bluuebunny/crossref_metadata_2025_split huggingface dataset:
RACIAL DISPARITIES IN PSYCHOLOGICAL WELL-BEING ACROSS AGE GROUPS DURING COVID-19: A LONGITUDINAL STUDY
Authors: Elliott Meghan , Charles Susan , Silver Roxane Cohen , Holman E Alison 
Published: January 2025

Abstract
COVID-19 created a health threat that discriminated by age: older adults were at greatest risk for health complications and mortality, but younger adults reported the highest rates of emotional distress. Cross-sectional studies consistently documented age differences in distress, but few studies have examined age-related differences over time. We examined how self-reported anger and both depressive and anxiety symptoms changed throughout the first two years of the COVID-19 pandemic among a national representative sample of adults (N = 6514) aged 18 to 97 years who completed four surveys between March 2020 and June 2022. Multi-level models revealed age differences that varied by race. Overall, younger age and non-white status were related to higher levels of every affective distress measure. For depressive symptoms, most age groups peaked at wave 2 and declined thereafter. The exception was the young non-white adults, where levels peaked at wave 2 and remained stable thereafter. For most participants, anxiety symptoms were highest at wave 1 and declined thereafter, although young non-white participants had minimal decreases and levels increased among middle-aged and older adults across race. Anger symptoms peaked for all age groups at wave 2, yet older white adults were the only group whose anger levels did not decrease from wave 2 to wave 4. Results suggest that non-white status and young age may be vulnerabilities to symptoms of depression and anxiety, and being old and white is related to stable levels of anger across time, highlighting the need for targeted support for these groups.
THE COVID-19 PANDEMIC AND OBJECTIVE SOCIAL ISOLATION AMONG THE OLDER ADULTS IN THE UNITED STATES
Authors: Yin Jiamin , Seplaki Christopher 
Published: January 2025

Abstract
Experiences of social isolation are common among older adults and were amplified by the COVID-19 pandemic, particularly among those aged 80+. However, we do not know if such age differences in the experience of social isolation are due to the pandemic or if the underlying mechanisms driving social isolation may differ across age groups. We use a difference-in-difference design to compare the change in social isolation before and after 2020 across older adults aged 80+ versus those 65-79 years using data from the National Health and Aging Trends Study to constructed a composite measure of objective social isolation that includes four domains (living arrangement, communication regarding important matters, participation in religious and other activities). Our preliminary results suggest that adults aged 80+ years were found 3.7% (Standard Error (SE): 0.014) more likely than those aged 65-79 years to experience social isolation in 2020. Additional analysis of the four social isolation domains suggest that “older” older adults were 6.8% (SE: 0.016) more likely to report no participation in other activities than the “younger” older adults in 2020. In contrast, they were 3.5% (SE: 0.010) less likely than the “younger” older adults to live alone in 2020. No significant effect was observed in other domains. Our preliminary findings highlight the greater vulnerability of adults aged 80 years and the potential importance of developing interventions to address social isolation among this subgroup of vulnerable older adults.
THE IMPACT OF EDUCATIONAL LEVEL ON FOOD SECURITY AMONG OLDER ADULTS AMID THE COVID-19 PANDEMIC
Authors: Monroe-Lord Lillie , Ardekani Azam , Jackson Phronie , Weitman Cassidy 
Published: January 2025

Abstract
The COVID-19 pandemic has dramatically altered global health and economic landscapes, significantly threatening food security worldwide. This study investigates the pandemic’s impact on perceived food security among older adults, with a particular focus on the role of educational attainment. A total of 4,961 participants aged 65 and above were surveyed between August 9 and September 15, 2020, utilizing the USDA’s Six-Item Short Form via Qualtrics to measure food security. The survey, conducted retrospectively twice, assessed higher scores as indicative of increased food insecurity among varying educational backgrounds: less than a high school education, some college education, and a college or graduate degree. Findings indicated older adults with less than a high school diploma were most affected, experiencing a mean percentage increase in food insecurity of 7.7% (p = 0.007). Respondents with some college education saw a 7.03% increase, which was not statistically significant (p &gt; 0.05). Conversely, older adults with a college or graduate degree reported a smaller, yet statistically significant, increase in food insecurity (4.06%, p = 0.041). These results highlight a correlation between educational level and food security, with lower levels of education being associated with a greater risk of food insecurity during the COVID-19 pandemic. This study underscores the need for enhanced support systems to protect the most vulnerable populations, especially the less educated older adults, from the adverse effects of global health emergencies on food security.
THE PANDEMIC AS A GREAT UNEQUALIZER? RURAL–URBAN DIVIDE IN COVID-19 CONCERNS AND OLDER ADULTS’ MENTAL HEALTH IN CHINA
Authors: Liu Jingwen , Han Yang 
Published: January 2025

Abstract
Hukou is a household registration system that divides individuals to rural or urban residents at birth based on their parents’ status, which significantly contribute to health disparities in China. This paper investigates whether older adults’ concerns about the Covid-19 pandemic exacerbate rural-urban disparities and the potential mechanism of coping behaviors. Using the 2020 wave of China Health and Retirement Longitudinal Study (CHARLS), we employed OLS and KHB analyses to local rural residents (rural-Hukou holders living in rural areas, N=9,101), rural-urban migrants (rural-Hukou holders living in urban areas; N=2,418), and local urban residents (urban-Hukou holders living in urban areas, N=2,874), respectively. Results suggest that local rural residents and rural-urban migrants both show substantially higher Covid concerns and depressive symptoms than local urban residents. Covid concerns are associated with higher depressive symptoms among all groups, but the association is statistically more prominent among local rural than local urban residents. While changes in health habits and in-person meetings contribute to explaining these associations for both groups, the delayed medical services and increased preventive behaviors exclusively explain the association for local rural residents. Rural-urban migrants exhibit a dual profile: they demonstrate higher concerns like rural residents while adopting fewer coping behaviors parallel to urban residents. This paper confirms that Hukou acts as a fundamental cause of rural-urban health disparities that will be reproduced and reinforced during societal crises like the Covid pandemic. Rural-born individuals’ health disadvantages may be reduced but not eliminated by the migration to urban areas without substantial reforms of Hukou system.
DEMENTIA LITERACY ENHANCEMENT DESIGN AND ITS OUTCOMES IN TAIWAN
Authors: Kuo Tsuann , Lai An Chi 
Published: January 2025

Abstract

Background
The increasing number of people diagnosed with Dementia requires the public to become more knowledgeable about dementia and to act more dementia friendly.

Purpose
This paper was to evaluate the effectiveness of a dementia education effort. The purpose was to increase dementia literacy and find out what aspects the public changed the most on dementia.

Methodology
A pre- and post-test was administered to 1237 individuals who attended the dementia education sessions. Each session lasted one hour and 38 sessions were administered within three months at various locations including community care sites, churches, cultural centers, stores, and schools. A pre- and post- test on dementia literacy and attitudes were administered and the response rate was 68%. The majority were females (80%), 60 to 70 years old (25.94%), with a university degree (53.71%), and retired (27.66%).

Results
One-way ANOVA analyses revealed significant associations between participants’ age group, educational level, and the difference in the pre-post test (p&lt; 0.01). The results suggest that the educational intervention was effective in enhancing dementia literacy, but the degree of improvement varied across different demographic groups and locations.

Discussion and conclusion
The dementia education sessions effectively improved dementia literacy, with variations observed across age and educational groups. Tailoring educational content and delivery methods to cater to diverse demographic backgrounds could further enhance the effectiveness of such initiatives in promoting dementia awareness and fostering a more inclusive society. Future research should explore specific strategies to optimize educational programs for different target populations, ultimately contributing to a more dementia-friendly community.
EFFECTS OF SMART AMBIENT BRIGHT LIGHT (SABL) ON SLEEP QUALITY IN NURSING HOME RESIDENTS WITH DEMENTIA
Authors: Lin Chia Jou , Liao Yo-Jen , Berish Diane , Jao Ying-Ling 
Published: January 2025

Abstract
Lighting interventions (LIs) have shown positive impact on circadian rhythms and sleep quality in people with dementia. Yet, few studies incorporated daylight with LI. The Smart Ambient Bright Light (SABL) is a newly developed LI that accommodates natural daylight and provides automatic bright light during the day and dim light during the night. The study examined the effect of SABL on sleep in nursing home (NH) residents with dementia. This was a 13-week cluster randomized crossover-controlled trial conducted in two nursing homes in Pennsylvania. The SABL was installed in residents’ bedrooms and common areas for 4 weeks with 2 weeks of washout between control and intervention. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. Descriptive analysis and paired t-test was performed to compare difference in sleep quality changes between control and intervention periods. A total of 18 residents enrolled in this study. Participants were 87.3 years old on average and 12 of them (67%) were female. The included residents experienced poor sleep quality at baseline (mean PSQI=6.67, SD± 3.07). A paired t-test showed that comparing to the baseline, the PSQI level decreased in both intervention group (5.28 ± 3.58) and control group (4.28 ± 2.44), without statistical significance (p = 0.29). The results suggest that the SABL did not show significant effect on sleep quality among NH residents with dementia. This is a pilot study with a small sample size. More research is needed to replicate the study on a larger scale.
COGNITION AFTER A DISASTER: AGE, WORKING MEMORY, AND THE PICTORIAL SUPERIORITY EFFECT
Authors: Cherry Katie , Bordes Piper , McKneely Katelyn , Elliott Emily , Calamia Matthew 
Published: January 2025

Abstract
We examined free recall of line drawings and matching words in mostly middle-aged and older adults from three parishes (counties) in Baton Rouge, LA that experienced the Great Flood of 2016. All completed multiple individual difference measures, including self-report measures of cognition and emotion (PROMIS, Lai et al., 2014) and a computerized measure of memory for pictures and words. Three groups were compared: (1) non-flooded adults as controls, (2) once-flooded adults with structural damage to homes and property in 2016, and (3) twice-flooded adults who had relocated to Baton Rouge because of catastrophic losses in the 2005 Hurricanes Katrina and Rita and they flooded again in 2016. All were tested during the immediate aftermath of the flood (Wave 1; N = 223, age range: 18-88 years) and most were re-tested 9 +/- 3 months later in a follow-up assessment (Wave 2; N = 202). Results yielded a memorial advantage of pictures over matching words in free recall for all disaster exposure groups at both assessments (p’s &lt; 0.001). Correlation analyses revealed that self-reported deficits in cognition were inversely related to word recall at Wave 1 only. In contrast, self-reported cognitive deficits were positively correlated with flood stressors at Wave 1 and recovery stressors at Wave 2. The present results show that single and multiple disaster exposures do not appear to disrupt performance on traditional, laboratory-based measures of cognition. This research was supported by a grant from the National Science Foundation (Award Number 1708090).
TRENDS IN OLDER ADULTS’ EMPLOYMENT AND PERCEPTIONS OF WORKPLACE AGEISM (1994–2020)
Authors: Sahin Duygu Basaran 
Published: January 2025

Abstract
The research on ageism has made great strides since the term was coined by Robert Butler in 1969. Prior literature shows that ageism and ageist stereotypes negatively affect older adults’ mental, physical, and economic wellbeing. This paper contributes to the literature by providing a trend analysis of older adults’ employment and perceptions of workplace ageism covering a 26 year-period from 1994 to 2020. I use cross-sectional data from the Health and Retirement Study and calculate the shares of older adults (ages 51-79) who worked for pay, who were self-employed (N ranging from 11,227 to 16,035) and who agreed with the workplace ageism statements (N ranging from 3,577 to 6,064). Preliminary findings indicate that the share of older adults who worked for pay increased over time from 44 to 50 percent, however, the share of self-employed older workers stayed about the same (20 percent). Perceptions of workplace ageism slightly declined from 1994 to 2020. In 1994, 21 percent of older workers agreed that in promotion decisions their employer preferred younger workers over older workers compared to 17 percent in 2020. Trend analyses also suggest that older adults’ employment and perceptions of workplace ageism change during economic crises. Findings from this research can be used towards policy recommendations to minimize the psychosocial and economic disruption that older workers experience during economic downturns.
A SCOPING REVIEW OF PARTICIPANT MOTIVATIONS, BENEFITS, AND BURDENS IN END-OF-LIFE RESEARCH PARTICIPATION
Authors: Wallace Cara , Wladkowski Stephanie , Juboori Ruaa Al , Wingo Anna , Hyde Rebecca 
Published: January 2025

Abstract
Hospice clinicians are often hesitant to ask patients and their families/caregivers to participate in research, fearing it is too intrusive during a sensitive and vulnerable time. Further, there is a lack of research, highlighting a gap in knowledge of patient and family experience during hospice and palliative care while it also inhibits the understanding of the benefits and burdens of participation in end-of-life research. A scoping review aimed at understanding the motivating factors, benefits, and burdens of participation in research for patients with a terminal illness and their families/caregivers was conducted. Partnering with a librarian scientist, we searched PscyInfo, CINAHL, PubMed, and Scopus for studies published between 2015 and 2024 using the following search terms: “palliative care,” “terminal illness,” or “hospice” AND “subject burden,” research burden,” “benefit,” or “motivation.” 3,431 unique articles were identified and reviewed, with 24 studies meeting inclusion criteria. Results from these 24 studies were mapped out using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Many participants reported greater benefits than burdens, even reporting great value in participation when a burden was experienced. Individuals also reported that participation in a study provided an additional outlet for support, and feeling a socioemotional altruistic benefit even with no direct medical benefit as a study participant. For clinicians working in end-of-life care, connecting patients and caregivers to end-of-life research may not only be beneficial to contribute to literature as well as an additional source of ongoing support for patients and their caregivers.
COMPARING ADVANCE DIRECTIVES LAWS IN TAIWAN AND THE UNITED STATES: IMPACT ON END-OF-LIFE CARE
Authors: Tu Yufang , Young Yuchi , O’Connor Melissa 
Published: January 2025

Abstract
The current study addresses increasing multicultural concerns regarding autonomy in end-of-life care decisions by comparing Advance Directives (AD) laws in the US, under the 1991 Patient Self-Determination Act (PSDA), and Taiwan, with its 2019 Patient Right to Autonomy Act (PRAA). By highlighting key legal differences and similarities, we aim to provide insights for enhancing in end-of-life care policies and understanding the impact of legal frameworks on patient autonomy internationally. To address our research objectives, we conducted a systematic literature review by searching the PubMed, ProQuest, and Hospice Foundation of Taiwan databases for the following keywords: (1) English and Chinese, (2) Published &gt;=1991, (3) United States or Taiwan (4) Patient Self-Determination Act, Patient Right to Autonomy Act, and advance directives. The results showed that both the US and Taiwan view ADs as essential for healthcare autonomy, allowing healthcare agents to represent incapacitated individuals. However, their AD legal frameworks differ significantly in legal requirements, scope, completion processes, healthcare agent eligibility, AD portability, and the promotional efforts. In the US, there is a need for stricter regulations governing patient-healthcare agent interactions to align decisions with patient preferences. Furthermore, enhancing universal portability of AD, particularly in emergencies, via cross-state recognition or digital sharing is essential. For Taiwan, we recommend expanding ADs to include emotional and spiritual aspects, for more end-of-life preferences. Incorporating psychiatric AD into Taiwan’s PRAA could enrich end-of-life care. Cross-culturally, making advance care planning more affordable, along with enhancing AD awareness through active healthcare provider involvement, could strengthen patient autonomy.
DOES COGNITIVE MISPERCEPTION AFFECT THE TIMING OF COMPLETING ADVANCE DIRECTIVES?
Authors: Lou Yifan , Lin Zhuoer , Chen Xi 
Published: January 2025

Abstract
While there has been extensive research on improving advance directives (AD) completion rates, less attention has been paid to the early engagement of AD. Studying factors that may be related to the earlier AD timing is critical as the initiation of AD is often delayed until “too late to be useful”. This study investigates one potential sociopsychological mechanism – cognitive misperception – that may be linked to the timing of AD completion. Data were from 3,675 older adults from the Health and Retirement Study who died between wave 2002 to 2018, completed living will or Durable Power Attorney of Health Care (DPAHC) before death, and had cognition measures no later than they did AD. Cognitive misperception was measured by the quartiles of differences between standardized subjective (self-rated memory) and objective cognition (working memory tests): conservative, no misperception, optimistic, and overconfident. Linear and logistic regression models were used to evaluate the relationship between cognitive misperception and (1) months between filing living will (or DPAHC) and death and (2) whether living will (or DPAHC) was filed within one year of death, respectively, net of demographic, socioeconomic status, and health covariates. We found that being conservative on cognition motivated older adults to file living will 8.62 months earlier, and being overconfident delayed older adults to file living will by 7.25 months. Being overconfident in cognition also significantly increased the likelihood of filing living will and DPAHC by 34% and 40%, respectively. Interventions targeting cognitive misperception may be effective in promoting early AD completion.
EXAMINING AGE BIAS IN CHATGPT RESPONSES TO USER QUESTIONS ABOUT DECISION-MAKING IN ADVANCED CANCER
Authors: McDarby Meghan , Mroz Emily , Hahne Jessica , Carpenter Brian , Parker Patricia 
Published: January 2025

Abstract
ChatGPT is an online, AI-powered chat application that provides human-like responses to user input. There is concern about bias in ChatGPT responses based on user demographics, yet no existing research has examined age bias in ChatGPT responses to questions about decision making (DM) in advanced cancer. The current study examined the content of ChatGPT responses to a hypothetical patient question about DM in advanced cancer. Replicating Nastasi and colleagues’ (2023) approach, we posed a medical-advice-seeking vignette to ChatGPT with variations on four hypothetical patient characteristics: age (45/65/85 years), race (Black/White), ethnicity (Hispanic/Non-Hispanic), and insurance status (Insured/Not Insured). Each vignette ended with: “Should I look for other treatments or focus on my quality of life?” Three coders categorized responses (ICC=.95) for mentions of nine topics relevant to DM in advanced cancer (e.g., consideration of clinical trials, suggestion to pursue second opinions, descriptions of hospice and palliative care, and encouragement to talk to providers for DM support). ChatGPT responses more frequently mentioned consideration of clinical trials to patients who were 45 compared to patients who were 65 and 85 years old (X2(2,N=96)=8.6, p=.01). There was a non-significant trend toward ChatGPT responses suggesting pursuit of second opinions more frequently for younger patients (X2(2,N=96)=3.0 p=.22). There were no age differences in mentions of hospice care (p&gt;.50), palliative care (p&gt;.30), or talking to providers for DM support (p&gt;.30). Findings indicate that ChatGPT responses to questions about advanced cancer DM may contain age bias. Future research should address how ChatGPT users navigate bias in responses.
EXPLORING END-OF-LIFE DEMENTIA CARE IN RESIDENTIAL CARE SETTINGS: TOWARD A RELATIONAL MODEL
Authors: Kontos Pia , Dupuis Sherry , Colobong Romeo , Delaney Erin , Gertin Robin , Engell Katia , MacTavish Erica 
Published: January 2025

Abstract
With the biomedicalization of death in Canada, and the stigma associated with both dementia and death, people living with dementia (PLwD) in Canada suffer painful and undignified end-of-life (EOL) experiences. There is growing evidence that relational approaches, which value relationships as complex and dynamic connections including broader social, cultural, political, and environmental forces, can reduce stigma and improve quality of care. Yet, these approaches have not been explored or implemented in EOL care. Further, despite that EOL care is a priority in a number of national dementia strategies, EOL research in Canada remains limited and has largely neglected the inclusion of PLwD. To address these limitations, we conducted arts-based research conversations with PLwD in residential care settings in Ontario, Canada. These sessions were guided by Liberation Arts (i.e., using the arts to challenge oppressive attitudes, policies and practices), co-facilitated by community artists and researchers, and focused on what compassionate, relational EOL care looks like from the perspectives and experiences of PLwD. Transcripts of the audio-recorded conversations and the art created with PLwD were analyzed using the participatory Critical and Creative Hermeneutic Analysis Framework. Our analysis highlights EOL as relational (i.e., a communal rather than an individual process), as demonstrated by prioritizing relationships (e.g., human, pets, biographical objects, place/space), honoring PLwD (e.g., cultural/religious traditions, contributions to life), and supporting living life until the end. Our analysis contributes to the nascent EOL research that is inclusive of PLwD and will importantly inform a new model of EOL care grounded in relational caring.