bluuebunny/crossref_metadata_2025 huggingface dataset:
Educational Intervention for Care Home Staff to Encourage Resident ACP
Authors: Soheilipour Shimae , Gutman Gloria , de Vries Brian , Kwan Helen , Jang Katrina
Published: December 2020

Twenty-five Multi-Ethnic (ME) and 21 Exclusively Chinese (EC) care home staff participated in an education intervention focused on helping staff assist residents/families with goals of care conversations and other aspects of ACP in a culturally sensitive way. Surveys were completed at baseline and 6-8 week follow-up. Staff reported that the education session increased their ACP knowledge and provided strategies to help them initiate relevant ACP conversations. Registered staff (nurses, social worker, physician) demonstrated significantly higher levels of confidence to participate in and assist residents/families with goals of care conversations after compared to before training.
Feasibility Study of a Digital Screen-Based Calming Device for Managing BPSD During Care
Authors: Gutman Gloria , Vashisht Avantika , Kaur Taranjot , Churchill Ryan , Moztarzadeh Amir , Karbakhsh Mojgan
Published: December 2020

MindfulGarden (MG) is a digital device resembling a flat screen TV, with touchless sensors that react to voice and motion. In this study 13 long-term care home residents aged 74-100 exhibiting Behavioural and Psychological Symptoms of Dementia (BPSD) were randomized to treatment and control groups. On days 1-3 the treatment group received usual care plus exposure to MG during morning and evening care - events well documented to be problematic for residents and care staff; controls received usual care only. On day 4 both groups were exposed to MG with verbal cueing. A 26-item checklist was used to record frequency and types of disruptive BPSD exhibited; care duration was recorded in minutes. There was a trend toward reduction of BPSD and duration of care during morning care. Findings suggest that verbal cueing may be important for successful implementation of MG in calming residents with dementia during routine care.
Hey Google, Remind Me to Write in My Diary: Voice Assistants for Daily Pain Monitoring
Authors: Shade Marcia , Hama Rasila Soumana , Rector Kyle , Kupzyk Kevin
Published: December 2020

Diaries can be important tools to document and communicate pain symptoms. Diary-based assessments can be prone to poor adherence and limitations with biased recall. One strategy to help adherence is to use voice assistant reminders. A sample of 15 community dwelling aging adults used the Google Assistant for reminders to complete pain self-management tasks. One task was a reminder created to write daily in a pain diary. Within the diary, participants could document a change in pain, pain severity, average and worst amount of pain, and pain relief. At follow-up, it was noted that participants adhered to writing most pain characteristics in the diaries, but there were times that each question was not answered. Participant’s pain characteristics varied, which could be a helpful assessment to communicate to health providers for pain management. This feasibility study is preliminary support that voice assistants may help with the daily pain diary completion.
Anticholinergic Medication Use, Dopaminergic Genotype, and Recurrent Falls
Authors: Rosso Andrea , Zhu Xiaonan , Marcum Zachary , Bohnen Nico , Sprague Briana , Rosano Caterina
Published: December 2020

Anticholinergic medications (A-chol) increase risk for falls; higher dopaminergic signaling may provide resilience to these effects. In 2489 older adults (mean age=74; 52% women) with 10 years of data on medication use, falls, and dopaminergic genotype (catechol-O-methyltransferase (COMT)), we assessed the association of A-chol use with recurrent falls (≥2) over the subsequent 12 months using generalized estimating equations. Effect modification by COMT (met/met, higher dopamine signaling, n=473 vs val carriers, lower dopamine signaling, n=2016) was tested; analyses were then stratified by COMT and adjusted for demographics and A-chol use indicators. During follow-up, 843 people reported recurrent falls. A-chol use doubled the odds of recurrent falls (OR [95%CI]=2.13[1.74, 2.60]), with a suggested effect modification by COMT (p=0.1). The association was present in val carriers (adjusted OR [95%CI]=1.93[1.36, 2.73]) but not in met/met (adjusted OR [95%CI]=1.30[0.53, 3.22]). Higher dopaminergic signaling may provide protection against the effects of A-chol use on fall risk.
Effects of Daily Vitamin D Supplementation on Objectively Measured Physical Activity: Results From the STURDY Trial
Authors: Schrack Jennifer , Urbanek Jacek , Wanigatunga Amal , Juraschek Stephen , Mitchell Christine , Michos Erin , Roth David , Appel Lawrence
Published: December 2020

Cross-sectional evidence suggests older adults with higher serum vitamin D are more physically active, but whether long-term vitamin D supplementation attenuates age-related declines in physical activity (PA) is undefined. We examined the association between vitamin D supplementation and daily PA in 639 STURDY participants (aged 77 (5.4) years; 44% women) over up to 24-months. Participants were randomized to receive 200 (n=275), 1000 (n=168), 2000 (n=59), or 4000 (n=63) IU/day of vitamin D3. PA was measured using the Actigraph Link wrist-worn accelerometer 24 hours/day for 7-days at baseline, 3, 12, and 24 months. In linear mixed models adjusted for baseline PA level, total daily PA appeared to decline (β=-43.3 counts, p=0.06) annually for all groups and there was no difference by vitamin D3 dose (p for group*time =0.14). These results suggest daily vitamin D supplementation has no effect on quantities of daily PA.
A Pharmacist-Led Medication Coaching Program Serving Senior Residents of Low-Income Housing
Authors: Bacci Jennifer , Akers Joshua , Mahan Katie , Meer Geoffrey , Kinter Jeffrey , Shields Anna
Published: December 2020

In 2015, one independent community pharmacy partnered with the local Area Agency on Aging to provide medication coaching to low-income, culturally diverse, older adults living in 6 affordable housing buildings in the Seattle area. A pilot was conducted during the 2015-2016 fiscal year to determine the need for and feasibility of the service. Process outcomes, including patient and service demographics, medication-related problems, and pharmacist interventions, were captured via the pharmacists’ patient care documentation. Pharmacists had 34 total visits with 17 unique residents who were taking an average of 8.1 medications. Pharmacists identified 97 medication-related problems, averaging 5.7 problems per resident, and performed 88 interventions, averaging 5.2 interventions per resident. The findings of this pilot demonstrated the needs and feasibility of implementing pharmacists’ services within a housing organization structure and has resulted in the continuation and growth of the program.
Nutritional Mediators of Cellular Decline and Mitochondrial Dysfunction in Older Adults
Authors: Fielding Roger
Published: December 2020

Aging is the primary risk factor for progressive loss of function, onset of disease, and increased vulnerability to negative health-related outcomes. These clinical manifestations arise from a decline in mitochondrial and metabolic processes considered the hallmarks of aging. Collectively, these changes can be defined as age associated cellular decline (AACD) and are often associated with signs and symptoms such as fatigue, reduced strength and low physical activity. This symposium will explore mechanisms, clinical signs, and emerging nutritional interventions for AACD. Dr. Feige’s presentation will serve as an introduction by highlighting mechanisms underlying functional declines in skeletal muscle with aging. He will discuss the Multi-Ethnic Molecular determinants of Sarcopenia (MEMOSA) study, which found impaired mitochondrial bioenergetic capacity in skeletal muscle of older adults with sarcopenia compared to age-matched controls, and identified mitochondrial function as a key target for intervention. Dr. Guralnik will discuss the connection between cellular changes and clinical manifestations of AACD. He will report on an expert consensus study group which developed an initial framework to identify self-reported symptoms and observable signs of AACD in adults over50 years. Lastly, Dr. Singh will discuss the evidence for nutritional interventions to address sources of AACD, focusing on those targeting mitochondrial dysfunction. Recent research on dietary interventions with urolithin A (an activator of mitophagy) and nicotinamide riboside (an NAD+ booster) will be reviewed. Overall, this symposium will highlight key mechanisms and clinical signs of AACD, and the potential for novel nutrition interventions to support cellular function and healthy aging.
Occupational Therapy for People Living With Dementia in the Community: Workforce Development Opportunities
Authors: Lepore Michael , Long Erin , Weiss Joan
Published: December 2020

Establishing a workforce capable of delivering evidence- and team-based HCBS for the growing population impacted by dementia is of growing public health importance. Occupational therapy (OT), in collaboration with other disciplines, offers promise for supporting people with dementia to live well at home. However, neither uptake of team-based programs for people with dementia nor availability of providers who work in teams to support people with dementia are well understood. We reviewed information from three federal programs to improve understanding of team-based workforce development needs and opportunities. Findings indicate that interprofessional evidence-based interventions for people with dementia are increasingly implemented but geographically limited and development of the OT workforce’s dementia capability is nascent in interprofessional/interdisciplinary training. OT is a key profession delivering evidence-based HCBS for people with dementia, but substantial opportunity exists for workforce development, including education, training, financing, recruitment, retention, care coordination, and translation and implementation of effective care.
Cerebral Microstructure in Aging Using Advanced Quantitative MRI
Authors: Bouhrara Mustapha , Khattar Nikkita , Kim Richard , Qian Wenshu , Alisch Joseph , Ferrucci Luigi , Resnick Susan , Spencer Richard
Published: December 2020

White matter (WM) maintenance through oligodendrocyte metabolism is an energy-intensive process. Myelin homeostasis is sensitive to hypoxia, ischemia, or hypoperfusion. Besides substrate delivery, adequate cerebral blood flow (CBF) is crucial for removal of metabolic byproducts such as iron. While some data show decreased myelin content and CBF with aging, the association between CBF and myelination is unknown. Further, breakdown of oligodendrocyte and iron may potentiate myelin loss through oxidative mechanisms. Whether iron deposition is related to myelination is unclear. Using advanced MRI methodology, we investigated associations between CBF deficits, myelin loss, and iron deposition in cognitively normal individuals. We found significant association between i) CBF deficits and myelin loss (N=67,age24-88), ii) myelin loss and iron accumulation (N=92,age21-94), and iii) CBF deficits and iron accumulation (N=35,age22-88) in critical brain structures. This work may lay the foundation for further investigations of age-related WM degeneration and markers to differentiate normal from abnormal alterations.
Partnering With African American Churches to Support Families Affected by Dementia Through Research
Authors: Epps Fayron
Published: December 2020

African Americans (AA) are disproportionately impacted by dementia when compared to the non-Hispanic white population, yet are significantly underrepresented in research. Often times, families in the AA community turn to their church for help when in distress. Recognizing that churches are frequently the cornerstone of AA communities, they are an ideal setting for health promotion, research, and education. However, many AA churches do not have the resources to support their congregants affected by dementia. To build capacity within churches to address brain health promotion and facilitate research access/participation, we partnered with 6 predominantly AA churches in the metropolitan Atlanta area to facilitate research and develop dementia-related programs. While stakeholders were initially reluctant, continual engagement with senior faith leaders helped to facilitate the successful development of a research registry of congregants interested in participating in faith-based and clinical research and establishment of new programs to congregants around brain health and dementia.
Gait and Balance as Predictors or Mediators of Falls in Glaucoma
Authors: Mihailovic Aleksandra , De Luna Regina , West Sheila , Friedman David , Gitlin Laura , Ramulu Pradeep
Published: December 2020

Balance and gait are modifiable targets for falls prevention and may play an important role in preventing falls in older visually impaired individuals. Balance and gait were objectively evaluated in the 239 Falls in Glaucoma Study participants (average age=70.5, 22% with moderate-severe visual field (VF) damage). Greater sway, more time in double support and greater swing time variability were associated with higher fall rates, while higher gait velocity and faster cadence were associated with lower rates (p<0.05 for all). Neither gait nor balance mediated the relationship between VF damage and fall rates, with VF damage remaining an independent predictor of fall in models including gait and/or balance features (RR =1.36 to 1.48, p-value= <0.001 to 0.005). While balance and gait measures are associated with fall rates, they do not explain why persons with greater VF damage fall more frequently, suggesting the importance of other factors such as hazard perception.
Fitness Matters as We Age: A Celebration of the VA Gerofit Program
Authors: Morey Miriam , Lee Cathy
Published: December 2020

In recognition of the GSA’s 75th Anniversary “Why Age Matters” we celebrate the 7th anniversary of the Gerofit dissemination initiative. Gerofit is an exercise and health promotion program for older Veterans that has been declared a Veterans Health Administration (VA) “Best Practice” and been disseminated to 17 VA’s across the country. Over 7000 Veterans have participated in Gerofit initiated programs and have reported robust outcomes including improved quality of life, physical and mental health, and high levels of satisfaction with the programs. For this symposium, we focus on newly acquired program outcomes that emphasize the importance of fitness as we age. The first paper compares hospitalization and emergency room visits between individuals participating in Gerofit for 12 months compared to a matched control group. The second paper describes four-year trajectories of physical performance to highlight the impact of becoming fit over expected normative trajectories. The third paper examines outcomes of a home-based geriatric walking clinic. The fourth paper describes the impact of exercise adherence on chronic pain. The fifth paper describes changes in medication utilization compared to a matched control group following 12-months of supervised exercise. These papers highlight the importance of fitness as a contributor to overall health during the aging process and celebrates that fitness matters, no matter when you start!
Food Insecurity in the United States: Identification, Treatment, and Implications
Authors: DiMaria-Ghalili Rose Ann , Bales Connie , Locher Julie
Published: December 2020

Food insecurity is an under-recognized geriatric syndrome that has extensive implications in the overall health and well-being of older adults. Understanding the impact of food insecurity in older adults is a first step in identifying at-risk populations and provides a framework for potential interventions in both hospital and community-based settings. This symposium will provide an overview of current prevalence rates of food insecurity using large population-based datasets. We will present a summary indicator that expands measurement to include the functional and social support limitations (e.g., community disability, social isolation, frailty, and being homebound), which disproportionately impact older adults, and in turn their rate and experience of food insecurity and inadequate food access. We will illustrate using an example of at-risk seniors the association between sarcopenia, the age-related loss of muscle mass and function, with rates of food security in the United States. The translational aspect of the symposium will then focus on identification of psychosocial and environmental risk factors including food insecurity in older veterans preparing for surgery within the Veterans Affairs Perioperative Optimization of Senior Health clinic. Gaining insights into the importance of food insecurity will lay the foundation for an intervention for food insecurity in the deep south. Our discussant will provide an overview of the implications of these results from a public health standpoint. By highlighting the importance of food insecurity, such data can potentially become a framework to allow policy makers to expand nutritional programs as a line of defense against hunger in this high-risk population.
Broadening the Conception of Food Insecurity Among Older Adults: Development of a Summary Indicator in the NHATS
Authors: Tucher Emma , Keeney Tamra , Cohen Alicia , Thomas Kali
Published: December 2020

Comprehensive measurement of food insecurity among older adults has focused on financial barriers to food access. Using data from the community-dwelling older adults in Round 5 of the U.S. National Health and Aging Trends Study (n=7,070), we constructed a summary indicator of food insecurity and inadequate food access incorporating items related to food scarcity within three domains: functional, social support, and financial limitations. We analyzed the construct validity of the summary indicator for known biopsychosocial factors associated with food insecurity among older adults. In 2015, 4.3% of community-dwelling older adults, approximately 1,673,775 million people, were characterized as food insecure or lacking adequate food access. Multivariable regression models identified that being homebound, frail, and experiencing community disability were associated with food insecurity and inadequate food access. These findings indicate food insecurity and inadequate food access among older adults is associated with functional and mobility characteristics and not isolated to financial barriers.
Lessons Learned From the Function and Behavior Focused Care Trial: From Efficacy to Implementation
Authors: Galik Elizabeth , Boltz Marie
Published: December 2020

Long term care residents with dementia are sedentary, experience rapid functional decline, and frequently exhibit behavioral and psychological symptoms of dementia. Our prior cluster, randomized controlled trial among 336 residents with moderate to severe dementia in 12 nursing homes demonstrated that it is possible to increase time spent in physical activity and decrease resistiveness to care through a theory based intervention, Function and Behavior Focused Care (FBFC). FBFC is based on the Social Ecological Model and Social Cognitive Theory and focuses on having long term care staff cue, model, and assist residents with dementia to engage in physical activity and perform functional tasks. Learning from prior work, it was noted that future implementation of FBFC would benefit from de-implementing inaccurate care practices, such as restricting resident mobility and providing custodial care and also by engaging a full stakeholder team in intervention activities. Additionally, there were measurement issues, such as the use of actigraphy with a sedentary, cognitively impaired population, and the need to assess the quality of care interactions between residents and staff. This symposium will review lessons learned from the FBFC trial and will discuss 1) facilitators and barriers to the implementation of the FBFC intervention within long term care settings; 2) measurement opportunities and challenges with a cognitively impaired long term care population; and 3) adaptation of the FBFC intervention to be appropriate for a dissemination and implementation trial that incorporates the Synthesis Model of De-Adoption and the Evidence Integration Triangle implementation strategy.
Mechanisms of Racial and Ethnic Differences in Cognitive Aging
Authors: Rosso Andrea , Manly Jennifer
Published: December 2020

Racial and ethnic disparities in age-related cognitive function and dementia risk in the US are well recognized. However, the psychosocial drivers of these disparities and underlying mechanisms are less well studied. This symposium will highlight novel research regarding our current understanding of racial/ethnic differences in brain and cognitive aging and the underlying mechanisms of the disparities. Frist, two papers will describe results regarding racial/ethnic differences in cognitive function and brain aging markers. Few studies have assessed racial/ethnic differences in cognitive function across age groups. Indira Turney will utilize data from a multigenerational study to explore how age impacts racial/ethnic differences in cognitive function. Underlying brain mechanisms of racial/ethnic differences in cognitive outcomes are also not well defined. Sara Godina will present a systematic review of racial/ethnic differences in structural markers of brain aging and neuropathology. Second, three papers will explore how various risk factors may explain the racial/ethnic disparities in cognitive outcomes. Melissa Lamar will demonstrate the differential associations of various blood pressure indicators with cognitive change among black older adults. B. Gwen Windham will present data from two studies that illustrate differential effects of common risk factors by race and region, highlighting inherent difficulties in race-place disparity research. Finally, Laura Zahodne will present results on how psychosocial factors, beyond socioeconomic status, contribute to racial/ethnic disparities in cognitive function. Jen Manly will lead a discussion on the implications of these results for the future of dementia prevention efforts for an increasingly diverse older US population.
The Longitudinal Association of Walking Efficiency With Brain Volumes in Community-Dwelling Older Adults
Authors: Schrack Jennifer , Liu Fangyu , Wanigatunga Amal , An Yang , Davatzikos Christos , Simonsick Eleanor , Ferrucci Luigi , Resnick Susan
Published: December 2020

Walking efficiency (WE) predicts mobility decline and is linked with higher fatigability. Fatigability is associated with cognitive decline and reduced brain volumes (BV), but the link between WE and BV is undefined. We examined associations between WE and BV in 860 participants of the BLSA (mean age 66.4(14.4) years, 54.5% women). WE was assessed during 2.5-minutes of usual-paced walking using indirect calorimetry and standardized per meter (ml/kg/m). BV measures were derived using MRI scans and an automated multi-atlas region-of-interest approach. In linear mixed models adjusted for demographics, education, BMI, intracranial volume, and cognitive status, lower baseline WE was associated with lower total, white, and gray matter, primarily in the frontal and temporal lobes (all p<0.05). Longitudinally, declining WE was associated with increasing ventricular and decreasing hippocampal volumes over follow-up (all p<0.01). Findings suggest rising age-related inefficiencies may reflect underlying brain atrophy and serve as a novel indicator for future interventions.
The Effect of Music Therapy on Cognitive Functioning Among Older Adults
Authors: Chen Kuei-Min
Published: December 2020

Music creates and fosters connection and interrelationships between individuals and encourages social interaction. Indeed, community-based interventions are a powerful way to engage older people. This presentation will provide an overview of music therapy and the impact it can have on the cognitive functioning of older people. Examples of music therapy interventions in the community can be found in nursing homes, hospitals, or communities. Differences in receptive (passive) music therapy and active music therapy will be discussed along with the impact these therapies may have on individuals experiencing cognitive decline. Moreover, studies of music therapy combined with other activities, such as exercise or art will be discussed. This research will be presented within the context of the recommendations put forth by the Global Council on Brain Health aimed at adults aged 50+.
Benefits of The Unforgettables: A Chorus for People With Dementia Together With Their Family Caregivers
Authors: Mittelman Mary
Published: December 2020

The Unforgettables was founded in 2011 for people with dementia and their family caregivers. We hypothesized that singing and rehearsing together would providing an opportunity for people in the early and moderate stages of dementia and their family caregivers to share a normative, stimulating and social activity. Pilot study results showed that quality of life and communication with the other member of the dyad improved for people with dementia; quality of life and, social support, communication and self- esteem improved for caregivers. Moreover, people with dementia learn new songs for every performance, suggesting that this activity may slow cognitive decline. The chorus continues to rehearse and perform, and now has approximately 100 members in two locations in NYC. These findings support the recommendations of the Global Council on Brain Health by underscoring the many benefits of music performance in enhancing social engagement and providing joy to participants and the community.
Perspectives of Persons With Dementia, Family, and Healthcare Providers on an Advance Care Planning Decision Aid
Authors: Geshell Lisa , Kwak Jung
Published: December 2020

Few evidence-based interventions to engage persons living with dementia in advance care planning (ACP) exist. We developed and explored the acceptability and appropriateness of an ACP decision aid for PLWD/family caregiver dyads living in the U.S. We conducted a mixed-methods study with 10 persons with dementia-caregiver dyads, and 4 healthcare providers. Content analysis and descriptive analysis were conducted. Major and subthemes included: (1) the role of caregivers during ACP discussion: clarifier, guide, and proxy; (2) decisional needs of persons with dementia for ACP: lack of knowledge and decisional conflict; and (3) perceptions of the decision aid: lack of clarity between advance directive types, a need to remove any questions that may be conceptually different, but appear similar to users, and need to include summary of decision-support needs. Findings provide implications for how healthcare providers can use a decision aid to facilitate ACP conversations with persons with dementia and caregivers.
Identifying Palliative Care Needs in Assisted Living
Authors: David Daniel , Brody Abraham , Sadarangani Tina , Wu Bei , Cortez Tara
Published: December 2020

Many residents of Assisted Living (AL) confront serious illness and therefore might benefit from greater access to Palliative Care Services to improve quality of life. We surveyed resident records and AL nursing staff to identify patients in need of Palliative Care. Preliminary findings showed that nurses predicted 23% would not be alive and 49% would no longer live in AL. A majority of residents were over the age of 90, yet 30% did not have a reported code status. These findings suggest that a substantial portion of AL residents may have unmet needs with respect to palliative care. Future interventions are needed to support advance care planning conversations and make palliative care more accessible to this population.
Prefrontal Cortex Control of Walking: Functional Near-Infrared Spectroscopy and Beyond
Authors: Rosso Andrea , Holtzer Roee
Published: December 2020

Cognitive control of walking may change with aging and is associated with poorer mobility and greater fall risk. The prefrontal cortex function is important for cognitive control of walking, and functional near-infrared spectroscopy (fNIRS) provides the primary means for assessing prefrontal activation during walking. Growing interest in fNIRS to assess cognitive control of walking has led to advancements in the methodologies for processing and analyzing the data, a greater sophistication of experimental protocols and participant samples, and implementation within intervention studies. These advancements will be highlighted in five presentations from an international group of researchers at the forefront of the field. First, Meltem Izzetoglu will provide direct comparisons of various data processing methodologies, demonstrating comparability across approaches. Three talks will demonstrate the range of applications of fNIRS to studying walking in older adults. Nemin Chen will present data on task-related patterns of prefrontal activation across walking tasks in relation to performance, cognitive function, and structural brain health. Sarah Fraser will present results from stair climbing, a critical task for daily function which also presents a fall risk. Inbal Maidan will examine how individual differences affect prefrontal activity during walking across older adults, younger adults, and patients with Parkinson’s disease or multiple sclerosis. Finally, David Clark will demonstrate the use of fNIRS in assessing outcomes from an intervention that combined walking with non-invasive frontal brain stimulation. Roee Holtzer will lead a discussion of the results and the future of fNIRS in assessing cognitive control of walking in older adults.
Using fNIRS to Capture Cerebral Oxygenation in Older Adults Navigating Stairs
Authors: Fraser Sarah , Salzman Talia , Kim Hyejun , Badawi Hawazin , Vallejo Diana Tobon , Lajoie Yves , Pilutti Lara , Farrell John
Published: December 2020

Navigating stairs is a complex motor activity and while it provides health benefits it can also increase the risk of falls in older adults (OA). The prefrontal cortex (PFC) contributions to stairclimbing (with or without a cognitive task) remain unknown. Using functional near infra-red spectroscopy (fNIRS) and wireless insoles, this study evaluated cerebral oxygenation changes (∆HbO2) in the PFC, gait parameters (speed) and cognitive performance (reaction time(RT)/accuracy) during stair ascent and descent in single (SMup/SMdown) and dual task (DTup/DTdown) conditions. OAs navigated stairs with or without a simple reaction time task. Participants had longer RTs in DTup (p < .001) and DTdown (p <.001) in comparison to standing, with no significant differences in accuracy or walk speed. ∆HbO2 was significantly different (p = .003) between SMdown and DTdown. Findings suggest that despite the simplicity of the cognitive task, dual-tasking on stairs resulted in increased cerebral oxygenation and slowed cognitive responses.
Social Volunteering in Aging Adults Increases Regions of the Amygdala and Correlates With Enhanced Generativity
Authors: Carlson Michelle
Published: December 2020

The Brain Health Study (BHS) of the Baltimore Experience Corps Trial (BECT) examined whether a randomized, controlled trial of an intergenerational social volunteer program, entitled Experience Corps, increased subregions of the amygdala related to socioemotional memory and risk for Alzheimer’s disease in aging adults. We further assessed functional correlates of these intervention-related changes and changes in aging adults’ developmental need to be generative, or, to give back to the well-being of others. The BHS simultaneously randomized 112 men and women (59 intervention; 53 control) within BECT to evaluate intervention impact on biomarkers of brain health at baseline and annual follow-ups during the two-year trial. Intention-to-treat analyses revealed program-specific increases in the shape of the centromedial and basomedial regions of the left amygdala (p’s≤0.05 adjusted), which were correlated with increases in generativity (p’s =0.06). Meaningful social engagement buffered amygdalar declines important to preservation of emotionally salient memory and risk for dementia. Part of a symposium sponsored by Brain Interest Group.
Hearing Loss in Older Adults: Implications for Cognitive Load and Brain Structure and Function
Authors: Lin Frank
Published: December 2020

Age-related hearing loss is prevalent in two-thirds of older adults and reflects progressive impairments in cochlear function leading to impoverished peripheral neural encoding of sound. Research has demonstrated the broader implications of hearing loss for the health and functioning of older adults, particularly with respect to brain aging and dementia. This presentation will summarize current epidemiological and neuroimaging evidence for how hearing loss in older adults affects cognitive load and brain structure/function and relate this contemporary research with previous psychological studies proposing ‘information degradation’ and ‘sensory deprivation’ hypotheses of how hearing may affect cognitive function. Finally, the design of an ongoing NIA-funded randomized controlled trial (ACHIEVE- Aging and Cognitive Health Evaluation in Elders) that will determine if hearing treatment reduces the risk of cognitive decline, dementia, and brain aging in adults will be discussed. Part of a symposium sponsored by Brain Interest Group.
Oral Health, Immigrant Status, and Adult Children’s Support Among Chinese American Older Adults
Authors: Jiang Nan , Wu Bei , Zhang Wei
Published: December 2020

Adult children play an important role in older immigrants’ health outcomes. Research has indicated that older adults may benefit from adult children caregivers’ support for oral health. However, little is known about children’s support for improving oral health for older immigrants. Using the 2018 survey of 430 Chinese older adults age 55 and older in Honolulu, Hawai’i, we examine the associations among immigrant status, adult children’s support and perceived oral health for Chinese American older adults. Emotional support from adult children protects the self-rated oral health for the immigrant group, while financial support is linked to fewer oral health problems among the US-born group. Therefore, the current study underlines the importance of investigating different pathways among foreign-born and native-born Chinese older adults with regard to children’s support on their oral health outcomes. Part of a symposium sponsored by the Oral Health Interest Group.
Implementation of a Care Management Program for Low-Income Older Adults
Authors: Schloen Anna , Grimaldi Helen
Published: December 2020

The focus of this session will be on the implementation of a new care management program in Chicago for low income older adults. Framed by the Exploration, Installation, Initial Implementation, and Full Implementation framework, the presenter will first discuss the process and outcomes of a needs assessment which informed the program. The presenter will share strategies and lessons learned from getting the program off the ground and initial lessons learned which informed the full program as it is operated today. In 2 years, the program has grown from 1 FTE to 4.5 FTE and to 250 clients. The presenter will provide strategies for managing growth while maintaining quality care. Finally, the presenter will provide information on the program's collaboration with a researcher to enhance evidence-based service delivery within the care management program. Participants will learn specific strategies they can take back to their own communities to implement care management programs.
The Role of Rehabilitation in Reducing Resource Use and Lowering Hospital Readmission Through Discharge Planning
Authors: Miller Kenneth
Published: December 2020

The transitions between medical settings, the community and back again is a complex and intimidating process for patients, families and caregivers. These transitions are vulnerable points where planning is key and must begin at the initial examination with rehabilitation providers (PTs/OTs,SLPs). These providers are key members of the healthcare team to facilitate effective transition management. In this session, attendees will learn the critical factors rehabilitation providers use to evaluate patients in order to facilitate successful care transitions. An overview of the indications for rehabilitation referral will be presented, as well as evidence for effective rehabilitation strategies. The speaker will present tools from the American Physical Therapy Association Home Health Toolbox and outline a decision-making process for care transitions based on the individual, caregivers, and health care providers to achieve successful transitions that reduce resource use and hospital readmission rates. Attendees will learn strategies to facilitate inter-professional collaboration, communication, and advocacy.
Hearing Loss and Cognitive Decline: Causal Evidence
Authors: Golub Justin , Sharma Rahul , Chern Alex , Rippon Brady , Ciarlegio Adam , Schupf Nicole , Brickman Adam , Luchsinger José
Published: December 2020

Age-related hearing loss (HL) has recently been associated with cognitive decline, dementia, and changes in brain structure. HL has near universal prevalence in later life (involving 80% of those over 80 years old) and is rarely treated (under 20% in the same age group). Dementia is also common in later life, carrying staggering societal implications, including a worldwide cost of over $605 billion/year. Research establishing an association between HL and cognition has included cross-sectional and prospective studies. New data show a link not only in the earliest stages of HL but also in hearing ranges still considered normal. The current evidence for an independent association between HL and impaired cognition, including a possible causal connection, will be reviewed. Plausible mechanistic pathways will be discussed with an emphasis on brain imaging biomarkers of dementia. Finally, future avenues for research and policy change will be proposed.
GSA COVID-19 Task Force: Developing a Research Agenda
Authors: Resnick Barbara , Zimmerman Sheryl
Published: December 2020

GSA COVID-19 Task Force members worked with organizational leaders and special interest groups to ascertain areas where further research about COVID-19 and older adults would be helpful. The responses were compiled into a single document to create a research agenda. Processes to share the agenda with federal agencies and partners will be shared.
Validity and Reliability of the Healthy Aging Instrument in Older Adults With and Without Fear of Falling
Authors: Thiamwong Ladda
Published: December 2020

An instrument to measure healthy aging has not been validated in older adults with and without fear of falling, expressing a methodological gap that limits research in this field. This cross-sectional study aimed to validate the 35-item Healthy Aging Instrument (HAI) in adults aged 60 years and over. 389 community-dwelling older adults from two provinces in Thailand were recruited. The mean age of participants was 70.4 years, and 63% were women. The HAI showed good construct validity and internal reliability in the total group and subgroups with respect to levels of fear of falling. All correlations among the HAI, Fall Risk Assessment Test, Fall Efficacy Scale-International, and full tandem stance test were significant. While Western cultures value the expression of thoughts and feelings, it is not particularly encouraged in Asian cultures. The HAI demonstrates good psychometric properties and provides the basis for measuring healthy aging in Asian older adults.
Development of Age-Friendly Health Systems in Culturally Diverse Settings
Authors: Lee Jung-Ah , Gibbs Lisa , Fitzpatrick Camille , Saville Neika
Published: December 2020

UC Irvine (UCI) GWEP partnerships were designed to address a startling increase in impoverished older adults and the disproportionate medical and social determinants of health faced by Latino and Asian communities. All partner clinics primarily serve racial/ethnic minorities, including Hispanic/Latino or Asian minorities (83-88%), with >90% below the 200% poverty threshold. Our major FQHCs include the academic UCI Family Health Center, Vietnamese and Korean community Services. We established an FQHC Geriatric Clinic at UCI with the 4 M’s paradigm (i.e., matter, mobility, medication, mentation) integrated into the clinic through the Medicare Annual Wellness Exam. We are disseminating this model to our smaller community sites, along with 4 M presentations. Roughly 5-7% of patients in FQHCs are over 65, allowing leadership time to prepare a foundation for increased growth. Furthermore, we have learned that each FQHC’s cultural setting and infrastructure is unique and requires a customized approach.
We’re in This Together, but . . . : Community-Engaged Research Process of an Arts Intervention With Older Adults
Authors: Sudha Sudha , Miller Lia
Published: December 2020

Community engaged (CE) methods are used in health-related research, but few discuss methodological aspects among older adults. We describe the methodology and lessons learned from a CE study of whether ARTmail, a structured participatory arts program, benefited older adults aged 60+ with memory symptoms / cognitive impairment (MS/CI). Our study, conducted in 2015-2017 with support from the NEA, was a partnership between a non-profit organization in North Carolina that provides creative programming for older adults with varied abilities, and researchers in an area University. Older adults with MS/CI symptoms receiving care in area communities were recruited into either the art intervention or a control group, in collaboration with community staff. We reflect on the CE research process with a partnership among community organizations, researchers, care staff, and older adults. Asymmetries in priorities, resources, and decision-making power are described, and implications for the research process and findings are discussed.
Space Use, Physical Activity, Sleep Quality and Self-Rated Health Among Late-Life Asian Immigrants
Authors: Li Wenjun , Proctor-Gray Elizabeth , Churchill Linda , Cheng Jie , Kane Kevin , Siden Rachel , Crouter Scott
Published: December 2020

Little is known about the health and health behaviors of non-English Speaking late-life Asian immigrants, which is attributable to language and cultural barriers to participate research. In our Healthy Aging and Neighborhood Study, we collected objective measures of space and time use, location- and time-specific physical activities using accelerometer and Global Positioning System devices, and self-reported sleep quality and health. We obtained 3,915 person-days of accelerometer readings from 511 participants including 43 Asians. Compared to non-Hispanic Whites, Asians had worse self-rated health and poorer vision, more medical conditions and physical limitations as measured by ADL and IADL. Asians had higher daily step counts overall and at home; high proportions of steps on sidewalk or street and senior centers, lower in fee-based outdoor recreational areas, less in restaurant and vehicle. Sleep quality did not differ significantly between Asians and Whites. Risk profiles differed between Asians and Whites, which warrants further investigation.
Family Members’ Experiences of Maintaining an Older Relative’s Functional Ability in Long-Term Care
Authors: Lehto-Niskala Vilhelmiina , Jolanki Outi , Jylhä Marja
Published: December 2020

Family members have important role in care of older people. In residential long-term settings family members can find themselves in an ambiguous situation: officially, responsibility for provision and quality of care rests with the care provider and staff members, but in practice family members participate in caring. This study explores the role of family members in residential long-term care settings, particularly in supporting their older relatives’ functional ability. Developing and maintaining functional ability lies at the very core of healthy ageing policies and long-term care. The data consist of semi-structured interviews with family members (n=16) from eight long-term care facilities in Finland. Thematic analysis yielded three themes: maintaining personhood, engaging in everyday life and monitoring care. Family members in our study were actively involved in care that supported the functional ability of their older relative. However, family members had also conflicting views about who was responsible for care provision. Some participants willingly accepted their caregiver responsibilities even in residential care, while others described their involvement in care not as a matter of choice but rather as one of necessity in order to ensure good quality care. It is important to see the family members’ viewpoint which, based on the results of this study, emphasizes personhood and continuity of care. If they are willing to participate, family should be able to take part in caregiving together with the care staff and their role should be recognized.
Ecological Momentary Assessment of Social Contact Satisfaction and Momentary Affect in Chinese Older Adults
Authors: Liu Huiying , Lou Vivian
Published: December 2020

Previous researches have examined the influences of satisfaction with social relations on affective well-being on a long time-frame among older adults. Using the Ecological Momentary Assessment (EMA) method, we examined within-person changes in social contact satisfaction in relation to momentary affect on short time-scales in 78 community-dwelling older Chinese. Each participant provided up to 7 EMA surveys per day during a one-week period and reported his/her satisfaction, positive affect (PA) and negative affect (NA). Multilevel modelling was used for testing the within-person concurrent and time-lagged relations of social interactions and affect. Higher satisfaction was concurrently associated with more PA and less NA. The satisfaction of prior contact was predictive of greater low-arousal PA during the next contact. Prior NA was predictive of lower satisfaction at the next contact. Such dynamic interplays of social and affective experiences should be considered to support the maintenance of affective well-beings in older Chinese.
Interdisciplinary Perspectives on Maintenance of Health Behavior Change
Authors: Hughes Jaime , Bettger Janet , Hughes Susan , Raj Mina
Published: December 2020

Modifying health behaviors can be difficult, especially for older adults who are challenged by multiple chronic conditions, reduced functional and/or cognitive capacity, and limited social support. Although much attention has been given to the theories, skills, and resources behind initiating and achieving behavior change, less work has focused on maintenance of health behaviors over time. This presentation will showcase pilot research inspired by RCCN’s first workshop, Achieving and Sustaining Behavior Change. Specifically, this pilot brings together an interdisciplinary team of behavioral scientists and health services researchers working at the intersection of intervention science and implementation science to better understand the construct of maintenance and discuss emerging methods for intervention development and evaluation. The presentation will utilize physical activity as an example behavior to demonstrate the value of interdisciplinary research, including recommendations on how some of the six NIA research centers can make unique contributions to understanding health behavior maintenance.