and surprise). Frequencies of each mood were coded into continuous variables for each participant in each recording. When comparing video and text prediction to determine “true labels,” the overall accuracy was 0.69, with F1 scores ranging from 0.57 to 0.79. In addition, the most common emotions were angry, happy, neutral, sad, and surprised. This study suggests that smartphone-recorded video could function as a useful tool for quantifying mood expressivity. This study established a preliminary method of affective assessment for older adults for telecare use based on socially assistive technology at a distance from the clinic.