bluuebunny/crossref_metadata_2025 huggingface dataset:
The Interplay of COVID 19, Remote Contact, and Race as Risk Factors for Depression
Authors: Bae Youngjoon , Abbott Katherine , Pachucki Mark
Published: December 2021

There have been concerns about how social distance policies and lockdowns due to COVID-19 have affected loneliness and depression among older adults in ways that may magnify racial disparities in health. We conducted panel logistic regression analyses with random effects using national data spanning 2004 to 2016 and the COVID-19 module (Wave 2020, administered in June and September) from the Health & Retirement Study (n=15,504). Individuals living in a nursing home, diagnosed with dementia or Alzheimer’s disease, and 64 years of age or younger were excluded from analyses. Age, gender, Hispanic status, education, marital status, working status, wealth, BMI, physical activity, smoking, drinking, and difficulty in meal preparation, eating without help, and grocery shopping were included as control variables. Findings suggest that older adults did not appear to experience increased loneliness during the pandemic relative to prior waves. However, Wave 2020 was an independent risk factor for depression. Greater in-person contact (OR: 0.97, CI: 0.95-0.99, p-val: 0.001) and remote contact (OR: 0.99, CI: 0.97-0.996, p-val: 0.008) were each independently associated with slightly decreased depression. Older Black Americans tended to be more depressed than their White counterparts (OR: 1.50, CI: 1.20-1.86, p-val: <0.001). However, a null interaction between race and wave suggested that Black Americans did not experience more increased depression in 2020 relative to prior waves. Analyses suggest that the COVID-19 pandemic might change at-risk groups for depression and communication by remote technology – often considered an inferior but necessary stopgap measure. Implications for practice and policy will be discussed.
A Comparison of Mental Health in a Sample of Older Women Before and During the COVID-19 Pandemic
Authors: Marshall Victoria , Sandhu Robina , Kanzler Kathryn , Espinoza Sara , Keel Pamela , LaCroix Andrea , Musi Nicolas , Kilpela Lisa
Published: December 2021

The COVID-19 pandemic has substantially impacted lives globally. Due to age-related risks, the older adult population has uniquely experienced negative changes caused by the pandemic. Research has also shown that the pandemic has disproportionately affected women. Therefore, it is important to understand how the mental health of older women has been impacted during this global crisis. This study aims to examine the differences in mental health indices in a sample of older women before versus during the COVID-19 pandemic. To date, participants include 201 women (aged 60-94) who completed an online survey of self-report measures assessing depression, anxiety, alcohol use, binge eating, positive affect, and emotional quality of life (QOL). We conducted one-way ANOVAs to compare each mental health construct in two samples of older women collected pre- and peri-pandemic. Results indicated that the peri-pandemic group reported significantly higher anxiety (F = 5.25, p = .02), with a trend for more role limitations due to emotional problems (F = 2.79, p = .09), than the pre-pandemic group. No significant differences emerged for levels of depression, alcohol consumption, binge eating, positive affect, or emotional wellbeing between groups. These findings point to the psychological resilience of older adults in the face of extreme adverse events, including this global crisis. Older women, while impacted differently during the COVID-19 pandemic, reported minimal exacerbations of mental health problems compared to older women pre-pandemic. Efforts to identify moderators that may either attenuate or promote further psychological resilience among older adults is warranted.
Benefit-finding buffers the effects of quarantine on older adults’ mental health during the COVID-19 pandemic
Authors: Cheng Sheung-Tak , Zhang Fan
Published: December 2021

Objective: Older adults’ health and well-being may suffer due to prolonged social isolation leading to loneliness and increased stress during the COVID-19 pandemic. The current study aimed to address the role of benefit-finding, defined as the capacity to derive meaning and positive aspects from stressful situations, in older adults’ adaptation to the effects of quarantine. Methods: 421 participants aged 50 or above in China participated in an online survey to study the effects of quarantine on loneliness, stress, anxiety, depression and life satisfaction, and the moderating role of benefit-finding. Results: The results showed that quarantine was basically unrelated to any outcome. Further analysis showed, however, that the effect of quarantine varied by levels of benefit-finding. Only people with lower benefit-finding reported a higher level of loneliness, perceived stress, anxiety and depression, but no relationships were found at higher benefit-finding. Conclusions: The findings extended our understanding of the role of benefit-finding in buffering the negative impact of adversity on older people. By mitigating the effects of prolonged social isolation, benefit-finding served as a protective factor in older people’s adaptation to the sequelae of this pandemic.
COVID-19 and Its Impact on Older Adults’ Routine and Urgent Health Care Visits
Authors: Wilkinson Lindsay , Masters Julie , Boron Julie Blaskewicz
Published: December 2021

Older adults have not only been disproportionately affected by the COVID-19 pandemic, but relatedly, are also more vulnerable to other health problems. Moreover, previous research on epidemics shows that health care services are often disrupted during health crises—leading to less access to and lower utilization of health services unrelated to the health crisis. The primary aim of this research is to examine the impact of the COVID-19 pandemic on both routine and urgent health care visits. Using data collected in December 2020 on adults ages 54 to 100 living in one of nine senior living communities (SLCs) in the state of Nebraska (n = 723), logistic regression models were used to investigate correlates of missed health care visits, adjusting for sociodemographic and health characteristics. The results show that 58% of older adults in SLCs skipped or postponed a routine health care visit due to the pandemic, whereas 8% of older adults missed an urgent health care visit. The results further reveal that older adults with better perceived health (p < 0.05), higher life satisfaction (p < 0.01), and higher resilience (p < 0.05) all had lower odds of missing a routine health care visit due to the pandemic. In contrast, those who missed an urgent health care visit were more likely to have higher perceived financial strain (p < 0.05). The findings from this study demonstrate the consequences of the COVID-19 pandemic on older adults’ health care utilization, which may have serious implications for their long-term health.
COVID-19 Impacts on Mental Health Care in Veterans Health Administration Community Living Centers
Authors: Jedele Jenefer , Griffin Cameron , Curyto Kim , Karel Michele
Published: December 2021

COVID-19 forced VHA Community Living Centers (CLC) to adjust how mental health (MH) care is provided. Beginning March 2020, admissions and staff entering CLC space were restricted in response to the pandemic. Some care shifted from in-person to virtual. Veterans were more isolated due to visitor restrictions and cancellation of communal activities. Pre-COVID, CLC teams cared for an already complex population – 80% of residents had a MH diagnosis (24% with serious mental illness). Changing resident composition and increased isolation may intensify challenges in providing MH care. Using VHA administrative data, we assess the impact of the changing CLC environment during the pandemic by comparing monthly average rates of MH diagnoses and provision of MH care and as-needed psychotropics to CLC residents pre-COVID (Oct 2019 – Feb 2020) to the COVID period (Mar 2020 – Feb 2021). CLCs experienced a 26% decline in the monthly resident census. However, the monthly percentage of residents with a serious mental illness increased 13%. Pre-COVID, virtual MH encounters were received by 2% of residents; 35% received an in-person MH encounter. During COVID, 8% received a virtual MH encounter and 33% received in-person. As-needed antipsychotics remained unchanged, while as-needed benzodiazepine prescriptions decreased 15%. Despite increased MH concerns, CLC teams did not appear to respond with increased pharmacological interventions. Rather, teams seem to have maintained clinical service connection for those with MH concerns. Documenting successful approaches for addressing MH needs during this challenging time will be instructive for future care during times of crisis.
Effect of Race and Dementia Prevalence on a COVID-19 Infection Control Intervention in Massachusetts Nursing Homes
Authors: Dufour Alyssa , Kosar Cyrus , Mor Vincent , Lipsitz Lewis
Published: December 2021

Nursing home (NH) residents, especially those who were Black or had dementia, had the highest infection rates during the COVID-19 pandemic. A 9-week COVID-19 infection control intervention in 360 Massachusetts NHs showed that adherence to an infection control checklist with proper PPE use and cohorting, was associated with declines in weekly infection rates. NHs were offered weekly webinars, answers to infection control questions, resources to acquire personal protective equipment, backup staff, and SARS-CoV-2 testing. We asked whether the effect of this intervention differed by racial and dementia composition of the NHs. Data were obtained from 4 state audits using infection control checklists, weekly infection rates, and Minimum Data Set variables on race and dementia to determine whether adherence to the checklist competencies was associated with decline in average weekly rates of new COVID-19 infections. Using a mixed effects hurdle model, adjusted for county COVID-19 prevalence, we found that the overall effect of the intervention did not differ by race, but proper cohorting of residents was associated with a greater reduction in infection rates among facilities with ≥20% non-whites (n=83). Facilities in the middle (50-61%; n=116) and upper (>61%; n=118) tertiles of dementia prevalence had the largest reduction in infection rates as checklist scores improved. Cohorting was associated with greater reductions in infection rates among facilities in the middle and upper tertiles of dementia prevalence. Thus, adherence to proper infection control procedures, particularly cohorting, can reduce COVID-19 infections, even in facilities with high percentages of high-risk residents (non-white and dementia).
Hospital in Home COVID-19 Monitoring: A Novel Approach to Keeping a Watchful Eye on Older Adults
Authors: Cooney Alissa , Serra Monica , Lee Monica , Oakman Kimberly , Medlin Laura , Ahuja Sunil , Restrepo Marcos , Sanchez-Reilly Sandra
Published: December 2021

Older adults suffering from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are at increased risk of death and hospitalization-related complications. The coronavirus disease 2019 (COVID-19) pandemic has forced adaptations in Telehealth, allowing COVID-19 patients to be managed at home. Traditionally, Hospital in Home (HIH) patients have better clinical outcomes and lower mortality compared to similar hospitalized patients. However, effectiveness of HIH for COVID-19 older adults remains unknown. This study examines the effect of age on rates of hospital readmission and overall mortality for patients enrolled in HIH after initial COVID-19 hospital discharge. A HIH COVID-19 monitoring program was developed to facilitate earlier hospital discharge and monitoring. Retrospective data between March 2020 and January 2021 were analyzed. Of the 402 subjects (age:26-99; mean:61.8), 13 (6.1%) subjects <65 years old vs 19 (10%) subjects □65 years old were readmitted to the hospital at least once. Two (0.94%) subjects <65 years old and 12 (6.3%) subjects □65 years old died. Older adults were 1.719 times more likely to be re-hospitalized (p=0.005) and 7.153 times more likely to die (p=0.017) compared to younger adults. Age remains a significant predictor of hospital readmission and mortality in subjects previously hospitalized for COVID-19 even when followed by monitoring programs like HIH. Further studies are needed to determine the best way to reduce hospital readmission and mortality rates for older adults after initial COVID-19 hospital discharge.
How COVID-19 Pandemic Changed Consumption of Fruits and Vegetables by Older Adults
Authors: Monroe-Lord Lillie , Ardakani Azam
Published: December 2021

This study aims to determine the changes in consumption of fruits and vegetables of older adults before and since the COVID-19 pandemic. The data collection was administered by Qualtrics through an online survey conducted in August and September 2020. The total participants were 10,050. Differences between consumption of fruits (fresh, canned, frozen) and vegetables (carrots, sweet potatoes, broccoli, spinach) before and since COVID-19. Date were analyzed using the Wilcoxon’s signed-rank test. Among participants, 5,767 females (57.4%) and 4,283 males (42.6%) and the average age of 62.09 (SD=11.22). 7.1% were Asian (N=701), 4.3% were Hispanic (N=429), 14.1% were African Americans (N=1393), and 74.5% were White (N=7,390). For total participants, consumption of fruits decreased significantly (p<0.001) since COVID-19. The decrease in consumption of fruits was larger in females (p<0.001) than males (p=0.026). It is likely because consumption of fruits by males was already low before the pandemic at 27% of the amount consumed by females. The decrease in consumption of fruits was not statistically significant in Asian (p=0.096) and African American (p=0.07), but significant in Hispanic (p=0.008) and White (p<0.001) participants. African American and Hispanic participants consumed a lower number of fruits before the pandemic compared to Asian and White participants. Consumption of vegetables had no significant change since COVID-19 for total participants regardless of gender and race. This study reported a significant decrease in the consumption of fruits, but not vegetables by older adults since COVID-19 pandemic.
Whole Team, Whole Person High-Involvement Quality Improvement Training for VA Community Living Center Leaders
Authors: Snow A Lynn , Clark Valerie , Zhao Shibei , Engle Ryann , Ott Corilyn , Nash Princess , Minor Lisa , Hartmann Christine
Published: December 2021

Long-term care is a challenging environment for quality improvement due to the high resident acuity, wide variation in resident needs, and wide variation in types and backgrounds of the large staff across three daily shifts. We report results from a learning collaborative undertaken to improve care quality and staff quality improvement skills in the VA CLCs through development of high functioning relationally coordinated teams operating in accord with person-centered care principles. The collaborative included 27 CLCs. Over 9 months leadership teams completed action assignments supported by 5 workshops and regular group coaching calls. Evaluation included fidelity monitoring (attendance, mid- and final progress reports), satisfaction questionnaires, and review of the VA quality measures (CLC Compare). Pre-post participant evaluations revealed a significant increase in positive responses to the question “to what extent do you think applying these new skills/knowledge will improve quality in your CLC?” and positive responses trending toward significance in ratings of abilities to apply new skills. Open-ended survey comments were positive and indicated change in understanding and practice: “utilizing the daily huddle to facilitate real time communication afforded the team a proactive approach to providing care and reducing acute exacerbations. We are able to avert, evaluate as a real time team and make it happen in the now not as a look back.”; “definitely unified front-line staff and CLC leadership.” Some changes were achieved in CLC Compare quality scores (e.g., falls with major injury rate had a 9.6 reduction (average rate = 3.39 pre, 3.07 post)).
Trends in Delirium Rate Across 14 Hospitals During the COVID-19 Pandemic: A Comparative Study.
Authors: Khan Ariba , Klumph Marianne , Schwank Alexander , Malone Michael , Sabih Asma
Published: December 2021

During the COVID-19 pandemic, strategies to prevent delirium in the hospital were limited due to restrictions in staff and visitor policies. Thus, we suspected the delirium rate may increase during the pandemic. This study aimed to investigate the trends in delirium rate over past 2-years and compare this trend prior-to-and-during the COVID-19 pandemic in hospitalized older adults. Data was retrospectively obtained from the Acute-Care-for-Elders Tracker snapshot, an electronic health record tool to identify the presence of delirium within 48hrs of hospitalization for patients ≥65 years. Periods of interests were 3/2019-6/2019 (pre-COVID) and 3/2020-6/2020 (during-COVID). A weighted rate was calculated for each month by combining data from all hospitals for the total number of inpatients ≥65 years. The overall trend in the delirium rate was assessed with simple linear regression models and an ANCOVA. A χ2 and a Wilcoxon-Signed-Rank-Test were utilized to test for differences in the overall delirium rate between two time periods. Overall median delirium rate was 6.8% in 70,562 encounters of 42,878 patients (mean age= 78 years; mean length-of-stay= 6.5 days). The median delirium rate increased by 2.1% (6.6%to8.6%), for pre-COVID vs. during-COVID, respectively (Z=-3.044,p<0.001). There were no significant differences between actual and projected weighted delirium rates (p=0.18). However, the weighted delirium rate—for both the actual and projected trend lines—demonstrated significant changes over time (p<0.001).The trend in delirium rate increased over the study time period regardless of the pandemic. Further analyses with longer time-frame are crucial to understand the consequences of the pandemic on delirium rate.
Nursing Home Satisfaction Surveys: Differences by Race, Age, and Gender
Authors: Castle Nicholas , Harris John , Wolf David
Published: December 2021

Nursing home satisfaction information has gained substantial traction as a quality indicator representing the consumers perspective. However, very little research has examined differences in satisfaction related to race, age and gender. As a quality metric, satisfaction measures are variously used for quality improvement, benchmarking, public reporting, and for adjustment to payments. As such, valid comparisons among facilities are important. To our knowledge, no adjustment to satisfaction scores are currently used for nursing homes. However, in many other settings this is a common practice. In this research, nursing home resident, family, and discharge satisfaction scores were examined from >4,000 participants. The data were collected in 2020 and come from 420 facilities. Satisfaction information came from the CoreQ surveys, which include 23 individual questions four of which can be combined to produce an overall satisfaction score. These CoreQ nursing home surveys are endorsed by NQF. Generally lower overall satisfaction scores were found for family members compared to current residents or discharged residents. Minorities (Black, Asian, Hispanic) had lower overall satisfaction scores compared to whites; however, the differences were not significant at conventional levels. Participants of the lowest age (<65 years) were significantly (p=<.05) less satisfied than older participants (>75 years) and males were significantly (p=<.05) less satisfied than females. The findings indicate that some case-mix adjustment may be applicable for nursing home satisfaction scores.
COVID-19 and Age-Friendliness in Higher Education
Authors: Beaulieu Celeste , Silverstein Nina , Bowen Lauren , Whitbourne Susan , Montepare Joann
Published: December 2021

During the COVID-19 pandemic, universities have changed to an online or hybrid format. These changes provide the opportunity for universities to be more accessible for all individuals. However, the logistics of university life during a pandemic has exposed significant and potentially enduring challenges and opportunities for designing and maintaining an Age-Friendly University. This study investigates perceptions of students, faculty, and staff in the lens of an age friendly university during the COVID-19 pandemic. This study draws on qualitative and quantitative data from over 10,000 faculty, staff, students, and life-long learners from 26 universities. Five items were asked to constituent groups about their perceptions on their university’s response to COVID-19. Overall, students had the poorest average perception of satisfaction with their university’s overall response to the pandemic, with 62% satisfied compared to 74% and 73% of faculty and staff, respectively. Further, 77% of faculty think the university’s response to continuing education accommodated their needs, compared to 69% of students. Respondents from private universities reported more positive satisfaction than respondents from public universities (M=4.23, SD=0.94; t(df=7405)=6.805, p<.001). Qualitative data suggest that older students and faculty needed more technological assistance during this transition to primarily online learning to keep older members involved in the community. Older staff felt that they were more likely to be furloughed and were the group most likely to not have a choice in working on or off campus.
Telehealth as an Element of Home and Community-Based Services in a Pandemic: An Intrinsic Case Study in Two Rural Areas
Authors: Karlin Nancy , Weil Joyce
Published: December 2021

COVID-19 has changed the face of health care delivery. Using technology as a way to ensure Home and Community-Based Services (HCBS) as an option for older adults in rural areas is of increasing interest as a result of the pandemic. Literature suggests older adults do not adopt telehealth and/or medicine practices due to barriers (e.g., Internet and computer availability) and do not use telemedicine as a form of communication with medical staff. However, the combination of needing health care during the pandemic and having federal coverage via Medicare for telehealth virtual visit. Still studies suggest older adults may lack the necessary information about how to adopt telehealth and telemedicine and that they do not see their benefits. Additionally, the cost of technology, limited Internet access and rural connectivity issues persist. This study evaluates the potential for telehealth/medicine use in rural communities through two case studies of rural older persons in the Eastern Plains of Colorado and rural Western Nebraska. Results indicate, for older persons responding to the telehealth/medicine questions, there is support for its potential use with some using teleconferencing, health portals, along with the expectation that telehealth/medicine would be part of new health care systems. Resistance was met by some older adults in the Colorado sample who preferred face-to-face contact alongside other concerns about potential usage barriers such as the lack of Internet services or consistent connectivity. These participants indicated a lack of awareness in finding out how to access this form of medical support.
The Impact of COVID-19 on Older Adults
Authors: Ungar Rachel , Tkatch Rifky , Huang Jane , Kraemer Sandra , Schaeffer James , Yeh Charlotte
Published: December 2021

Background: The onset of the COVID-19 pandemic has dramatically influenced the health and well-being of older adults. Changes in lifestyle patterns has required reframing communication habits and learning new skills to maintain social connections and access healthcare. Objectives: To assess 1) well-being measured prior to and during the COVID-19 era; and 2) use and comfort level of technology for social interactions and telehealth visits during this time. Methods: A mailed survey to a randomly selected national sample (>65) during the summers of 2018, 2019, and 2020. Measures included mental and physical well-being and various psychosocial measures. For 2020, questions related to COVID-19 and the use of technology were included. Results: A total of 4,696 (2018), 3,976 (2019) and 2,726 (2020) responded to these surveys (response rate ~27%). Overall, most constructs remained stable despite the ongoing pandemic. Most respondents reported average or high resilience (90%), high purpose (48%), stable social networks (76%), and low stress (55%). However, loneliness increased during 2020 (57%). Respondents who used technology were more likely to connect with family and friends. Only 43% reported high comfort with using technology, with older age (>75) less comfortable. At the time of the survey 37% had not seen a healthcare provider through telehealth services, and 15% felt their healthcare needs were not met by a telehealth experience. Conclusion: Results demonstrate that respondents were doing well during COVID-19. Yet increases in loneliness and greater technology needs to stay socially connected and to access healthcare may result in negative long-term health outcomes.
Older Adults’ Worry about COVID-19: Associations with Experiences of COVID-19 Among Social Connections
Authors: Leggett Amanda , Koo Hyun Jung , Kobayashi Lindsay , Finlay Jessica , Lee Hannah , Baker Elaina
Published: December 2021

The COVID-19 pandemic has challenged the physical and mental health of older adults, yet it is unknown how much older adults worry about their own exposure. As older adults are at increased risk for severe complications from COVID-19, understanding patterns of worry may inform public health guidelines and interventions for this age group. We investigated older adults’ worry about COVID-19 in the early months of the pandemic and associations with familial/friend’s diagnosis or disease symptoms. Data comes from the baseline (April/May 2020), one-month, and two-month follow-up surveys from the COVID-19 Coping Study, a national longitudinal cohort study of US adults aged ≥55. We used linear regression models to investigate the association between self-reported familial/friend diagnosis or symptoms with pandemic worry, accounting for demographic factors and individual diagnosis or experience of COVID-19 symptoms. Participants (Baseline=4379, 1 month= 2553, 2 month=2682) were 67 years old on average, 72% were female, 5.7% were non-White, and 80.5% had a college degree. At baseline, 26.6% of participants had friends or family who had been diagnosed or experienced symptoms of COVID-19. Having friends or family diagnosed or with symptoms of COVID-19 (B=0.08, SE=0.04, p<.05), being female (B=0.42, SE=0.03, p<.001), and having higher educational attainment (B=0.06, SE=0.02, p<.001) were significantly associated with greater worry about COVID-19. These associations were consistent over 3 months. Understanding if worry about the pandemic correlates with following public health guidelines is a key next step so intervention strategies can prioritize older adults and their social networks.
Prevalence of social isolation before and during the COVID-19 pandemic: A nationwide web-based survey in Japan
Authors: Murayama Hiroshi , Okubo Ryo , Tabuchi Takahiro
Published: December 2021

The coronavirus disease 2019 (COVID-19) pandemic is assumed to have increased the number of socially isolated older adults. Public health researchers and policymakers are concerned about the deleterious effects of social isolation on individuals’ health. However, there is only limited evidence on the prevalence of social isolation. This study investigated the change in prevalence of social isolation caused by the spread of COVID-19 and examined various associated factors. Accordingly, data from the JACSIS study, a nationwide cross-sectional web-based questionnaire survey (N=28,000, age: 15–79 years) conducted in August–September 2020 (during the pandemic) were analyzed. The respondents who contacted family members, friends, or neighbors less than once a week were considered socially isolated. We examined individuals’ frequencies of contact, including meeting in person, e-mail/text message, voice call, and video call, in January (before the pandemic; recall question) and August 2020. The weighted prevalence values of social isolation were 26.8% (26.0%–27.5%) in men and 15.8% (15.1%–16.4%) in women before the pandemic and increased to 34.4% (33.6%–35.2%) and 21.4% (20.7%–22.1%), respectively, during the pandemic. Further, compared to the younger age group, the increase in prevalence during the pandemic was greater for the older age group for both genders. Multinomial logistic regression analysis revealed that those who came to be socially isolated during the pandemic possessed a greater fear of COVID-19 than those who were not continuously socially isolated. These findings suggest the necessity of developing immediate measures for social isolation and risk communication regarding COVID-19.
Villanova ReachOut Forming Connections with Older Adults
Authors: Whitehouse Christina , Curley Catherine , Gomes Caitlin , McKay Michelle , Brewer Christine , O'Connor Melissa
Published: December 2021

Older adults are at increased risk for loneliness and social isolation. Research on loneliness identifies increased rates of depression, increased cognitive decline, and poor cardiovascular health outcomes. The COVID-19 pandemic forced many older adults into social isolation for protection against this insidious virus. Mandated lockdowns and personal decisions to shelter-in-place produced a tremendous increase in rates of loneliness, especially among older adults. Identifying a need for communication and relationships, we created Villanova ReachOut, a program that partners interprofessional students (N= 66) with older adults (N=53) through weekly telephone or video calls. To assess the impact of our program we developed a five question survey administered via phone to older adults and a 13-item survey for volunteers to assess training, satisfaction, needs and impact of the program. Of the older adults (n=16) who completed the survey, 78.6% believe the program helped them feel less isolated throughout the pandemic and 93.8% indicated they looked forward to weekly calls with their partner . Volunteers who completed the survey (N=25), overwhelmingly stated they enjoy and look forward to their calls (100%) and their communication skills have improved (92%). Volunteers reported being paired up with an older adult for weekly conversation had a positive impact on their personal and professional development. Findings from our program evaluation provide rich data in descriptions of positive impact for both the older adult and volunteer. These findings also support the need for programs that engage in intergenerational dialogue, specifically targeting older adults and the potential older adult workforce.
Development and Psychometric Testing of Coding Scheme for Dementia Family Communication Using Video Observation
Authors: Kim Sohyun
Published: December 2021

Understanding communication behaviors between persons living with dementia and family caregivers is essential for meaningful social interaction and decrease problematic behaviors and caregiving burden. The purpose of this study was to develop and test the psychometric properties of a coding scheme for dementia care interactions. The coding scheme items were developed from literature and expert review, and the pilot testing on 16 video-recorded interactions. A secondary analysis was conducted using 77 videos from 21 dyads of dementia family interactions naturally occurred in the participant’s home. The final coding scheme consists of 11 codes for persons living with dementia (6 nonverbal and 5 verbal) and 12 codes for family caregivers (7 nonverbal and 5 verbal). Content validity was excellent (I-CVI = .93, S-CVI/UA = .71, S-CVI/Ave = .93 with 6 experts). Inter-item correlation was acceptable for both caregiver codes (positive nonverbal = .21, positive verbal = .15, negative nonverbal = .36, negative verbal = .29), and patient codes (positive nonverbal = .13, positive verbal = .27, negative nonverbal = .15, negative verbal = .18). Intra-rater reliability (Cohen’s Kappa = .83, percentage of agreement = 83.88%) and inter-rater reliability (Cohen’s Kappa = .81, percentage of agreement = 81.75%) were excellent. Findings suggest the preliminary psychometric properties of the newly developed coding scheme to assess dyadic interactions of persons living with dementia and their informal caregiver in-home care situations. Future testing of the coding scheme for application in communication interventions to improve quality social interaction in dementia care is discussed.
Findings from Community Workshops Designed to Help Expand Arizona's Dementia Capable System
Authors: Coon David , Angulo Aylin , Cortes Marielysse , Carbajal Berta , Stotler Kassey , Weatherall zenya , Goldman jami
Published: December 2021

Among the 5.8 million people living with Alzheimer’s disease (AD), there are three vulnerable groups where community partners can join efforts to serve the community more comprehensively. These include (a) people living alone with Alzheimer’s disease and other related dementias (ADRD) who may or may not have a family caregiver, (b) people with Down Syndrome or another intellectual or developmental disability aging with ADRD and their family caregivers, and (c) people with ADRD and their family caregivers in the Latino community. Dementia capable systems are designed to address the needs and concerns of all individuals, families, and communities impacted by ADRD. The project develops and expands ADRD programs and services across Arizona through educational workshops, case management services, and evidence-based programs. Workshops (N=67) were provided to a variety of professionals and community members ranging from promotores/CHW’s (community health workers) and case managers to family caregivers and people living with dementia (N=2,272). Workshops successfully attracted a substantial proportion of Hispanic or Latino/a participants (63%) and women (84.5%). Perception of benefit ratings were overwhelmingly positive with over 90% of participants agreeing or strongly agreeing that: the workshops met expectations; they were willing to attend other programs by us; and they learned something they could use. Moreover, based on their workshop experience, they felt more confident that they could help these three underserved populations. Overall, workshops were clearly acceptable to participants and feasible to deliver. In addition, they contributed to an increased awareness in ADRD related to the project’s three target groups.
Rising Geographic Variation in Alzheimer's Disease Mortality
Authors: Franco Yujin , Ho Jessica
Published: December 2021

The burden of Alzheimer’s disease (AD) mortality has increased rapidly, growing by nearly 4- (men) and 6-fold (women) between 1990-2017. Limited attention has been paid to geographic inequalities in AD mortality. This study examines age-standardized AD mortality across 10 regions and the urban/rural continuum among adults aged 65+ using National Center for Health Statistics mortality and population data. We also examine mortality for a broader category, Alzheimer’s disease and related dementias (ADRD), to address potential underreporting. The East South Central has the highest AD death rates and experienced larger increases–5-fold (men) and 7-fold (women)–than the nation as a whole. The Middle Atlantic consistently experienced the lowest AD mortality over the past quarter-century. Differences between the best- and worst-performing regions widened over time. AD mortality was 2.5 times higher in the East North Central than the Middle Atlantic region in 2017 (268 vs. 110 [men] and 374 vs. 147 [women] deaths per 100,000). Rural areas facing health care shortages and socioeconomic deprivation may encounter substantial challenges in addressing rising AD mortality. In several regions, rural disadvantages in AD mortality emerged and widened over time. The largest gaps between nonmetros and large central metros are in the East North Central, South Atlantic, and New England, as well as Appalachia (men) and West South Central (women), with nonmetros having 14-56% higher mortality than big cities. These findings identify the heavy burden of AD mortality in the Southern and rural U.S. and have important implications for health care, service, and caregiving provision.
Self-Experienced Cognitive Function in the Digital Era: Are Older Adults at Risk of Subjective Cognitive Decline?
Authors: Smith Samantha , Splonskowski Moriah , Jacova Claudia
Published: December 2021

Older adults often find it difficult to use everyday technology proficiently. We hypothesized that these difficulties would be exacerbated in those with subjective cognitive decline (SCD), that is, self-perceived worsening of cognitive functions that has been associated with increased risk of future dementia. Here we investigated the relationship between SCD symptom burden and technology proficiency. A nation-wide sample of adults (N=483) ages 50-79 (66.5% female; 14.5% age >70) completed an online survey via a crowdsourcing website, Amazon Mechanical Turk. The survey included the Subjective Cognitive Decline Questionnaire (SCD-Q MyCog) (0-25, M=4.71, SD=5.77), questions about respondents’ proficiency with computer, smartphone, and tablet (4-12, M=9.72, SD=1.97), and the PROMIS depression (M=13.18, SD=6.32) and anxiety (M=13.04, SD=5.68) scales. Linear regression was used to examine the ability of technology proficiency to predict SCD score. We also probed the interaction of technology proficiency with age ( <70 vs. >70 years), and adjusted for covariates. We found that the age/technology interaction (B=-0.80), older age (B=7.49), lower education (B=-1.08), higher depression (B=0.20) and anxiety (B=0.16) symptoms predicted higher SCD burden (R-squared=.16). For respondents >70 years low technology proficiency predicted high SCD burden (B=-.79) whereas for those <70 years no relationship was found. Our study draws attention to older adults’ self-experienced cognitive function in the digital era. The association between low technology proficiency and SCD may signal the adverse impact of the digital era on those who experienced technology only later in life. It is equally possible that declining technology proficiency is an indicator of emerging neurodegenerative disease.
“I’m Getting Older Too”: Challenges and Benefits Experienced by Very Old Parents and Their Children
Authors: Boerner Kathrin , K. Kim Yijung , Gallagher Elizabeth , Kim Kyungmin , Jopp Daniela
Published: December 2021

Very old parents and their “old” children are a growing group in industrialized countries worldwide. Since most very old persons have outlived spouses and friends, their children, many of whom have reached old age themselves, are likely to become their primary social contact and to shoulder the care provision role. However, virtually nothing is known about the nature and implications of this relationship constellation. To fill this gap, the present study explored the challenges and rewards of the very old parent-child relationship. In-depth interviews were conducted with 114 parent-child dyads (parent age ≥ 90; child age ≥ 65). Narrative interview data on challenges and rewards were audiotaped, transcribed, and then systematically reviewed and coded, identifying recurrent themes and defining categories that reflected these themes. While both challenges and rewards were present, more rewards than challenges were reported overall. However, comparing parent and child perspectives revealed that the balance of challenges and rewards was less favorable for children. Narrative data further showed that the sense of burdening their children heavily weighed on at least a fourth of parents, reflecting this as a serious concern not only for children but also for parents. Challenges reported by children were often characterized by references to children’s own advanced age and health problems, and the prolonged caregiving involvement due to their parents’ longevity. Healthcare professionals, policy makers, and families should be made aware of this increasingly common phenomenon, and specific services and policies will be needed to adequately support very old adults and their families.
'We Had More in Common Than I Thought': Scamming as an Undergraduate Service Learning Topic Involving Older Adults
Authors: Getz Marjorie
Published: December 2021

An ongoing activity that cuts across several courses in the Gerontology Certificate Program at our College is the completion of implicit association exercises focused on age. Most college students show a distinct preference for those who are younger adults. It is difficult to get across to these students that the construct of being an adult is appropriate for all people beyond adolescence without relevance to age. College students enrolled in healthcare programs often have distorted views of aging and may not fully appreciate that all adults may share common aspects of their current lives. We describe qualitative analyses of reflections taken from an undergraduate psychology course that included a service learning component involving older adult learners. The service learning lessons focused on victimization associated with fraud and scamming. The classroom structure involved round table discussions with direct contact between college students, older adults and local law enforcement personnel. Reflective practices were used to integrate course content (development in adulthood) into this service learning activity. We report on qualitative data taken from student reflections. Content analyses of reflective essays identified five themes which operated to produce stronger identification between age groups: frequency of being scammed across all 21 participants; insight that learning continues across the lifespan; understanding that broad learning challenges impact people (for different reasons) at both ends of the adult age spectrum; respect for adoption of strategies that facilitate learning/compensate for cognitive changes that occur with aging; acknowledgement that familiarity breaks down barriers between people.
A Massive Open Online Course to Educate Healthcare Professionals & Caregivers About Alzheimer’s Disease
Authors: DiBartolo Mary
Published: December 2021

Over 6 million Americans and 50 million persons worldwide are estimated to have Alzheimer’s disease (AD) as it remains the major cause of dementia in the older adult population. Both healthcare professionals and family caregivers struggle with the complexities of caring for individuals with this progressive neurological disease. To address the ongoing knowledge and care gap regarding Alzheimer’s disease among both healthcare professionals and family caregivers, a comprehensive massive open online course (MOOC) was developed and made available via the edX platform. MOOCs are open access and interactive courses offered via the web; they have emerged as a popular, self-paced mode of distance learning. Launched in 2020, the MOOC titled, Alzheimer’s Disease & Dementia Care, consists of five modules reviewing symptoms, diagnosis, medications, communication and care tips, as well as a module outlining special considerations when the person with AD is hospitalized. While this educational strategy targets healthcare professionals (such as nurses, physical therapists and related practitioners), it is also designed for lay caregivers or anyone who wants to learn more the disease. The course utilizes a variety of teaching modalities and is free. To date over 7000 persons have enrolled from over 140 countries. MOOCs remain an innovative and engaging educational strategy to reach a global audience. More importantly, they can serve as an another outlet to enhance both the competence and confidence of both healthcare professionals and family caregivers by sharing best practices in caring for those with Alzheimer’s disease and related dementias.
Moving Toward an Age-Friendly University: Survey Process of GSU 50+ Students
Authors: da Rosa Grace , Laures-Gore Jacqueline , Barber Sarah , Qureshi Mariam , Burgess Elisabeth
Published: December 2021

The proportion of Georgia’s population that is 60 years and older is growing rapidly. The 2010 U.S. Census Bureau predicted a growth of more than 20% of older adults by the year 2030. Georgia residents who are 62 and older are eligible to take courses at no or little cost at public state colleges. Due to the expected increase in Georgia’s aging population, access to a free university education, and the large number of currently enrolled 62+ students at Georgia State University (GSU), it is crucial that GSU become an Age-Friendly University. During Fall 2019, a survey was distributed to 1046 students aged 50 years plus; 411 completed the survey (39% response rate). This presentation describes the process involved in designing and distributing the survey. Unique aspects of the survey’s development include the cross-generational and interdisciplinary contributions of the student, faculty, affiliates, and staff from GSU’s Gerontology Institute. The goal was to learn more about GSU students 50 years and older by assessing their motivation for attending school, challenges on campus, perceptions of how the university is currently addressing their needs, factors/resources that have helped/are helping them to adjust to school, and the extent to which they experience age discrimination on campus. The long-term goal of the survey is to use this information to direct GSU in becoming an Age-Friendly University.
Now What? Maintaining Momentum after Achieving Designation as an Age-Friendly University
Authors: Martin Diane , Brandt Nicole , Orwig Denise , Resnick Barbara , Mansour Daniel , Galik Elizabeth , Schumacher John , Upton Meredith
Published: December 2021

The Age-Friendly University (AFU) designation in higher education recognizes the institution’s commitment to a culture of age-inclusivity across programs and policies. While AFU institutions are embracing the demographic shifts in higher education and society at-large, effectively responding to the needs and desires of an increasingly older population requires ongoing acceptance and support from campus leaders to maintain momentum and stay relevant within a dynamic field. This session will describe the intentional and systematic approach utilized by an AFU steering committee to build interest in and develop meaningful collaborations in multiple domains across campus, including at the level of the president. Our initiatives focus on five themes that align with the 10 age-friendly university principles: support for workforce development, broadening community engagement, expanding engagement in aging research and dissemination, addressing barriers related to aging and our physical environment, and facilitating age-friendly efforts across our state. We will present our experiences in expanding awareness of and support for the AFU movement on our campus and share a model for institutions seeking ideas for sustainability of their own initiatives.