bluuebunny/crossref_metadata_2025_split huggingface dataset:
INSTRUMENTS MEASURING SELF-CARE BEHAVIORS OF OLDER ADULTS WITH CHRONIC KIDNEY DISEASE: A SCOPING REVIEW
Authors: Jeamjitvibool Thanakrit , Tanglai Wirampa 
Published: January 2025

Abstract
Promoting self-care behavior among older adults with chronic kidney disease (CKD) is critical for preventing kidney deterioration, particularly in the early stages, as symptoms often become noticeable only in later stages. Numerous assessment tools exist, but their suitability and quality remain uncertain. This review aims to identify, assess methodologies, and consolidate psychometric properties of self-care assessment instruments for older adults with CKD. We followed Askey & O’Malley’s (2005) scoping methodology and PRISMA-ScR guidelines. PubMed, Scopus, CINAHL, PsycInfo, and Embase were searched until October 5, 2023. Included studies tested measurement properties of self-reported instruments assessing self-care behaviors in older adults with CKD, were published in English, and appeared in peer-reviewed journals. The COSMIN framework was used to appraise study quality. Ten articles addressing instruments for self-care behaviors in older adults with CKD were included. Based on COSMIN, no article reported complete measurement properties. Six instruments were developed with theory support, while no theoretical underpinning was identified for three instruments. Only one instrument was developed based on qualitative research. Some instruments were applied to a combined population, such as patients with diabetes and CKD. Although there have been advances in creating tools for assessing self-care behaviors in older adults with CKD, no single instrument fully reported measurement properties. Decision-making regarding which of the available tools is appropriate for practice or research should consider their intended purpose, scope, and any underlying theoretical principles. Future research should focus on developing a comprehensive instrument for CKD self-care behaviors that exhibits high methodological quality.
THE ROLE OF GENDER AND POLYSUBSTANCE USE IN ABUSIVE BEHAVIORS EXHIBITED BY DEMENTIA FAMILY CAREGIVERS
Authors: Hernandez Jessica , Browning Wesley , Yildiz Mustafa , Winstead Vicki , Pickering Carolyn 
Published: January 2025

Abstract
This study investigates the impact of polysubstance use on the likelihood of abusive and neglectful behaviors among dementia family caregivers, with a particular focus on how these relationships differ by gender. Utilizing Generalized Linear Mixed Models (GLMM), we analyzed data from 453 caregivers, assessing substance use and behavioral outcomes measured daily over a 21-day period. Our findings reveal that polysubstance use significantly increases the risk of both psychological and physical aggressive behaviors. When examining the interaction effects, we observed that the combination of being male and engaging in polysubstance use was particularly associated with a heightened risk of these behaviors, underscoring the importance of considering gender in caregiver assessments. The final models, refined through a stepwise selection process, incorporated key covariates such as caregiving hours, relationship type, emotional regulation difficulties, caregiver age, and ethnicity. These models offered a more comprehensive picture, showing that the dynamics of the caregiver/care-recipient relationship and the caregiver’s emotional regulation capabilities were significant factors influencing the likelihood of neglect and psychological aggression. In contrast, gender significantly modulated the association between polysubstance use and physical aggression. These nuanced insights highlight the complex interplay between caregiver demographics, substance use behaviors, and the potential for harmful caregiving practices. Our study emphasizes the need for targeted interventions that address the specific stressors and risks associated with male caregivers, as well as the broader implications for support programs that account for the multifaceted challenges faced by dementia family caregivers.
WHEN AND HOW PERCEIVED CONTROL BUFFERS AGAINST COGNITIVE DECLINES: A MODERATED MEDIATION ANALYSIS
Authors: Hamm Jeremy , Lachman Margie , Duggan Katherine , Mogle Jacqueline , McGrath Ryan , Parker Kelly , Klepacz Laura 
Published: January 2025

Abstract
People vary widely in their rates of age-related cognitive decline. Slower rates of decline have been linked to individual differences in perceived control, but less is known about how (mechanisms) and at what stage in the lifespan (moderators) this modifiable psychological resource is linked to preserved cognitive functioning. Our study examined changes in light physical activity (LPA) as an unexplored mechanism that may link changes in two facets of perceived control (personal mastery, perceived constraints) to 9-year trajectories of cognitive aging. We also examined whether mediated pathways were moderated by age (i.e., differed across the adult lifespan). We analyzed 9-year data from the Midlife in the United States Study (n=2,456; age= 56±11 years) using autoregressive mediation and moderated-mediation models. Mediation models showed that changes in personal mastery and perceived constraints predicted changes in LPA (βs=.06-.08, ps&lt;.01), which in turn predicted 9-year changes in episodic memory and executive functioning (βs=.05-.13, ps&lt;.02). Moderated-mediation models showed that, for episodic memory, the mediated pathways were strongest in old age and emerged only for constraints: For only older adults, declines in constraints predicted less decline in LPA (β=.11, p&lt;.001), which in turn predicted slower declines in episodic memory (β=.05, p=.001). Results were consistent in sensitivity analyses that controlled for levels and changes in moderate-to-vigorous physical activity. Our findings inform lifespan theories of control and provide initial evidence that changes in a largely overlooked health behavior (LPA) may underlie the influence of perceived constraints on cognitive functioning, with this pathway becoming more pronounced in late life.
PSYCHOSOCIAL PROTECTIVE FACTORS FOR COGNITIVE AGING: THE MORE THE BETTER
Authors: Taylor Morgan , Schiloski Kylie , Lachman Margie 
Published: January 2025

Abstract
Research demonstrates that demographic (e.g., age, education) and behavioral variables (e.g., physical activity, smoking) are related to individual differences in cognitive aging. Although some work has examined modifiable psychosocial factors (e.g., control beliefs, purpose in life, social contact) in relation to cognitive aging, they are typically examined separately. To examine their additive rather than net effects, we standardized and averaged three psychosocial factors to create a continuous composite of sense of control, purpose in life, and social support in a sample of adults (N = 2,497, ages 28-85) from the second (2004-2006) and third (2013-2014) waves of the Midlife in the United States study. Using multiple regression, we tested the composite as a predictor of 9 to 10 year changes in episodic memory and executive functioning. Results showed that those higher on the psychosocial composite demonstrated less decline in both cognitive measures, even after controlling for established demographic, health, and behavioral risk factors of cognitive aging. We then assigned participants a score of 0 if they were below the median or a 1 if equal to or above the median on each psychosocial factor, such that total scores varied from 0 to 3. Those high on all three factors were better able to maintain their cognitive health compared to those who had fewer. These findings suggest that interventions that focus on a combination of psychosocial factors could be protective in reducing the rate of cognitive decline in middle and older adulthood.
SUBMAXIMAL CONTROL AND EXPLOSIVE STRENGTH MAY BETTER DETECT COGNITIVE IMPAIRMENT THAN MAXIMAL STRENGTH
Authors: McGrath Ryan , Parker Kelly , Hamm Jeremy 
Published: January 2025

Abstract
Electronic handgrip dynamometry presents novel opportunities to feasibly collect muscle function attributes that are amenable to healthy behavior modification, which may have implications for identifying and delaying cognitive impairment. We sought to evaluate differences in electronic dynamometry derived aspects of muscle function by cognitive impairment status in older adults. Cognitive function was assessed with the Saint Louis University Mental Status exam, and standard scoring was used to categorize cognitive impairment. Participants squeezed an electronic handgrip dynamometer with maximal effort for determining strength capacity. Thereafter, participants attempted to squeeze the dynamometer at 25% of their maximal handgrip strength (HGS) for 10-seconds, and the coefficient of variation quantified submaximal control. Participants then squeezed the dynamometer as hard and fast as possible for calculating rate of force development (RFD): (delta force/delta time). The analytic sample included 125 adults aged ≥65-years (age: 70.83±4.79; 66.4% female). Submaximal control was significantly poorer in persons with a cognitive impairment (6.91±5.89) compared to those that were cognitively intact (4.80±3.42; p&lt;0.05). Similar differences for submaximal control were observed in females with a cognitive impairment (7.97±6.70) compared to females without cognitive impairment (5.41±3.91; p&lt;0.05). RFD was significantly lower in males with a cognitive impairment (51.0±25.7) relative to males without (72.94±26.51; p&lt;0.05). No significant differences were observed for maximal HGS. Although several muscle indices are important for health, engaging in modifiable lifestyle behaviors, including physical activities that emphasize RFD and force control at different levels and durations, may serve as an intervention target for muscle and cognitive function.
ASSOCIATIONS BETWEEN NEIGHBORHOOD QUALITY AND COGNITIVE FUNCTION ARE MODERATED BY INTERPERSONAL STRESSOR CONTROL
Authors: Cerino Eric , Goldtooth Amanda , Livingston Raechel , Horowitz Chloe , Witzel Dakota , Rush Jonathan , McCoy Megan , McCarthy Michael 
Published: January 2025

Abstract
Studying modifiable psychosocial risk factors for dementia is crucial to inform approaches for dementia prevention, especially among those with lower neighborhood quality. Perceived control is an important psychosocial resource for cognitive health. Most prior work, however, focuses exclusively on global aspects of control, ignoring influences of more dynamic aspects of control over specific experiences in daily life, such as daily stressor control. Therefore, we used data from the Midlife in the United States study and the National Study of Daily Experiences (N=1,651, Mage=62.09, SE=12.11, 56.65% Female) to address this gap and examine associations of stressor control and neighborhood quality with cognitive function. Over two waves of eight consecutive days of data collection, respondents reported perceived control over interpersonal and non-interpersonal stressors they had experienced. Respondents also completed assessments of neighborhood quality, executive function (EF), and episodic memory (EM). We employed linear regressions to assess concurrent (wave 2) and prospective (ten years later at wave 3) associations of stressor control and neighborhood quality with cognitive function. Concurrent associations between better neighborhood quality and better cognitive function (EF, EM) were amplified among those with lower interpersonal stressor control. No prospective associations with cognitive function ten years later emerged. Results indicate that better neighborhood quality may be beneficial for cognitive health, especially for individuals with lower perceived control over interpersonal stressors such as arguments and avoided arguments. We discuss the value of promoting better neighborhood quality as an important social determinant of cognitive health and aging when psychosocial resources are comparatively limited.
DEVELOPMENT AND VALIDATION OF A PREDICTION MODEL FOR SIX-MONTH SURVIVAL OF MEDICARE BENEFICIARIES IN ASSISTED LIVING
Authors: Huang Andrew , Dionne Laura , Reddy Ann , Serina Peter , McCreedy Ellen 
Published: January 2025

Abstract
Prediction of mortality risk is a prognostic tool for identifying who may benefit the most from timely and appropriate end-of-life care. However, few mortality risk prediction models have been developed for community-dwelling older adults in assisted living centers (ALCs). To estimate individual risk of all-cause mortality for Medicare beneficiaries in assisted living, we used data extracted from electronic health records (EHR) and linked with Medicare claims from 2015-2022 to develop and validate a multivariable logistic regression on the outcome of all-cause mortality occurring within six months. Eligible residents had at least one year of Medicare enrollment, six months of continuous Medicare fee-for-service and Part D drug coverage, and no history of hospice at the time of prediction. Candidate predictors included individual-level demographics, healthcare costs and utilization, and available clinical features, including diagnoses, medications, and assessments of physical and cognitive function. Final predictors were identified with stepwise selection procedures and expert opinion. A k-fold cross-validation scheme with stratified sampling was used and model performance was assessed on discrimination and calibration statistics. We identified 31,274 residents from 1,228 ALCs eligible for mortality risk prediction. At baseline, the mean (sd) age was 85.3 (7.7) years, 69.0% were female, and 87.2% identified as non-Hispanic White. Dementia was prevalent among 11.5% of residents and 6.3% of residents died within six months. The final model returned an AUROC of 0.74 and calibration plots showed consistency between predicted and observed mortality outcomes. This EHR and claims-based model may help residents in ALCs receive better targeted end-of-life care.
SEXUAL ORIENTATION AND THE ONSET AGE OF CHRONIC DISEASES AND DISABILITIES
Authors: Chen Jen-Hao 
Published: January 2025

Abstract
One key to increasing healthy lifespan and reducing health disparities is delaying the onset of chronic conditions and associated disabilities, especially among marginalized groups. Despite this understanding, relatively few research studies investigate the onset age of chronic diseases and disabilities by sexual minority. This study analyzed pooled data from the 2013-2019 U.S. National Health Interview Survey (NHIS) to investigate the relationships between sexual orientation (i.e., heterosexual, homosexual, bisexual, and other sexual minorities) and the onset of chronic diseases and disability. The study first calculated the onset age for a wide range of chronic conditions and disabilities (i.e., vision and hearing problems, hypertension, diabetes, cancer, intellectual disabilities, etc.), then used weighted regressions to link sexual orientations to the age of chronic disease and disability onset, controlling for a wide range of sociodemographic characteristics. Results suggest that there are considerable disparities in the onset age of chronic diseases and disabilities between heterosexual individuals and sexual minorities. Bisexual and homosexual individuals were significantly more likely to have chronic diseases and disabilities earlier in life than their heterosexual counterparts, with bisexual individuals being the most disadvantaged. These disparities were not accounted for by the higher education and income levels observed in some sexual minority groups. However, there was no difference in terms of disease and disability onset between heterosexual individuals and other sexual minorities. Some cohort differences were found. Given the historical discrimination against sexual minorities and challenges related to HIV, these findings underscore the need for policy interventions to improve sexual minorities’ healthspan.
HYPOTHETICAL INTERVENTIONS ON LONELINESS AND MEMORY FUNCTION AMONG US MIDDLE-AGED AND OLDER ADULTS
Authors: Ikesu Ryo , Rojas-Saunero L Paloma , Hayes-Larson Eleanor , Mayeda Elizabeth Rose 
Published: January 2025

Abstract
Evidence has shown that middle-aged and older adults who experience persistent loneliness have lower memory function compared to those with transient loneliness or those who never feel lonely, but it remains unclear whether sustained interventions on loneliness, as opposed to a one-time intervention, are more effective in preserving late-life memory function. Researchers are increasingly using hypothetical intervention approaches to estimate the impact of population-level interventions with observational data. Using the nationally-representative Health and Retirement Study in 2006–2016 (n=16,977; median baseline age, 68), we estimated the population-level effects of two hypothetical interventions of loneliness on memory scores 8 years after baseline: [A] preventing loneliness at baseline and 4 years after baseline (sustained intervention at two time points) and [B] preventing loneliness only at baseline (one-time intervention). We used targeted maximum likelihood estimation to account for censoring and both baseline and time-varying confounding (health-related behaviors, working status, household wealth, social relationships, and health conditions). In this approach, we accounted for the possibility that people with lower memory function feel lonely more often than those with higher memory function. Compared to the natural course (i.e., no intervention), both sustained and one-time interventions were associated with slightly higher memory scores 8 years after baseline (0.026 standardized units [95% CI: 0.003–0.048] for the sustained intervention; 0.021 standardized units [95% CI: 0.005–0.037] for the one-time intervention). Our findings suggest that both sustained and one-time interventions on loneliness may preserve memory function at the population level.
REASSESSING POSITIVE RESULTS: DETECTION BIAS IN EPIDEMIOLOGIC DEMENTIA STUDIES OF ELECTRONIC HEALTH RECORD DATA
Authors: Wang Jingxuan , Choi Minhyuk , Zimmerman Scott , Chen Ruijia , Schaefer Cathy , Blacker Deborah , Glymour M Maria 
Published: January 2025

Abstract
Many epidemiologic studies of dementia use electronic health record (EHR) data, which are vulnerable to detection bias. Dementia is more likely to be detected when patients have more contact with the healthcare system. Using EHR data from the UK Biobank (UKB) and All of Us (AoU), we evaluated potential detection bias by estimating associations of three negative control exposures with dementia. We included 298,784 UKB participants and 105,836 AoU participants aged ≥ 55 without baseline dementia and estimated associations of kidney stone, forearm fracture, and urinary tract infection (UTI) with incident dementia. All diagnoses were ascertained from EHR data. We used Cox models to evaluate associations of binary exposure with all-cause dementia overall and in 4 time intervals after the exposure (0–1, &gt;1–5, &gt;5–10, and &gt;10 years) compared to individuals with no prior exposure. All models adjusted for demographic and socioeconomic factors. Our results showed that all three exposures were associated with an elevated risk of dementia, especially in the first year after exposure diagnosis. The association attenuated in subsequent years. It suggests the chance of receiving a dementia diagnosis increases sharply in the first year following a diagnosis of kidney stone, forearm fracture, or UTI, although the influence of these conditions on dementia pathology is likely to be small or null. These short-term increases likely represent detection bias, i.e., they would not have received a dementia diagnosis at that time in the absence of the medical attention necessitated by kidney stone, forearm fracture or UTI.
NURSE WAGES IN NURSING HOMES: ANTECEDENTS AND CONSEQUENCES
Authors: Pradhan Rohit , Banaszak-Holl Jane 
Published: January 2025

Abstract
A substantial body of research has established that nurse staffing intensity and skill mix have a consequential impact on nursing home (NH) care quality. Unfortunately, NH staffing has been marked by multitudes of challenges including high levels of turnover and absenteeism. The literature suggests that an important reason why NHs have struggled with nurse staffing is the relatively lower wages vis-à-vis other important areas of the U.S. healthcare system, such as hospitals. These challenges underscore the importance of examining nurse wages within the NH setting, as wages not only affect staff retention and satisfaction but overall performance. Despite the apparent need for competitive wages to attract and retain skilled nurses, NHs operate in a resource-constrained environment, making wage increases a complex issue for administrators. The overarching goal of this symposium is to explore the antecedents and consequences of nurse wages in NHs. As part of the symposium, we include studies examining nurse wages and quality, the organizational and market-level factors associated with nurse wages, and the impact of nurse wages on financial performance. The findings and discussions may offer valuable insights for both managerial decision-making and policy formulation, aiming to address the systemic challenges of nurse staffing in NHs and improve NH performance, particularly quality of care.
PLACE AND AGING WITH DEMENTIA: NEW ASSESSMENTS FOR PERSON-ENVIRONMENT PROCESSES
Authors: Oswald Frank , Chaudhury Habib , Wahl Hans-Werner 
Published: January 2025

Abstract
There has been growth in research addressing stability and change in the relationship between the physical environment and older persons, particularly people living with dementia. However, differentiated assessments to examine or measure person-environment relationships are limited. Additionally, there is a lack of resources to inform development of physical environments supportive of people living with dementia. This symposium addresses creative measures, and application strategies to advance understanding of the role of place for people living with dementia. First, Florack and colleagues present a three-step modification of the Meaning of Home Questionnaire (MoH) for use with people living with dementia by means of simplification and addition of specific items, an initial evaluation of psychometric characteristics, and the development of a final version and its validation. Second, Niedoba and Oswald present findings from walking interviews with people living with dementia, highlighting that these interviews allow to observe and discuss everyday life person-environment processes and provide a comfortable atmosphere promoting personal reflections on the experience of living with dementia. Third, Margot-Cattin and Gaber provide evidence from the Participation in ACTivities and Places OUTside Home (ACT-OUT) questionnaire based on a transactional perspective of the person-environment relationship, showing that people with dementia experience a higher rate of abandonment of places than people without dementia. Four, Chaudhury and colleagues introduce three knowledge mobilization resources that can inform and engage with various stakeholders, including municipalities, community-based organizations, advocacy groups, planning and design professionals, persons living with dementia and care partners. Finally, Wahl serves as the session’s discussant.