bluuebunny/crossref_metadata_2025_split huggingface dataset:
DEEP DIVES INTO STATE POLICY: LOCATING LEVERS TO IMPROVE CARE FOR ADULTS AGING ALONE
Authors: Lowers Jane 
Published: January 2025

Abstract
The Health and Aging Policy Fellowship facilitates fellows’ exposure to the intricacies of policy development and implementation in a variety of settings. My HAPF placement at ADvancing States provided an opportunity to investigate how individual states define “family” in regard to caregiving for older adults, both through regulations and Medcaid waivers. For state aging and disability directors, this analysis offered insight into how state policies aligned with federal policies, including the Older Americans Act, and opportunities to adapt other states’ efforts to support unpaid caregiving networks. As a researcher, this fellowship work provided insight into the types of evidence needed to advocate for equitable services and supports for adults aging without biological family. This presentation will provide an overview of HAPF placement focused on state-level policies.
HEALTH RESILIENCE AND FORTITUDE FACTORS IN THE HRS
Authors: Allen Rebecca , Smith Jacqui 
Published: January 2025

Abstract
This symposium presents data from recent waves of the Health and Retirement Study, a nationally representative sample of older adults in the United States, examining environmental transition and health variables as they relate to fortitude. Using stress process models and the Meikirch model of health as theoretical underpinning, these presentations examine fortitude by focusing on 1) transitions in place of residence and loneliness (inverse of fortitude), 2) relationship quality and pain intensity, and 3) sleep disorders, relationship quality, and life satisfaction. The first presenter found that subjective health, transitional threat, and social and community engagement all were significantly related to self-reported loneliness. However, the interaction between engagement and transitional threat did not explain additional variance in the model. The second presenter found that the association between perceived spousal support (personally acquired potential) and well-being significantly decreased when controlling for the intensity of pain (biologically given potential) experienced by the respondent. Similarly, using the Meikirch model of health, the third presenter conducted simple linear regression analyses to assess the relations between sleep disorders, perceived life satisfaction, and perceived spousal relationship quality. Having a sleep disorder significantly predicted life satisfaction and perceived problems in spousal relationships. Thus, perceived stress due to environmental transition and the interplay between biologically given potential and personally acquired potential explain significant variance in fortitude, as measured by loneliness (inversely), well-being, and life satisfaction. The discussion will address strengths and challenges in examining fortitude as a construct of interest in the nationally representative Health and Retirement Study dataset.
THEY’VE GOT MY BACK: THE ROLE OF PAIN INTENSITY AS A MEDIATOR BETWEEN PERCEIVED RELATIONSHIP QUALITY AND RESILIENCE
Authors: Carranza Erick , Peeples Landon , Buxton Michael , Jacobs M Lindsey , Allen Rebecca 
Published: January 2025

Abstract
Recent increases in the population of aging adults reflect a dire need to examine the social contexts that influence their experiences in relation to physical and mental health, especially during the ongoing coronavirus pandemic. Previous work identifies how perceived care partner relationships play a role in reducing psychological distress for aging adults facing a chronic illness (Schroepfer, 2008). Evidence also suggests that perceived relationship quality is associated with experiencing greater pain and disability (Campbell, 2012). However, little is known about the dynamic interplay between perceived relationship quality, pain intensity, and resilience. This presentation aims to draw upon the Meikirch model of health examining pain intensity as a biologically given potential and relationship quality as personally acquired potential while experiences during COVID-19 may be interpreted as environmental determinants of health. The objective is to understand how relationship quality influences levels of resilience (i.e., psychological well-being) and is then mediated by the intensity of pain. The mediation analysis was conducted using a secondary data approach with responses (N = 2686) from the 2020 wave of the Health and Retirement Study, a nationally representative sample of older adults in the United States. Results revealed a significant indirect effect, indicating that the association between perceived spousal support and resilience decreased when controlling for the intensity of pain experienced by the respondent. Future directions include examining responses from spouses to compare dyadically the perceptions of relationship quality and how these perceptions relate to pain intensity within one partner and dyadic perceptions of couple resilience.
RESILIENCE IN HEALTH ADVERSITY: THE ROLE OF COMMUNITY ENGAGEMENT AND TRANSITIONAL THREAT
Authors: Fromenthal Ashley , Allen Rebecca 
Published: January 2025

Abstract
Older adulthood is a time of many transitions and oftentimes comes with challenges such as financial difficulties, functional health decline, and a decrease in social support. Together, these challenges may accentuate feelings of loneliness in older adulthood. These challenges may be exacerbated when older adults face threats within their environment such as having housing issues or moving to a “worse” neighborhood. The current study aimed to explore community-based resilience factors for older adults facing transitional threats and functional health struggles centered around Lazarus and Folkman’s Transactional Model of Stress and Coping. Using 2020 data from 4,688 participants in the Health and Retirement Study (HRS), multiple linear regressions were conducted to examine whether the relationship between subjective health and loneliness is mediated by transitional threats, and if social and community engagement moderate the mediating relationship. Results of the regressions show that the overall model is significant F(2,4546) = 78.11, p &lt;.001, and that each of the predictor variables were significantly related to feelings of loneliness. However, results show that the interaction term (engagement x threat) did not explain a significant amount of variance in the model. This may be due to the measurement of these constructs within the HRS. Specifically, trait-dependent measurement of dynamic constructs such as feelings of loneliness and behavioral engagement may not be sensitive enough to detect moderated mediation effects within the context of transitional threats.
SLEEP DISORDERS AND THEIR IMPACTS ON OLDER ADULT SPOUSAL RELATIONSHIP
Authors: Geisser Sophia , Fromenthal Ashley , Carranza Erick , Hilgeman Michelle , Snow A Lynn 
Published: January 2025

Abstract
Aging is associated with biological and psychosocial impairments that affect individuals’ sleep and quality of life. Approximately half of older adults suffer from a sleep disorder. Daytime consequences such as fatigue, excessive sleepiness, irritability, mood swings, and/or cognitive difficulties may be present with sleep disorder diagnoses, impacting interpersonal relationships. There is limited research on associations between sleep disorder and spousal relationship quality in older adults. The need to expand the field of research in sleep disorders is urgent, as sleep disorder diagnoses are expected to rise with the growing older adult population. The objective of this presentation is to describe a conceptual model of sleep disorders and relationship quality informed by the Meikirch model of health: sleep disorders represent biologically given potential, relationship quality represents personally acquired potential, and the COVID-19 pandemic represents the environmental determinants of health. Applying this theoretical underpinning, the Health and Retirement Study data from 2020 was analyzed via simple linear regression analyses to assess the relationships between sleep disorders and perceived life satisfaction in spousal relationships. Results show that having a sleep disorder significantly predicted life satisfaction: F(1,4647) = 40.49, p &lt;.001. (b =.09, S.E. =.02, t = 6.36, p &lt;.001, 95%CI[.06,.13]); and having a sleep disorder significantly predicted perceived problems in spousal relationships: F(1,4560) = 15.49, p &lt;.001 (b = -.12, S.E. =.03, t = -3.94, p &lt;.001, 95%CI[-.17,.06]). Understanding sleep-related associations may inform interventions to promote well-being and life satisfaction for older adult couples.
PERSON-ENVIRONMENT FIT UNDERLYING PERSONALITY DEVELOPMENT IN MIDDLE AND LATE ADULTHOOD
Authors: Beam Christopher , Sharp Emily Schoenhofen 
Published: January 2025

Abstract
The corresponsive principle and the niche-picking principle have been used to explain personality development across adulthood. The corresponsive principle posits that reciprocal effects between people and their environments intensify personality traits because environments are selected based on these traits while the niche-picking principle posits that these reciprocal effects simply maintain existing trait levels. Using a longitudinal sample of twins from the Swedish Adoption/Twin Study of Aging (SATSA), we tested whether the corresponsive principle or the niche-picking principle better explained longitudinal within-family differences in neuroticism, extraversion, and openness to experience across two stages of adulthood development: middle adulthood (36--56 years) and older adulthood (56--91 years). Using exploratory data analysis and multilevel structural equation modeling, we show that niche-picking rather coresponsivity tends to provide a better overall description of the development of neuroticism, extraversion, and openness in middle and older adulthood. Within families, twins generally preserve their rank-order stability but do not diverge over time. Instead, there is a generally tendency for twins to maintain within-family differences over time or even become more alike, regardless of whether twins are identical or fraternal. Nevertheless, the role that niche-picking might play in the personality development across adulthood generally is low, as the majority of the total variance of neuroticism, extraversion, and openness is attributed to stable genetic and environmental variance, particularly in older adulthood. Taken together, these findings suggest that environmental variance - whether independent of or correlated with genotype - takes on an increasingly stronger role in personality development over the lifespan.
LONELINESS AND SOCIAL ISOLATION AMONG VULNERABLE, DIVERSE, AND MINORITY GROUPS: NOVEL RESEARCH AND PRACTICAL INSIGHTS
Authors: O’Sullivan Roger , Victor Christina , Cudjoe Thomas 
Published: January 2025

Abstract
Loneliness and social isolation are global public health challenges with concerning implications for mental, cognitive, and physical health. Extensive evidence documents the prevalence, incidence, and negative health outcomes associated with loneliness and social isolation. In contrast, there is a dearth of research offering focused insights into three under-researched ‘at-risk’ populations: those with severe mental health illness, different racial and minority groups, and people who identify as LGBT. This symposium will address this gap by examining the experience of loneliness in these three populations and providing evidence to inform the development of future public health, policy, and service interventions. Pomeroy provides context with an overview of issues constraining progress in the field, including measurement inconsistency and the lack of diversity in studies of loneliness and social isolation. O’Sullivan, Taylor, and Victor highlight the importance of studying loneliness and social isolation within subpopulations and at-risk groups. O’Sullivan describes qualitative interviews with mental health patients to examine their conceptualization and lived experience of loneliness. Taylor’s paper examines the issue of race, neighborhoods and their confluence on feelings of loneliness among older adults in the United States. Victor using longitudinal data reports that rates of chronic loneliness over three years are twice as high amongst LGB and minority ethnic groups compared with the general population aged 50+. Cudjoe, as discussant, highlights the implications for policy, services, and future research in this area and the need for focused public health solutions to tackle loneliness and social isolation.
THE LANGUAGE OF LONELINESS: DEFINITIONS, EXPERIENCES, AND CONCEPTUALIZATION: THE VOICE OF MENTAL HEALTH SERVICE USERS
Authors: O’Sullivan Roger 
Published: January 2025

Abstract
Loneliness is an important public health issue that describes a complex subjective personal experience of one’s desired and actual or perceived social and/or emotional connections. In recent years we have seen a rise in the study of loneliness especially from a quantitative perspective. However, our qualitative understanding of what it means to be lonely and the everyday language best used to capture the personal experience of loneliness remains limited. This presentation based on life story interviews, with older adult mental health service users (18), objectively defined as lonely, gives voice to their definitions, personal experiences and overall conceptualization of loneliness. It sets out a thematic analysis of responses to the question “What does loneliness mean to you? Responses include subjective and objective aspects, frequency, duration and intensity as well as social; emotional and existential loneliness. Loneliness was not defined by participants in a singular manner and was discussed alongside social isolation, depression, grief, as well as feelings of emptiness, boredom and hopelessness. The insights are important to inform how we frame loneliness in research, policy and practice and highlights that our language needs to be sufficiently diverse to capture the complexity of loneliness not only for work with mental health service users but in society as a whole.
LONELINESS TRANSITIONS AMONG MINORITY ETHNIC AND LGB POPULATIONS IN THE UK
Authors: Victor Christina , Rippon Isla 
Published: January 2025

Abstract
Loneliness has been identified as a major public health problem. Although there is a substantial body of research about loneliness in older adults in the UK, there is a significant evidence gap reporting experiences of loneliness among older people from ethnic minorities and those who identify as lesbian, gay, or bisexual (LGB). We focus upon the experiences of loneliness for adults aged 50+, from LGB and minority ethnic communities. Using waves 9-12 of the annual UK Household Longitudinal Study (UKHLS/Understanding Society) we measured loneliness using the three-item UCLA scale with a score of 6+ out of 9 defining loneliness. 7,646 respondents completed the loneliness measure at each wave. 1.7% of participants identified as LGB and 4.3% as Asian, 2.5% as black and 1.4% as mixed /other ethnicity. We grouped respondents into three categories: (a) consistently lonely; (b) consistently not lonely and (c) fluctuating loneliness. A higher proportion of LGB respondents were consistently lonely (16.4% vs 9.2%), compared to heterosexual respondents. Respondents from black (14.1%), Asian (11.2%) and other ethnic minorities (17.5%) were more likely to be consistently lonely in comparison to white respondents (8.9%). Shortcomings in data available on these groups of interest limit our analytical power to examine the importance of micro, meso and macro-level risk factors. Preliminary findings suggest that socio-demographic predictors for fluctuating or persistent loneliness differ in our groups of interest in comparison with white or heterosexual respondents. The higher level of persistent loneliness in the two groups has potential implications for their health and wellbeing.
THE IMPACT OF THE COVID-19 PANDEMIC ON TEMPORARY AGENCY CARE STAFF USE IN OREGON ASSISTED LIVING
Authors: Dys Sarah , Tunalilar Ozcan , Levchenko Yuliana 
Published: January 2025

Abstract
Temporary agency staff (TAS) use in long-term care has become a spotlight issue due to workforce shortages and increased dependence during the COVID-19 pandemic. Nursing homes (NH) and assisted living communities (AL) rely on TAS to maintain compliance with staffing standards and meet residents’ needs. Settings with high TAS utilization have been associated with more deficiency citations and lower quality ratings. While recent NH studies show a substantial increase in chronic use of TAS, no similar studies document ALs’ use and change of TAS. Using data from a representative sample of Oregon ALs in 2016 and 2023, we compare differences in and organizational (license type, size, Medicaid contracts, profit status, rurality) correlates of TAS use by estimating linear and logistic regression models. Share of ALs with any TAS use increased significantly from 13% in 2016 to 22% in 2023 (p=0.012). In 2016, there were no differences in the likelihood of ALs using any TAS, except for size. In 2023, ALs with Medicaid contracts and in rural areas were 46% and 44% less likely to report using any TAS, respectively. TAS mix used also differed between 2016 and 2023. TAS use decreased for registered nurses (53.8% vs. 25.9%; p=0.005) and increased for licensed practical nurses (0.8% vs. 10.2%; p=0.060) and certified nursing assistants (6.5% vs. 38.2%; p&lt;.001), with no significant difference in personal care aides. Findings contribute to understanding how ALs utilize TAS and can potentially add to policy debates around more stringent regulations for NH and AL staffing.
HOW TO TRAIN ENOUGH PROFESSIONAL DEMENTIA CAREGIVERS IN CHINA TO MEET THE FAST GROWING NEED?
Authors: Gong Zengliang , Cai Gege , Xu Chunjuan 
Published: January 2025

Abstract

Purpose
This paper try to establish an effective system for training dementia caregivers basing on the practices of a leading provider in China. Method: 1. Establish a holistic memory care program and curriculum system, and deliver them through a set of training programs to cover both first-line caregivers and managers, such as an 8-hour orientation session for newcomers, 23-hours on-job training per year, 40-hour training for new managers. 2. Estabilish a case competition among all communities of the provider across China, so that the team could learn from the specific care practices and from each other. 3. Test different training programs empirically to improve training effectiveness.

Results
1. The memory care team in the provider has grown substantically, and the number of certified trainee of 8-hour orientation session has increased to 1400 since 2021. 2. The turnover rate of caregivers in the memory care area is 5% lower than the overall turnover rate of the care building. The turnover rate for memory care managers dropped from 57% in 2021 to 21% in 2023. 3. The experimental group that learned the concept and values of “person-centered care” first was significantly better than the control group in learning knowledge and skills in dementia care.

Conclusion
Systematic and practice-based training programs are conducive to quickly cultivating professional caregivers for dementia care. The Chinese government and the senior care industry should invest more resources in establishing similar training programs to meet the urgent needs of people with dementia and their families.
OLDER ADULT FALLS AND LIMITATIONS IN ACTIVITIES OF DAILY LIVING
Authors: Haddad Yara , Rice Ketra , Chen Jufu , Kakara Ramakrishna 
Published: January 2025

Abstract
Falls among older adults (65+) often lead to injury and loss of independence. Our study aimed to estimate the odds of developing limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL) after a fall. We used 2015-2020 Medicare Current Beneficiary Survey data to estimate the odds of developing ADL/IADL limitations in the year following a fall and examined risk and protective factors for developing them. Using logistic regression, we calculated crude and adjusted odds ratios (OR) and 95% Confidence Intervals (CI), adjusting for demographic, economic, comorbidity, and physical activity variables. Older adults reporting a fall had twice the odds of developing limitations in ADLs (OR=2.02; CI:1.70-2.39) or IADLs (OR=2.01; CI:1.72-2.34) the following year compared with those who did not fall. Among those who fell, adjusted ORs for developing ADL or IADL limitations were significantly higher for adults aged 75+ compared with those 65-74 but were significantly lower for adults who engaged in moderate or vigorous activity for ≥ 2 hours per week during baseline compared with those who did not. Although the likelihood of developing limitations after a fall may increase with age, results suggest engaging in moderate or vigorous physical activity of ≥ 2 hours per week may be protective. Regular physical activity with structured strength and balance exercises has been shown to reduce falls risk. The Stopping Elderly Accidents Deaths and Injuries (STEADI) initiative encourages health care providers to screen and assess for falls risk and intervene using strategies such as physical therapy.
MOBILITY ABILITIES MEDIATE THE ASSOCIATION BETWEEN A MORE ACTIVE LIFESTYLE WITH MOBILITY DISABILITY
Authors: Lange-Maia Brittney , Wang Tianhao , Oveisgharan Shahram , Hausdorff Jeffrey , Bennett David , Buchman Aron 
Published: January 2025

Abstract
Few studies have analyzed sensor-derived metrics of both mobility abilities and total daily physical activity (TDPA). We sought to determine if sensor-derived mobility metrics and quantitative indices of TDPA were independently associated with prevalent and incident mobility disability. Quantitative mobility metrics from 724 ambulatory adults (mean age 82 years, 77.4% female) were derived from a belt-worn sensor. A wrist-worn sensor worn quantified TDPA (up to 10 days). Mobility disability was characterized at baseline and longitudinally using the Rosow-Breslau scale. We examined cross-sectional association of the mobility metrics and TDPA with the odds baseline of disability using logistic regression, and incident disability using Cox models. Several mobility metrics (e.g. step time variability, turning angular velocity) and TDPA were significantly related to prevalent and incident mobility disability when examined in separate models. When examined together, however, the association of TDPA with mobility disability was attenuated. Mediation analysis indicated that the mobility metrics individually mediated between 7%-47% (p&lt; 0.001) of the association between TDPA and cross-sectional mobility disability, and between 20%-40% of the association between TDPA and incident mobility disability. As a group, mobility metrics mediated 58% of the association between TDPA and cross-sectional mobility disability, and 53% of the association with TDPA and incident mobility disability (p&lt; 0.001 for all). Sensor-derived mobility metrics may distinguish different aspects of mobility disability and partially link a more active lifestyle with reduced disability. These findings can inform the design of intervention studies to develop targeted therapies to maintain ambulation and independent living in late life.