bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE RELATIONSHIP BETWEEN THE FEAR OF FALLING AND QUALITY OF LIFE IN NURSING HOME RESIDENTS: THE ROLE OF ACTIVITY RESTRICTION
Authors: Xu Dongjuan , Wang Yaqi , Zhu Shanshan , Wang Kefang 
Published: December 2022

Abstract
Falls among older adults are a significant later life course event with detrimental impacts on health, quality of life (QOL), and mortality. Fear of falling (FOF) is a common problem, which can lead to physical and social activity restriction and poor QOL. However, few studies have comprehensively explored the relationships among FOF, activity restriction, and QOL among nursing home residents. This study aimed to investigate: 1) whether FOF is negatively associated with QOL; and 2) the mediating role of activity restriction in the relationship between FOF and QOL among nursing home residents in mainland China. This is a cross-sectional study. A total of 316 residents from 27 nursing homes participated in this study. The mixed-effects multivariate linear or ordinal logistic regression models were conducted. All statistical models were adjusted for resident- and facility-level variables. More than half of nursing home residents (55.4%) reported they often or always reduced their activities. As expected, FOF was directly associated with lower levels of QOL (β = -0.19, p = 0.010). However, the strength of this association was attenuated and no longer significant with the inclusion of activity restriction in the model. FOF was positively associated with activity restriction (β = 0.33, p &lt; 0.001) and activity restriction was negatively associated with QOL (rarely/sometimes reduced activity: β = -1.23, p = 0.386; often/always reduced activity: β = -3.85, p = 0.014). Given the aging of our populations, it is important to take FOF and activity restriction into account when caring for older people.
INTERVENTIONS TARGETING LONELINESS AND ISOLATION AMONG LONG-TERM CARE RESIDENTS: A SYSTEMATIC REVIEW
Authors: Raciti Audrieanna , Lyons Amy , Chang Yu-Ping 
Published: December 2022

Abstract
The impact of loneliness and social isolation on health is a significant concern among people residing in long term care. Researchers have begun to design and test interventions to lessen the burden of these impacts on the individual as well as our already strained healthcare system. The purpose of this review is to synthesize types and outcomes of interventions designed to reduce loneliness and isolation among long term care residents. Six databases: CINAHL, PUBMED, Cochrane, Web of Science, PsycInfo, and Embase were searched to identify studies leveraging the use of various interventions for alleviating feelings of loneliness and isolation within long term care residents. Multiple keywords were used including loneliness, social isolation, long-term care, nursing home, treatment, and strategies. Articles were screened if they were published between 2012 and present. Twenty studies were included in this systematic review. All studies have a small sample size. Only four studies were randomized controlled trials. Interventions included laughter therapy, adaptive sports, social robotics, horticultural therapy, spirituality, electronic cognitive behavioral therapy, music therapy, virtual reality, expressive arts, telephone discussions, video conferencing, peer mentoring, and animal assisted therapy. The majority of the interventions demonstrate a significant improvement in alleviating feelings of loneliness and social isolation, while some interventions also show improvement in quality of life and physical ability. However, some studies have a high attrition rate. Future research is needed to utilize a more rigorous design with a large sample size. Participant engagement should be considered as part of the intervention activities.
USE OF COMPLEMENTARY HEALTH APPROACHES AND PRESCRIPTION OPIOIDS AMONG VETERANS WITH MUSCULOSKELETAL DISORDERS
Authors: Han Ling , Goulet Joseph , Skanderson Melissa , Redd Doug , Brandt Cynthia , Zeng Qing 
Published: December 2022

Abstract
Complementary and integrative health approaches (CIH) are recommended in national guidelines for managing chronic pain and de-prescribing opioids. We followed 1,993,455 opioid-naïve Veterans with musculoskeletal disorders for two years after index diagnosis during 2005-2017. CIH exposure was defined as primary care visits for acupuncture, massage and chiropractic therapy using natural language processing and administratively coded data. Opioid prescriptions dispensed during follow-up period were abstracted from Veterans Health Administration electronic pharmacy records. Propensity score (PS) was used to match one control for each CIH recipient. Overall, 140,902 (7.1%) Veterans received CIH, with those age ≥65y the lowest prevalence (2.7%). Cox proportional hazard model revealed that time to first opioid prescriptions was longer for CIH recipients than PS-matched controls (136,148 matched pairs) and varied across age (p for interaction 0.003). The adjusted Hazard Ratio (HR) was 0.48 (95% Confidence Interval (CI): 0.45-0.51) for Veterans age ≥65y, 0.44 (95% CI: 0.43-0.45) for 50-64y and 0.47 (95% CI: 0.46-0.48) for ≤49y. Restricted mean survival time (RMST) models estimated a smaller CIH benefit for Veterans ≥65y, with an average 3.3 (95% CI: 3.2-3.5) month RMST difference, in contrast to 4.2 (95% CI: 4.1-4.3) and 3.7 (95% CI: 3.6-3.8) months for younger counterparts. Sensitivity analyses in full cohort or modeling total supply and daily dose of opioid prescriptions derived consistent results. These findings suggest potential benefits of CIH in delaying and reducing opioids prescriptions for patients with chronic pain. The observations of lower rate and smaller benefit of CIH use among older Veterans warrants further investigations.
BRAIN RESPONSE IN THE ELDERLY AFTER TAI CHI PRACTICE ASSESSED WITH NEUROIMAGING TECHNIQUES: A LITERATURE REVIEW
Authors: Liu Hao (Howe) , Salem Yasser , Arguello Eric 
Published: December 2022

Abstract
Tai Chi (TC) has been often provided to older adults by rehabilitation professionals for medical dysfunction and anti-aging healthcare. In the last 10 years, there has been an increase in the number of studies examining the effects of TC on brain as assessed by neuroimaging including near infrared spectroscopy (NIRS), and structure and functional magnetic resonating imaging (sMRI & fMRI). Thus, the purpose of this literature review is to evaluate how TC practice may affect the brain in the elderly as assessed by neuroimaging techniques. A comprehensive literature search was conducted using a variety of key words with different search engines to search from the last 10 years until January 15, 2022. Studies were included if they investigated topographic brain responses after TC practice in the elderly population. A total of 12 original studies with 15 articles met the criteria and were included for the review process. The results showed increased volume of cortical grey matter, improved neural activity, and increased neural connectivity in different brain regions, including the frontal, temporal, and occipital lobes, followed by cerebellum and thalamus. Intriguingly, the longer one practices TC, the more his/her brain areas may be altered. Such neural findings after TC practice are often associated with neurobehavioral improvements in attention, cognitive execution, memory, emotion, and risk-taking behaviors. Tai Chi is a promising exercise that is able to improve morphological capability and neurofunctional activity in the brain in the elderly. These improvements seem to be associated with time-length of TC practice.
SCALING UP A FALL PREVENTION PROGRAM IN RURAL COMMUNITIES: FEASIBILITY AND LESSONS LEARNED
Authors: O'Connor Melissa , Strommen Jane , Brotherson Sean , Estepp Philip , Grace Rachel , Pedersen Megan , Undem Teri , Saxena Divya 
Published: December 2022

Abstract
In North Dakota, 28% of adults over age 65 report falling each year, resulting in substantial morbidity and mortality. Evidence-based fall prevention programs can benefit quality of life and maintenance of daily living activities, particularly for community-dwelling older adults. The Stepping On fall prevention program, a national evidence-based program, is designed to educate older adults about risk factors for falls, safety strategies, and coping behaviors. The program consists of seven weekly community-based workshops conducted in a small-group setting by two trained facilitators. The Stepping On program was introduced in North Dakota in March 2012. Since that time, 132 workshops have taken place in rural communities across the state, serving 1,502 participants. The number of workshops and participants steadily grew between 2012 and 2019. In the year 2012-13, 127 individuals participated in ten workshops. By 2019, before the program was suspended during the pandemic, 199 individuals participated in 16 workshops; 24 workshops had previously been held in 2018. The current study discusses the implementation process as the program scaled up and expanded to more locations. The feasibility and sustainability of conducting the program in isolated rural areas, challenges encountered, and lessons learned will also be discussed. It is important that residents in rural communities have access to evidence-based programs like Stepping On so they can experience the benefits.
STRATEGIES TO ADDRESS COVID-19 VACCINE HESITANCY AMONG OHIO NURSING HOME STAFF
Authors: Kunkel Miranda , Applebaum Robert , Nelson Matt 
Published: December 2022

Abstract

Background
Nursing home staff members unvaccinated against COVID-19 pose an ongoing public health risk considering their frequent contact with older adults, a population especially vulnerable to the virus. In order to address vaccine hesitancy and foster vaccine confidence effectively among nursing home staff, evidence-based health communication strategies are necessary.

Methods
Using a dataset composed from three sources of Ohio nursing home data, the research questions guiding this study are as follows: 1) What is the relationship between engaging in various strategies to address vaccine hesitancy and vaccination rates among staff?; 2) Does hiring infection preventionists affect vaccination rates among staff? Multivariable linear regression techniques were used to assess all variables.

Results
Peer counseling and providing time off to the staff for vaccination statistically significant strategies to reduce vaccine hesitancy among staff. Compared to facilities that did not engage in peer counseling, those that did saw an average increase of 3.6% of their staff vaccinated. Compared to facilities that did not provide time off to their staff for vaccination, those that did saw an average increase of 4.2% of their staff vaccinated. Discussion: Peer counseling should be pursued as a viable strategy for fostering vaccine confidence among nursing home staff and further studied in more diverse populations. Implications for nursing home staff acceptance of facility-wide initiatives will be discussed.
SEDENTARY BEHAVIORS AND PHYSICAL ACTIVITY EXPERIENCES OF LATINX OLDER ADULTS: A THEMATIC CONTENT ANALYSIS
Authors: Bohplian Suweena , Liu Kristy , Fritschi Cynthia , Bronas Ulf 
Published: December 2022

Abstract
Sedentary behavior (SB) accounts for ~7.5 % of cardiometabolic mortality globally. The burden of cardiometabolic disease is especially high among Latinx adults and increases with age. Physical activity (PA) is crucial for maintaining health, yet most Latinx older adults do not meet PA guidelines and spend much time in SB. The aim of this study was to use thematic content analysis to describe the meaning of SB; and the experiences, facilitators, and barriers to PA among Latinx adults. Individual interviews were conducted among 30 Latinx older adults aged 55 to 75 years (60.7 ± 5.7 years) and BMI 20.78 to 42.13 kg/m2 (29.8 ± 4.4 kg/m2) who were enrolled in a larger study of PA. Results showed major themes included meaning of SB, consequences of SB, barriers, and facilitators of PA. Meaning subthemes included sitting for leisure as different from sitting work and value statements about laziness. Three participants did not understand the word “sedentary behaviors”. Consequence subthemes included effects on physical (circulation, obesity, fatigue) and mental health (cognitive and psychological). Barriers to PA included COVID-19, environment (weather, safety), culture (language, no relationships with non Latinx communities), time constraints (work), and physical conditions (pain and illness). Facilitators of PA include self-motivation, family, and community support (public parks, gyms, PA program from community organizations). These findings shed deeper meaning about SB and PA among the Latinx culture. These findings will be key in developing culturally appropriate interventions to improve physical and mental health specifically for the Latinx older adult population.
COGNITIVE-MOTOR GAMING IN OLDER ADULTS: FEASIBILITY OF TELEASSESSMENT AND TELEREHABILITATION ON FALL RISK
Authors: Bhatt Tanvi , Subramaniam Savitha , Kitsiou Spyros , Kannan Lakshmi , Wilson Edwina 
Published: December 2022

Abstract
There is limited guidance for clinically relevant tele-assessment, and access to a comprehensive physical-activity (PA) based telerehabilitation paradigm to enhance physical function, and slow progression of frailty among older adults (OA). In this we first examined the usability, safety, and feasibility of tele-assessment and telerehabilitation program on physical, and CV function. Subsequently evaluated its compliance and effectiveness. Healthy OAs (n=23,&gt;65 years) participated a custom-designed exergaming-based tele-exercise program (EG-BTxP) delivered in home-setting for 4 weeks (3 sessions/week) consisting of 4 exercise modules: Dancing, aerobics, cognitive-motor gaming and mind-body exercises (yoga and tai-chi) in groups of 5. Pre- and post-training, a real-time online teleassessment was performed and change in lower limb strength, endurance (30-second chair stand test), static balance (one-legged stand test, Romberg test), and dynamic balance (4-step square test), aerobic endurance (2-minute step in place test) were assessed. Participants were provided with wearable sensors and education to self-monitor heart rate during exercise and report back to health coach after each module. Participants responded positively on the qualitative usability survey and there were no adverse events . All participants were able to tolerate the teleassessment and tele-intervention with a compliance of &gt;90%. Post-training, there were improvements in 30-second chair stand test; (p&lt; 0.01), one-legged stand test, Romberg test, and 4-step square test, (p&lt; 0.05). Further, number of steps in the 2-minute step-in-place test increased (p &lt; 0.05). These findings suggest that gaming-based tele-exercise programs could be safely implemented in community-based settings to increase compliance with participation for improved physical rehabilitation outcomes.
STRATEGIES TO IMPLEMENT AGE-FRIENDLY CARE FOR OLDER ADULTS ACROSS CONVENIENT CARE CLINICS
Authors: AlDossary Heba , Bender Anna , Foradori Megan , Pohnert Anne , Hughes Robin , Greenberg Sherry , Dolansky Mary 
Published: December 2022

Abstract
A growing proportion of the population in the United States are older adults, and they are frequent users of convenient care clinics. This is particularly true for older adults from systematically marginalized communities who may be at greater risk for chronic health conditions and unmet healthcare needs. These trends render convenient care clinics critical sites to reimagine the provision of care for older adults. To improve the quality of care the CVS MinuteClinic implemented the Institute of Healthcare Improvement’s Age-Friendly Health Systems 4Ms Framework (assessing What Matters, Medication, Mentation, and Mobility). Research to evaluate two interventions (reflective learning and virtual clinic participation) to improve healthcare providers’ (HCP) uptake of the 4Ms was implemented. After the interventions, HCPs were provided a self-administered online survey to capture qualitative reports of reflections on learning and implementing the 4Ms. A total of 32 providers from both groups completed the survey. Using a codebook thematic analysis approach, facilitators and barriers for implementation were identified as were HCPs’ innovative approaches to consistently and effectively implement the 4Ms. Facilitator themes were the presence of resources (e.g., peer coaches) and the perceived value of the 4Ms model. Barrier themes included time, documentation issues, workflow challenges, HCP stress, and HCP comfort. Innovation themes included designing efficient workflows, scaffolded 4Ms learning, and collaboration. These findings underscore the supports/innovations to amplify and challenges to address to support HCPs in learning and implementing the 4Ms to improve the quality of care for older adults.
IMPACT OF A SOCIAL CONNECTION PROGRAM ON OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Ungar Rachel , Tkatch Rifky , Cheng Yan , Kraemer Sandra , McGinn Michael , Wicker Ellen 
Published: December 2022

Abstract

Background
Research demonstrates social connections decrease loneliness and improves life satisfaction among older adults. However, the COVID-19 pandemic limited social connectedness, specifically for older adults. Thus, programs aimed to increase social connectedness among older adults are integral to their well-being. Purpose: The primary objective of this study was to determine if the telephonic Peer-to-Peer (P2P) program could improve social connectedness and reduce loneliness among older adults. A secondary objective was to improve life satisfaction and social support.

Methods
Eligible older adults (age 65+) were recruited via outbound calls and/or a mailer. Participants were mailed a T1 survey, completed intervention training, and matched into a dyad. The matched dyad engaged in weekly telephone calls for 12 weeks. Post 12 weeks, participants completed a T2 survey, and a T3 four weeks later.

Results
A total of 475 participants completed a T1, and 125 dyads (250 individuals) completed a T3. Older females were more likely to participate (77% female, 44% 75+ old). Individuals who were lonelier at baseline showed a significant improvement in loneliness throughout the program, as well as improvement in social support, life satisfaction, and subjective happiness.

Conclusion
Results from this program showed significant improvement in psychosocial well-being outcomes for lonely older adults. This program took place during the initial months of the COVID-19 pandemic and demonstrated success for lonely older adults with limited technology who may have been socially isolated during this time.
SOCIAL SUPPORT AND LONELINESS AS DETERMINANTS OF THE ONSET OF DISABILITY AMONG PUERTO RICAN OLDER ADULTS
Authors: Matos-Moreno Amilcar , Mehta Neil , Villamor Eduardo , Wang Lu , de Leon Carlos Mendes 
Published: December 2022

Abstract

Background
The effect of loneliness and social support on health is poorly understood among older Puerto Ricans. As family size continues to decrease in Puerto Rico due to out-migration, a higher number of older adults have fewer family members to rely on, which may lead to detrimental health outcomes.Method: Using both waves (2002-03 and 2006-07) of the Puerto Rican Elderly: Health Conditions database, we examined the association between social support, living alone, and incident disability among a sample of older adults over 60 years of age residing in Puerto Rico. Disability was defined as the occurrence of difficulties with Activities of Daily Living (ADLs).

Results
13.4% of older adults in our sample developed some form of disability. Older adults who developed a disability indicated receiving higher levels of social support (2.04 vs. 1.64) and loneliness (30.7% vs. 22.8%). Using multivariate logistic regression, we found that receiving social support increased the odds of developing a disability by 17% (OR: 1.17; CI: 1.02 – 1.35). Older adults who live alone had 58% higher odds of developing a disability (OR: 1.58; CI: 1.01 – 2.46).

Conclusion
The presence of social support and loneliness was correlated with a population prone to developing disabilities. Our findings concur with the well-established literature on psychosocial determinants in late life. However, this study represents the first attempt to understand psychosocial measures and disability in Puerto Rico. Public health organizations and healthcare systems must develop new societal mechanisms of support for older adults at risk of developing disabilities.
NOBODY KNOWS ME HERE: LONELINESS AMONG OLDER AFRICAN IMMIGRANTS
Authors: Adeniji Dolapo , Ashirifi Gifty , Adamek Margaret 
Published: December 2022

Abstract
Migration in later life is often accompanied by stressors such as acculturation and disconnection from previous social networks in one’s country of origin. Loneliness emerged in previous studies as one of the challenges that negatively impact older immigrants’ physical and mental health. Despite the rapid growth of this population in the United States, there is limited knowledge about loneliness experiences of older African immigrants. Thus, this study explored the loneliness experiences of older African immigrants living with their adult children in the United States. In-depth interviews were conducted with nine participants aged 69-84. The tape recordings of the interviews were transcribed verbatim for thematic analysis. Findings show that loneliness was prevalent among study respondents, despite living with their adult children’s family. Four major themes emerged from the study: 1) “Nowhere to go” (loneliness experience), 2) “It makes one sick if one is doing nothing” (consequences of loneliness), 3) “My grandkid makes me happy” (protective strategies) and 4) “If they ask older people to come. I will go there” (way forward in the community). Living with adult children may not prevent loneliness for older immigrant parents. Although the participants demonstrated resilience, their coping strategies were insufficient to overcome their loneliness. To address the gap in resolving loneliness, strategies are needed to increase older African immigrants’ social connectedness with their peers, family, and community. Interventions that promote social interactions and embeddedness into their local community are needed to ensure a good quality of life for older African immigrants.