bluuebunny/crossref_metadata_2025 huggingface dataset:
UNMET NEEDS AMONG ADULTS AND OLDER ADULTS IN BRAZIL, ELSI-2019
Authors: Andrade Flavia , Chen Xiayu
Published: December 2022

Many older adults in Brazil struggle to receive adequate assistance in later life. To better understand this issue, this study examines the prevalence and characteristics of unmet needs of adults ages 50 and older with difficulties performing activities of daily living (ADL), instrumental activities of daily living (IADL), the caregiving patterns, and the consequences of unmet needs in Brazil. We use data from the second wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) study conducted in 2019-2021 (N=9,949). Results indicate that the prevalence rate of ADL was 8.9% (95% CI 7.6 – 10.5), and the prevalence of IADL was 15.6% (95% CI 13.1 – 18.5). Among those with ADL difficulties, 11.5% (95% CI 8.2 – 16.0) reported having unmet needs. Among those with IADL difficulties, 8.8% (95% CI 6.1 – 12.4) reported having at least one activity with unmet needs. Unmet needs were higher among younger adults, those living alone, Black or mixed race, or the Northeast region. Most of the care (87%) was provided by family members, primarily daughters, and wives. About 20% of caregivers had to stop working or studying to provide the needed care. Those with ADL unmet needs were less likely to visit friends or family, whereas IADL unmet needs were associated with lower odds of visiting a doctor. Our study provides the first glimpse of the characteristics of those with currently unmet needs among adults in Brazil and of caregivers. Unmet needs are associated with social isolation and worse healthcare use.
THE IMPLEMENTATION OF GERIATRIC EMERGENCY DEPARTMENT ACCREDITATION (GEDA) IN RURAL CRITICAL ACCESS HOSPITALS
Authors: Flaherty Ellen , Biese Kevin
Published: December 2022

The largely rural setting of Northern New England offers unique challenges to implementing improved acute care for the growing geriatric population. Northern New England is one of the United States’ most rapidly aging regions, with Vermont and New Hampshire being the second and third oldest US states respectively by median age (U.S. Census 2017). There is a need to expand innovations in geriatric emergency medicine to reach older adults in rural areas such as Northern New England. Dartmouth-Hitchcock Medical Center and the West Health are collaborating on a project leveraging telehealth to extend the reach of a GED to rural hospitals, as well as investigate the opportunities for scaling and sustaining this concept to other rural facilities across Northern New England and throughout the country. This symposium will focus on our experience implementing a hub and spoke model to achieve our goal of improving the care of older adults in rural emergency departments.
ENHANCING FEDERAL REVENUE FOR HOME AND COMMUNITY-BASED SERVICES UNDER THE AMERICAN RESCUE PLAN ACT
Authors: Miller Edward , Beauregard Lisa
Published: December 2022

The American Rescue Plan Act (ARPA) includes a one year 10 percentage point increase in the Federal Medical Assistance Percentage for Medicaid-funded home and community-based services (HCBS). The goal is to strengthen state efforts to help older adults and people with disabilities live safely in their homes and communities rather than in institutional settings during the COVID-19 pandemic. This presentation provides a detailed description and analysis of this provision, including issues state governments need to consider when expending the additional federal revenue provided. It also draws lessons from the Affordable Care Act’s Balancing Incentive Program to suggest insights for the potential of ARPA to promote further growth in Medicaid HCBS programs. The presentation concludes by highlighting the importance of instituting strategies and processes for maximizing enhanced federal matching funds under ARPA in preparation for subsequent availability of substantial additional federal resources targeting Medicaid HCBS under other proposed initiatives.
CHARACTERISTICS OF LEADERS OF AGING CENTERS
Authors: Charness Neil
Published: December 2022

In December of 2021 and January of 2022, current leaders of Centers on Aging belonging to the GSA Age Directors interest group were invited to fill out a survey inquiring about their backgrounds, training for leadership, and perceived needs for training via an online Qualtrics survey. Thirty-one responses were received though a few responses were missing for most questions. The sample mostly resided in the USA (86%), and identified mainly as female (63% female, 37% male). Most were married (90%). The average age of a respondent was 58 years (SD=9; range 37-74). Respondents were not diverse: 97% White. Most had doctoral level education (1 Master’s level). The results indicate that there is a need to enhance and develop leadership skills in diverse mid-career gerontologists in order to provide replacements for an aging cohort of directors. Results are also consistent with prior National Academies’ recommendations for training the gerontological workforce.
WHAT LEADERSHIP SKILLS ARE NEEDED TO DIRECT GERONTOLOGY PROGRAM: SURVEY RESULTS FROM LEADERS ACROSS THE COUNTRY
Authors: Lichtenberg Peter
Published: December 2022

Gerontology programs across the country, including Centers, Institutes and Departments play a key role in promoting the field and the careers of the scientists they connect with. A recent survey of 30 Gerontology leaders from the GSA interest group found that 60% of them received no leadership training before becoming a Director or Chair in their program. Only 50% of those who received some generic leadership training found that it prepared them for their current role. This presentation will highlight some of the potential areas of focus for leadership training more specific to Gerontology programs. Among the topics most highly valued by the Gerontology Program leaders include budgets, managing people, negotiating difficult situations, understanding different leadership styles, teamwork, ethics and diversity, equity and inclusion. This session will frame some of the key aspects of leadership training including a deeper understanding of universities as organizations; and negotiating for resources.
MID- AND LATER-LIFE COMMUNITY COLLEGE STUDENTS: OFF-TIME EDUCATION AND THE SIGNIFICANCE OF INTRACOHORT DIVERSITY
Authors: McGrew Kathryn , Cummins Phyllis , Dikhtyar Oksana
Published: December 2022

Workers ages 45 and older make up about 45% of the U.S. labor force. To meet labor market demands in the U.S., employers will need to rely on mid- and later-life (MLL) (age 40 and older) workers. Through a gerontological lens, using both qualitative and quantitative data, we investigated the “off-time” enrollment of MLL community college students to explore how their enrollment decisions and academic goals are situated in the timing and intersection of life events and transitions, such as the responsibilities of work and family. We conducted 12 focus group interviews with MLL community college students (n=68) in Ohio and conducted a quantitative analysis of the distribution of academic goals by age group. We conclude that the foremost characteristic of MLL students as a group is its within-group heterogeneity and the greatest barrier to serving MLL students is in how we have been thinking—or failing to think—about them. We take a first slice at disaggregating “adult” students and turn away from deficit narratives to identify opportunities and assets among MLLs. Finally, we offer a theory to explain how especially wide within-group diversity of MLL academic goals is produced by cohort divergence of life events, transitions and trajectories; diverse enrollment precipitants; and individual point-of-time appraisals of lifetime elapsed and lifetime remaining. We suggest that community colleges, already leaders in adult education, are in a unique position to effectively serve MLL students by recognizing and accommodating their diversity. We present implications and strategies for colleges, policymakers and researchers.
THE ESTABLISHMENT OF A COMMUNITY NETWORK TO SUPPORT FAMILY CAREGIVERS
Authors: Kuo Tsuann
Published: December 2022

In 2021, 114 Caregiver Resource Sites were established in Taiwan to provide case management and services for family caregivers who may experience caregiving burnout due to long-term care. Each Caregiver Resource Site is responsible for serving 60-100 caregivers. An effort was made to recruit volunteers and gather resources so caregivers can be surrounded in the care-friendly community network, including care counseling, support groups, caregiving skill classes, relaxation activities, caregiver café, and in-home coaching for hard-to-care moments. By forming this community network to support caregivers, it has reduced caregiver burnout and avoided possibly negative tragedies due to caregiving.
THE IMPLICATIONS OF THE BUILD BACK BETTER BILL FOR AGING HEALTH POLICY
Authors: Nadash Pamela
Published: December 2022

The Build Back Better Bill passed by the U.S. House of Representatives (HR 5376) included ambitious healthcare and long-term care provisions that would have greatly benefited older people, although the Bill itself represents a considerable scaling down of the Biden Administration’s original proposals. This presentation reviews key provisions of the Bill that would impact older people: paid family and medical leave, efforts to strengthen the direct care workforce, and investments in home and community-based services. In addition, the Bill expanded Medicare coverage to include hearing, dental, and vision coverage, and expanded tax credits for the medical expenses associated with family caregiving. Although the House bill failed to make it through the Senate intact, some of the provisions are likely to have staying power. This presentation reviews the Bill’s progress and assesses implications for future efforts to expand access to these benefits.
WE DID MORE DAMAGE: HOW COVID-19 COLLAPSED THE CONVOYS OF CARE FOR RESIDENTS LIVING WITH DEMENTIA
Authors: Hackett Sara , Peterson Lindsay , Vogel Carlyn , Dobbs Debra
Published: December 2022

COVID-19 has posed a multitude of challenges for nursing homes (NHs) and assisted living communities (ALCs). However, little information is known about how the pandemic impacted residents living with dementia. Using the convoys of care framework, we conducted a qualitative descriptive study to gain insight regarding administrators’ perceptions of how care for residents living with dementia was altered. Forty-two participants, representing 16 NHs and 43 ALCs in Florida, participated in one 60-minute semi-structured interview. Thematic analysis revealed that the convoys of care for those living with dementia were strained by the competing demands associated with maintaining residents’ social and medical care. Explicitly, participants emphasized how diminished family involvement, the increasing responsibilities of staff, and the climate of the industry, contributed to disrupted convoys of care. Consequently, this study may help inform policy and practice as it details which care strategies worked, which did not, and considerations for moving forward.
RESTRICTIONS ON RESIDENT CONTACT IN ASSISTED LIVING DURING COVID-19: A MIXED-METHODS STUDY
Authors: Peterson Lindsay , Hackett Sara , Bhattacharyya Kallol Kumar , Dobbs Debra
Published: December 2022

Efforts to protect assisted living residents from COVID-19 by limiting contact warrant attention. Assisted living was developed as a social model where care is provided in a home-like environment. Given the social dimensions of assisted living, we sought to better understand the effects of COVID-19-based restrictions in assisted living. We surveyed (online) assisted living community (ALC) administrators (N=130) between October 2020 and March 2021 as part of a larger project on COVID-19 in Florida. We then interviewed a subset of participants (N=26). Administrators of chain-affiliated ALCs (compared to non-chain) were 2.7 times more likely to report resident-contact limitations had disrupted care (p=0.02). Larger ALCs (25 or more beds) were marginally more likely to report care disruptions (p<0.10). Three main themes emerged from our qualitative interviews – varying interpretation of COVID-19 guidelines, effect of precautions on residents, assisted living as a home. Policy implications of these findings will be discussed.
MAPPING BARRIERS AND FACILITATORS OF ACCESS TO HEARING HEALTHCARE RESOURCES TO THE COM-B FRAMEWORK
Authors: Schutte Debra , Templin Thomas , Schutte Brian
Published: December 2022

Age-related hearing impairment (ARHI) affects 20-40% of older adults. However, many people with hearing impairment fail to seek professional evaluation and treatment, delay seeking treatment, or abandon treatment. The purpose of this study was to identify barriers and facilitators of access to hearing healthcare resources in a rural setting and to characterize these barriers within the COM-B (capability, motivation, and opportunity) framework. Survey packets were handed out following services at a rural community church; 72 completed surveys were returned. The mean age of participants was 54.4 years. Thirty-one percent of respondents reported moderate to severe hearing impairment; of these individuals, 7 (31%) were currently using a hearing aid. Rates of hearing protection use fell below the Healthy People 2020 target of 53% across occupational and leisure noise exposure. Forty-eight percent (N=34) of participants had never had their hearing tested as an adult. Overall perceived barriers were significantly correlated with age (r= .260, P = .034) and perceived hearing loss (r=-.277, P= .025). Barriers were identified across all domains and subdomains of the COM-B framework. Barriers clustered in the reflective motivation domain, in which participants undervalue the significance of hearing loss. Barriers also clustered within the social and physical opportunity domains, suggesting a lack of access to providers and an undervaluation of hearing loss by others (family and health care providers). These findings provide evidence regarding the accessibility of hearing healthcare services in rural settings and will serve as a foundation for the design of a community-tailored hearing health intervention.
UNEQUAL LOSS: DISPARITIES IN RELATIONAL PROXIMITY TO A COVID-19 DEATH AMONG US OLDER ADULTS
Authors: Riley Alicia
Published: December 2022

The COVID-19 pandemic has devastated communities of color in the U.S. at disproportionate rates. Racial-ethnic and language disparities in COVID grief may be even more extreme than those in individual mortality. We drew on the National Social Health and Aging Project (NSHAP) COVID Study, a supplement to the nationally-representative longitudinal survey. The analytic sample consisted of 2,554 community-dwelling older adults in the U.S. interviewed between September 2020 and January 2021. We used descriptive analysis to evaluate disparities by race/ethnicity/language subgroups in relational proximity to a COVID-19 death (aquaintaince < friend/family member < household member < spouse) and multiple logistic regression to evaluate disparities in experiencing at least one COVID-19 death in one’s social network. English-speaking, Non-Hispanic Black and Latino older adults were over-represented in every category of proximity to a COVID-19 death, but overrepresentation in proximity to a COVID-19 death was greatest among Spanish-speakers of any race. Although Spanish-speaking respondents were only 4.6% of the full sample, half of the respondents who lost a spouse to COVID-19 were Spanish-speakers. Disparities by language and race/ethnicity persisted even with the inclusion of controls for age, sex, marital status, education, and nativity. The most extreme disparities in closeness to COVID-19 death were experienced by Spanish-speakers of any race/ethnicity. It is unclear if this disparity is driven by language alone or the intersection of language and nativity and associated systemic vulnerabilities. Observed disparities could also reflect variation by language and immigrant identity in network size and structure, including connections to relatives in other countries.
SURVIVAL AFTER DEMENTIA DIAGNOSIS: VARIATION BY RACE/ETHNICITY AND GEOGRAPHIC FACTORS
Authors: Lin Haiqun , Jarrín Olga , Wu Bei , Duberstein Paul , Zafar Anum , Lopez Maria
Published: December 2022

This study describes racial and ethnic variation in dementia diagnosis and survival time between diagnosis and death for Medicare beneficiaries aged 50 years and older who died in 2018 (n=1,998,282). The prevalence of diagnosed dementia was higher among non-Hispanic white (45.7%), Black (45.5%), and American Indian/Alaska Native (44.1%) decedents compared to Asian American/Pacific Islander (42.7%), and Hispanic (38.5%) decedents. Median survival time in years was shorter for American Indian/Alaska Native (2.51, IQR 0.7-6.0) and white (2.85, IQR 0.8-6.3) beneficiaries, and longer for Asian American/Pacific Islander (3.36, IQR 1.0-7.3), Black (3.38, IQR 0.9-7.4), and Hispanic (3.83, IQR 1-8.2) beneficiaries. Median survival time also varied by geography and was shortest for Hispanic decedents in Arizona (2.37, IQR 0.6-6.0) and New Mexico (2.92, IQR 0.8-7.0) compared to New Jersey (4.85, IQR 1.5-8.9) and Puerto Rico (5.45, IQR 1.1-12.8). Among Black decedents, survival was longest in New Jersey (3.80, 1.1-7.9) and Arkansas (4.22, 1.0-8.5).
END-OF-LIFE CARE PLANNING AND SATISFACTION AMONG THE HEALTH AND RETIREMENT STUDY DECEDENTS
Authors: Rahemi Zahra , Malatyali Ayse , Cidav Tom , Jarrín Olga , Dye Cheryl , McMahan Christopher
Published: December 2022

The frequency and timing of advance care planning among individuals living with cognitive impairments vary by race/ethnicity and other sociodemographic factors. This study examined relationships between advance care planning and end-of-life care satisfaction among participants in the Health and Retirement Study (Exit files 2002-2018). Among decedents with cognitive impairment (n=3,102), Black and Hispanic participants were less likely to have a living will (OR=0.22, 0.19) and less likely to discuss end-of-life care (OR=0.422, 0.544) compared to White and non-Hispanic participants, respectively. Black and Hispanic participants were more likely to prefer all possible end-of-life care (OR=3.29, 3.34) and less likely to refuse extensive-care measures (OR=0.34, 0.48) compared to White and non-Hispanic participants. Participants dissatisfied with end-of-life care were 48% less likely to have a living will. End-of-life care planning disparities among racial/ethnic groups can inform interventional and educational programs to improve equity in end-of-life care.
FINANCIAL DISTRESS OF ADULT CHILDREN TAKING CARE OF AGING PARENTS
Authors: Wang Mengya , Bartholomae Suzanne
Published: December 2022

Providing care to parents is often a rewarding experience for adult children, however, one trade-off is the toll it takes on the caregiver's own financial security. Using the framework of life course theory, the current research examines the sources of support (family, community and the government) that may reduce parental caregivers' financial distress. In this study, we examine whether intensive parental caregivers are experiencing financial distress and whether the association between caregiving and financial distress is ameliorated by the presence of having siblings, community support, and government policy supportive of caregiving. This study utilizes data provided by the fifth wave of the survey of health and retirement in Europe (SHARE). Preliminary analyses are consistent with previous studies, that providing intensive care to parents is associated with an increased risk of experiencing healthcare hardship. Moreover, the findings align with life course theory as having support from family members and the government is associated with lower levels of financial distress. However, the effect of community support is not significant. This study suggests that adult children, especially adult daughters, sacrifice their own financial security for the benefit of caring for their parents. In addition, having a broad support network, such as caregiving support groups and caregiving educational programs, can reduce adult children’s financial distress, and enable them to provide care longer, which avoids or delays the need for costly institutional care. Ongoing analyses examine the potential long-term consequences of caregiving.
INVOLVING PEOPLE WITH A FRONTOTEMPORAL DEMENTIA DIAGNOSIS IN DEMENTIA RESEARCH
Authors: Roes Martina , Heppner Marie-Marleen , Teupen Sonja , Oyebode Jan , Heislbetz Claus , Goetz Vanaditz , Pivodic Lara , Massimo Lauren
Published: December 2022

Frontotemporal Lobar Degeneration (FTLD) is a form of dementia that is characterized by prominent and gradual changes in behavior and language, whereas memory is relatively preserved (therefore different from Alzheimer dementia). In our FTD project we analyze care services for people with FTLD in Germany and we are working together with persons with FTLD and their partners as patient advisors. Our presentation will reflect on how we communicate (e.g. easy Language), how we communicate with the dyads (e.g. balance within the dyads), how we prepare for and engage during meetings as well as how this influences our research project. In summary, building trust and staying connected between meetings, being transparent about expectations and applying a narrative approach seems to be a way to successfully involve people with FTLD and their partners as advisors in dementia research.
EXISTING DATA SETS FOR FAMILY CAREGIVING AND BEREAVEMENT RESEARCH: HIGH-VALUE APPLICATIONS AND KEY CONSIDERATIONS
Authors: Tay Djin , Goodwin Rebecca
Published: December 2022

Aging and the end of life is marked by greater reliance on others to address increasingly complex care needs. At the end of life, nine in 10 caregivers are family members. Reliance on family caregivers will continue to increase as the home outpaces hospitals and nursing facilities as place of death. As the population ages and dependence on family caregivers increases, it is critical to examine the impact of family on aging and end-of-life experiences and conversely, the impact of end-of-life caregiving and bereavement on families’ health and well-being. Population-based data, such as registries that link administrative, health and vital records or nationally representative datasets, minimize the challenges of selection bias, low response rates, and underrepresentation of racial and ethnic minority groups that are common in prospective clinical research. However, few population-based datasets exist that can facilitate research on family caregiving. This symposium includes five presentations focused on the use of population-based data for family caregiving research-- the first examines the social and caregiving network of adults who age solo using the National Health and Aging Trends Study data. The next two presentations examine how family characteristics are associated with place of death and end of life treatment utilization among nursing home decedents using linked statewide data. The final two examine how family caregivers are impacted by different death and dying experiences in Utah and Denmark. Leveraging population-based data to understand the end-of-life dynamics within a family system has the potential to advance family caregiving research, clinical practice, and policy.
INFORMAL CARE NETWORKS AMONG ADULTS AGING SOLO
Authors: Lowers Jane , Zhao Duzhi , Bollens-Lund Evan , Kavalieratos Dio , Ornstein Katherine
Published: December 2022

More than 20% of older adults lacks proximal family caregivers. Yet is it unclear who provides support for this growing population. Using 2015 National Health and Aging Trends Study data for 2,998 community-dwelling Medicare beneficiaries who received help with at least one task (e.g., bathing, shopping, insurance help) in the past month, we identified individuals aging solo (no spouse/partner or children residing in the same state) and determined social and caregiving network size and composition. Compared to married peers with nearby children, adults aging solo (7.6% of sample) had social networks of similar size but greater diversity (i.e., more friends, neighbors). Adults aging solo were significantly more likely to rely on paid help and a wider network of informal caregivers, including distal family, and friends. Social networks can anchor interventions to help adults aging solo prepare for future care needs and inform policies to support informal caregiving.
FAMILIAL AND SOCIODEMOGRAPHIC DETERMINANTS OF PLACE OF DEATH: A RETROSPECTIVE STUDY OF THE UTAH POPULATION DATABASE
Authors: Kelly Brenna , Hanson Heidi , Meeks Huong , Hollingshaus Michael , Tay Djin , Ellington Lee , Stephens Caroline , Ornstein Katherine
Published: December 2022

Consistent with preferences, home deaths in the US increasing — yet most Americans still die in hospitals or other healthcare facilities. Although declining health has been considered the primary factor influencing place of death, few studies have examined how family support and sociodemographic factors influence place of death. This study examined a population-based cohort of 205,932 decedents aged 50+ who died in Utah between 1998 and 2016. Using multivariate logistic regression models, we found that having a living spouse or child was associated with decreased odds of a healthcare facility death (spouse: AOR= 0.62, CI 0.65-0.59; child: AOR = 0.80, CI 0.79-0.82). Additionally, educational attainment (graduate degree: AOR = 0.95, CI 0.91-0.99) and non-Hispanic/Latinx ethnicity (AOR = 0.81, CI 0.79-0.85) were associated with decreased odds of a home death. Our findings highlight the importance of families in place of death and suggest that sociodemographic and economic disparities persist even in death.
HEALTH AND WELL-BEING OF FAMILY CAREGIVERS FOLLOWING HOSPICE USE
Authors: Utz Rebecca , Hollingshaus Michael , Ornstein Katherine , Tay Djin , Stephens Caroline , Smith Ken
Published: December 2022

Some patterns of hospice use are potentially disruptive and stressful for both patient and family. Using a decedent sample of 17,320 hospice users from the Utah Population Database, linked to the health records of spouse and first-degree relatives (child, parent, sibling, Mean=3.36 per decedent). Stroke decedents had higher odds of delayed admission (i.e., <7 days of hospice), while those with dementia and COPD had higher odds of extended use (i.e., >6 months of hospice), compared to cancer decedents. Family members, especially spouses, who experienced delayed admission or extended use had higher odds of hospitalization and increased use of antidepressants, both prior to and following the death, compared to those with more normative hospice use (6 months or less, typical of cancer patients). The hospice experience has both immediate and lasting consequences on the family; eligibility criteria for the hospice benefit may need to be modified by admitting diagnosis.
SERIOUS MENTAL ILLNESS EXACERBATION POST-BEREAVEMENT: A POPULATION-BASED STUDY OF PARTNERS AND ADULT CHILDREN
Authors: Tay Djin , Thygesen Lau , Ornstein Katherine
Published: December 2022

The death of a family member may trigger exacerbations among individuals with serious mental illness (SMI). We hypothesized that bereavement would be associated with SMI exacerbations among bereaved partners and adult children diagnosed with SMI. Using linked population-based registries in Denmark, we identified partners and adult children diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder, and major depression in the five years preceding the family member’s death. Generalized estimating equations were used to estimate the odds of SMI exacerbation two years after decedent death. Partners had increased odds of SMI exacerbation at 3 months into bereavement compared to 9-12 months prior to partners’ death (AOR=1.43, [1.13-1.81]). Children with a history of SMI had lower odds of SMI exacerbation in the second year of bereavement. Sociodemographic characteristics and co-occurring alcohol and substance abuse disorders were associated with higher odds of SMI exacerbations. These findings have implications for targeted bereavement support.
CHRONIC PAIN AND CIRCUMSTANCES OF FALLS IN COMMUNITY-LIVING OLDER ADULTS
Authors: Cai Yurun , Leveille Suzanne , Shi Ling , Chen Ping , You Tongjian
Published: December 2022

Chronic pain is a risk factor contributing to mobility impairment and falls in older adults. Little is known about the patterns of fall circumstances among older adults with pain. This prospective cohort study described frequencies of fall circumstances (i.e., location, activities, and self-reported causes of falls) and examined the relationship between chronic pain and fall circumstances among 765 community-dwelling older adults (mean age=78.1, 63.9% women) in the MOBILIZE Boston Study. Pain severity, fall occurrence, and fall circumstances were recorded using monthly calendar postcards and fall follow-up interviews during a 4-year follow-up. Descriptive analyses summarized frequencies of fall circumstances. Generalized estimating equation (GEE) models examined the relation between monthly pain ratings and circumstances of the first fall in the subsequent month. Among 1,829 falls, 965 (52.8%) falls occurred indoors and 804 (44.0%) falls occurred outdoors, 60 (3.2%) falls with missing location information. Commonly reported activities and causes of falls were walking (915, 50.0%), slips/trips (943, 51.6%), and inappropriate footwear (444, 24.3%). GEE models suggested that compared to fallers without pain, fallers with moderate-to-severe pain had around twice the likelihood of reporting indoor falls (adj.OR=1.93, 95%CI:1.32-2.83), falls in living/dining rooms (adj.OR=2.06, 95%CI:1.27-3.36), and falls due to health problems (adj.OR=2.08, 95%CI:1.16-3.74) or feeling dizzy/faint (adj.OR=2.10, 95%CI:1.08-4.11), but they were less likely to report falls while going down stairs (adj.OR=0.48, 95%CI:0.27-0.87) or falls due to slips/trips (adj.OR=0.67, 95%CI:0.47-0.95) in the subsequent month. Future studies may investigate whether better pain management and tailored fall prevention in elders with chronic pain could lead to fewer falls.
A NEW NORMAL: EXAMINING THE LINKAGES BETWEEN SOCIAL TECHNOLOGY AND LONELINESS
Authors: Ryou Yeon Ji , Peterson Natasha , Wang Mengya , Svec Joseph
Published: December 2022

As the COVID-19 pandemic continues to shape social landscapes, social isolation and loneliness are major issues with mental and physical ramifications. In recent years, individuals of all ages are turning to social technology (ST) to communicate with loved ones. However, the viability of ST as a substitute to in-person interaction remains hotly debated. Moreover, few studies examined how psychosocial factors interact with ST in mental health outcomes. Using the 2020 survey data (N = 1,969) from Health and Retirement Study (HRS), this research examines whether and to what extent ST ameliorates loneliness among 65+ individuals. We identify which personality dimensions moderate the relationship between ST and loneliness using the conceptual framework of the five-factor and the unified theory of acceptance and use of technology model. Linear regression analyses are conducted to determine direct and interaction effects. Results indicate that greater ST use corresponds negatively with loneliness. We also observe that particular personality traits (e.g. extraversion) are negatively associated with loneliness, while neuroticism corresponds positively with loneliness. In the interaction between neuroticism and ST, neuroticism mitigates the association between social technology and loneliness. These findings indicate that ST can be a positive source of social connectivity but the extent may be conditioned on personality profiles. Plausibly, neurotic individuals may exacerbate behavioral propensities by technology use. As evidenced by the robust independent effects of ST and conditional nature of technology connections with neurotic profiles. These findings imply that future intervention should consider individual differences when developing mental health programs using ST.
SOCIAL DISPARITIES IN INFLAMMATORY BIOMARKERS MEDIATED BY POOR SLEEP QUALITY
Authors: Obiagwu Joseph , Mu Christina , Lee Soomi
Published: December 2022

This study investigated whether sleep quality mediates the relationship between race/SES and biomarkers (CRP, IL6, IL10, TNF-α). Participants in the Midlife in the United States Study (n=1,689; Mage=53.02) completed the Pittsburgh Sleep Quality Index and provided information on eight life-course indicators to measure SES. Black individuals and those with lower SES had poorer sleep quality and higher inflammation compared to their counterparts. Poorer sleep quality mediated the relationship between being Black and higher CRP (β=0.02, 95%CI [0.002, 0.04]), IL6 (β=0.008, 95%CI [0.0002, 0.02]), IL10 (β=0.008, 95%CI [0.0004, 0.02]), and TNF-α (β=0.004, 95%CI [0.0002, 0.01]). Poorer sleep quality also mediated the relationship between lower SES and higher CRP (β=-0.01, 95%CI [-0.01, -0.001]), IL6 (β=-0.003, 95%CI [-0.007, -0.00]), IL10 (β=-0.003, 95%CI [-0.01, - 0.0003]), and TNF-α (β=-0.002, 95%CI [-0.004, -0.0002]). Improving sleep quality may help reduce the risk of inflammation in at-risk groups and subsequently reduce health disparities.
DAYTIME SLEEPINESS AND WEIGHT CHANGE AMONG ADULTS: FINDINGS FROM THE WISCONSIN SLEEP COHORT STUDY
Authors: Liu Yin , Barnet Jodi , Hagen Erika , Peppard Paul , Reither Eric , Mignot Emmanuel , Plante David
Published: December 2022

BMI trajectories are associated with nighttime sleep, but it is less clear how they relate to daytime sleepiness. We examined the association between levels and changes in daytime sleepiness and BMI among men and women using growth curve models among 1047 participants in the Wisconsin Sleep Cohort Study (mean [sd] age = 51.1 [8.0] years at baseline). The outcome variable was BMI (kg/m2). Key predictors were self-reported sleepiness measured by the Epworth Sleepiness Scale (ESS), and the objective Multiple Sleep Latency Test (MSLT) scores at each data collection wave. Men, but not women, who were sleepier had higher BMI levels. Age moderated the association between changes in ESS and MSLT sleepiness and BMI trajectories. The association was weaker for older men, but stronger for younger men; such effect was the opposite for women. The MSLT models further suggested that women who were sleepier had steeper increases in BMI over time.
ALL YOU NEED IS LOVE? SPOUSES' AFFECTION ACROSS MARITAL INTERACTION CONTEXTS
Authors: Haase Claudia , Stephens Jacquelyn , Meier Tabea
Published: December 2022

Affection is a positive emotion that plays an important role in intimate relationships. In a laboratory-based dyadic study of 52 middle-aged married couples (104 individuals) from highly diverse socioeconomic backgrounds, we examined spouses’ subjective experience of affection across different marital interaction contexts, correlates, and specificity. Results showed that (1) wives and husbands experienced lower affection in a conflict conversation compared to a positive conversation. Moreover, (2) for wives, higher affection in the conflict conversation was associated with lower physiological reactivity (i.e., less heart rate acceleration from baseline to conflict discussion). For wives, higher affection was also associated with higher marital satisfaction for themselves and their husbands. These findings were specific to affection and did not robustly emerge for other positive emotions. These findings support views of affection as a positive, context-sensitive emotion that may become particularly important in intimate relationship conflict. Directions for future research are discussed.
CONTINUED OPIOID USE REDUCES PERCEIVED CHANCE OF LIVING TO AGE 75 AMONG YOUNG-OLD INDIVIDUALS WITH CHRONIC PAIN
Authors: Fennell Gillian
Published: December 2022

Pain limits older adults’ predictions of their own life expectancies. Due to their analgesic properties and simultaneous linkages to depression, poor subjective health, and functional disability, it is uncertain if the use of opioids augments or contributes to limitations in subjective life expectancy (SLE). This study uses 2016 and 2018 data from the Health and Retirement study to assess the predictive value of prescription opioid use transitions on perceived chances of living to age 75 (SLE). Our sample includes 50 to 62 year-olds who reported pain in both waves (N=1,977). The OLS model controls for pain intensity and activity interference, socio-demographic factors, six chronic conditions, depression, and the 2016 baseline outcome measure. Relative to non-opioid users, respondents who transitioned off of opioids after 2016 reported significantly higher SLEs in 2018 (b=5.56, p=.05). Respondents who used opioids in both waves reported significantly lower SLEs relative to non-opioid users (b=-4.17, p=.02). Individuals who began using opioids following the 2016 wave were no different on SLE than non-opioid users (p=.11). Higher 2016 SLE predictions and being female were associated with higher SLEs. Being never married and ever having diabetes were negatively associated with SLE. Continued opioid use among individuals with chronic pain reduced anticipated chances of living to 75 whereas transitioning off of such medications had the opposite effect. Despite their analgesic properties, prescribed opioid use has negative effects on future outlook independent of pain, health status, and depression. As a consequence, continued opioid users may poor health and/or financial planning decisions.
PREVENTING FALLS WITH PERTURBATION-BASED BALANCE TRAINING: HOW LARGE ARE THE HIP JOINT CONTACT LOADS, AND ARE THEY SAFE?
Authors: Graham David , Whitten Justin , Oleary Bryant , Barrett Rod , Tarabochia Dawn
Published: December 2022

Perturbation-based training (PBT) is a balance training method presenting a high-challenge to balance which is extremely effective when compared to conventional training approaches. Common PBT methods use rapid treadmill belt translations with varying numbers of perturbations (20-1400 perturbations over 1-8wks). Importantly, the joint loads experienced during a stumble may be high enough to feasibly fracture bone (up to 12.7 Body Weights). However, the contact loads experienced during PBT are unknown. Because of increasing the prevalence of PBT it is necessary to specifically evaluate the range of joint loads experienced during PBT. Twelve participants completed a single PBT session of 24 perturbations. During both training and testing, participants movements were measured using a motion capture system which tracks body movements and records the forces under the feet. Hip joint contact loads were determined using Computational Musculoskeletal Modelling utilizing open-source software OpenSim. These techniques estimate the magnitude and pattern of force development of individual muscles and subsequently estimate the internal loads experienced by the hip joint.Hip joint contact loads were 4.90 ± 1.27 BW which is substantially lower that those previously reported by Graham et al. (2016) and Bergman et al. (2004) and is lower than the 5.5BW spontaneous fracture load boundary estimated by Schileo et al. (2014). Comparing the initial perturbation to the final perturbation revealed a 22% reduction in contact loads. We conclude that PBT performed using rapid translations on a treadmill are likely safe but suggest caution for individuals with poor bone mineral density or reduced neuromuscular function.
USING COLLABORATIVE ACTION RESEARCH TO PILOT TELEPRESENCE ROBOTS IN LONG-TERM CARE
Authors: Hung Lillian
Published: December 2022

The COVID-19 pandemic has exposed the fragile state of patient involvement in research and presented new opportunities. The telepresence robot project aims to tackle social isolation and loneliness in older people with dementia in Long-Term Care (LTC) homes. My team took a Collaborative Action Research (CAR) approach to work with stakeholders, emphasising meaningful involvement of patient partners (people with dementia), family partners, frontline healthcare workers throughout all phases of the research process. In this paper presentation, I will discuss how we apply the core principles of CAR to engage stakeholders to carry out the study during the COVID-19 pandemic – a challenging time. It is precisely at times like this that we need to work with patient partners and frontline workers to uncover lessons learned for meaningful solutions to address the most pressing social problems. I will share stories about challenges and creative strategies used. Finally, practical lessons learned will be discussed.
PERCEIVED AND PERFORMANCE FATIGABILITY: NOVEL FINDINGS ON CORRELATES, CONSEQUENCES, AND CANDIDATE GENES
Authors: Glynn Nancy W , Schrack Jennifer , Simonsick Eleanor
Published: December 2022

Characterizing fatigability enables quantification of an individual’s susceptibility to fatigue in the context of standardized physical task(s). This approach eliminates self-pacing, and is a less-biased, more sensitive approach to assess the presence and severity of fatigue, a critical prodromal symptom of chronic and acute health conditions. Collectively, we have established the Pittsburgh Fatigability Scale (PFS) and Borg Rating of Perceived Exertion at the end of a standardized 5-minute treadmill walk (RPE Fatigability) as prognostic indicators of aging-related outcomes. Recently, we extended our methodological work in developing a novel accelerometry-based performance fatigability measure of slowing down during in-lab walking (Pittsburgh Performance Fatigability Index, PPFI). This symposium presents findings from the Study of Muscle, Mobility, and Aging (SOMMA), Long Life Family Study (LLFS), and Baltimore Longitudinal Study of Aging (BLSA). Specifically, using SOMMA, Ms. Qiao will share development and validation of the PPFI using a usual-paced 400m walk, Ms. Moffit will report the association of fitness (i.e., VO2peak) with PFS physical and mental fatigability, and extending the SOMMA findings, Dr. Moored will detail the dual roles of fitness and fatigability on life-space mobility. Using LLFS data, Ms. Gay will report associations of variants (SNPs) in 272 candidate autosomal genes involved in energy metabolism (previously associated with mitochondrial dysfunction disease) with PFS physical fatigability. Lastly, using BLSA data, Dr. Wanigatunga will compare the discriminatory power of RPE Fatigability versus general fatigue symptoms for predicting mortality. Our Discussant, Dr. Simonsick, will provide critical review in the context of new directions for fatigability research.
PROS AND CONS OF PERFORMING RESEARCH AT AN INTERSECTION OF MULTIPLE DISCIPLINES
Authors: Engeland Christopher
Published: December 2022

In the last few decades, team science has become increasingly common and the need for interdisciplinary researchers has likewise increased. There is a stronger need than ever for individuals who can speak across disciplines, serving as a hub (and sometimes a translator) to unite researchers in different fields. Researchers with diverse methods (from those using animal models and bench-side science to biobehavioral observations and clinical approaches) all have a strong need for understanding each other’s work and to express it clearly to others. The ability to function and communicate at multiple intersections is needed to optimize the interpretation and understanding of scientific findings, along with their translation to clinical practice, implementation to intervention, and dissemination to the public. Performing research at these complex intersections of fields and roles is both challenging and rewarding. The pros and cons of a research career situated at these intersections will be discussed.
APPLYING NEW METHODS TO EXISTING DATASETS TO TEST STRESS EFFECTS ON BIOLOGICAL AGING
Authors: Zavala Daisy , Dzikowski Natalie , Gopalan Shyamie , Reid Kerry , Graham-Engeland Jennifer , Engeland Christopher , Veeramah Krishna , Scott Stacey
Published: December 2022

Novel opportunities to examine how life experiences connect to health and mortality through biological aging have increased due to the affordability of genomic analysis. Although epidemiological studies suggest associations between stress and accelerated biological aging, most if not all measures in the past have been global, data cross-sectional, and from primarily white samples. As part of a completed measurement study, a diverse sample (n=140, 25-65 years, Mage=47, 65% Female) provided detailed stress measures, including EMA and lifetime stress assessments, and consented to future analysis of their blood samples. We successfully used decade-old blood samples to estimate methylation-based epigenetic clocks and examined them within the context of various stress measures as a preliminary phase of a future longitudinal study. Additional whole genome sequencing will also allow for future work that incorporate continuous measures of genomic ancestry when examining lifetime discrimination-related stress, rather than simply testing for demographic group differences.
CHANGES IN PERSONALITY TRAITS AND SOCIAL SUPPORT BEFORE AND AFTER RETIREMENT
Authors: Pfund Gabrielle , Hill Patrick , Allemand Mathias , Kivi Marie , Berg Anne Ingeborg , Thorvaldsson Valgeier , Hansson Isabelle
Published: December 2022

Aging is tied to transitions in occupational, social, and personal contexts, which can have implications for changes in who one is and how connected they feel to others. The current study uses data from 5,844 older adults (Ages: 60-66) with six annual reports on the Big Five personality traits and three distinct social support types (family, friends, relationships) to investigate how personality and social support change together, and the role retirement plays in these changes. Random intercept-cross lagged panel models were conducted to evaluate the associated changes in each trait and social support type while accounting for the time-varying covariate of retirement status. Higher social support across all relationship types was associated with higher agreeableness, extraversion, and conscientiousness and lower neuroticism both between- and within-person. Furthermore, entering retirement predicted an increase in social support with friends and relationship partners, but no consistent change in any of the personality traits.
FACTORS ASSOCIATED WITH ELECTRONIC WEARABLE DEVICE USE AMONG US OLDER ADULTS
Authors: Li Mengchi , Li Qiwei , Budhathoki Chakra , Szanton Sarah , Li Junxin
Published: December 2022

Electronic wearable devices(EWD) have been increasingly used in the adult population. Although health benefits of using EWDs may be appealing through health self-monitoring(e.g., physical activity, heart rate, and sleep), safety alerts(e.g., fall risk detection), or stress reduction(breathing technique), there is a lack of understanding in EWD use among older adults. This cross-sectional study used self-reported data of 3370 older adults aged 65 to 104 years from the Health Information National Trends Survey 2019 and 2020. We examined the prevalence of EWD use and used Logistic Regression Models to identify social factors (gender, race/ethnicity, education, and income) associated with the use of EWDs in older Americans. We found that EWD users increased from 13.3% in 2019 to 17.4% in 2020 in older Americans. After adjusting for age, insurance, smoking, marital-status, chronic conditions, region, and all other social factors of interest, we found that older men(Odds Ratio[OR]= 0.58, 95%Confidence Interval[CI]:0.45, 0.73), Black/African American older adults(OR=1.50, 95%CI: 0.41, 0.68), older adults who did not attend college(OR=0.62, 95%CI: 0.46, 0.83), and those with household income lower than $35,000(OR=0.32, 95%CI: 0.24, 0.46) were less likely to use EWDs. Interestingly, before adjustment, EWD use in Black/African American older adults(OR: 1.02, 95%CI:0.74, 1.34) did not differ from that in White/Caucasian older adults. Our findings suggest inequality of EWDs use in older Americans: those with lower education and income had less access to EWDs and fewer potential health benefits from EWDs. This study highlights the needs of equal access to EWDs and addressing social inequalities among older Americans.