bluuebunny/crossref_metadata_2025 huggingface dataset:
Trials and Tribulations: Palliative Care Trial Recruitment Approaches and Challenges
Authors: Enguidanos Susan , Rahman Anna , Lomeli Sindy
Published: December 2021

In 2017, we received funding form the Patient-Centered Outcomes Research Institute to conduct a large, state-wide, randomized controlled trial to test the effectiveness of a home-based palliative care (HBPC) program within accountable care organizations. Participants were randomized to either HBPC or enhanced usual care, where physicians were provided added training and support in core palliative care practices. Originally, we planned to obtain patient referrals to the trial from primary care physicians, however we were unable to engage primary care physicians in patient identification processes. In this session we will describe the numerous trial modifications made to our trial recruitment methods and the success of each approach. Ultimately, after 20 months of trial recruitment, we had recruited just 28 patients and 10 of their caregivers. Findings from this terminated trial may inform other researchers in development of participant recruitment methods.
Presidential Symposium: Social Engagement, Isolation, and Loss During the COVID-19 Pandemic
Authors: Antonucci Toni , Umberson Debra , Carr Deborah
Published: December 2021

The COVID-19 pandemic has transformed social life across the globe and had a particularly profound impact on older people. In this BSS Presidential Symposium, we address the annual meeting’s theme—Disruption to Transformation: Aging in the “New Normal”—by inviting noted experts to address implications of the COVID-19 pandemic for social engagement and isolation. The speakers address this theme from sociological, psychological, demographic, and public health perspectives with attention to racial disparities and the impact of the pandemic on patterns of isolation and loneliness in the population, methods for conducting research with older populations, patterns of bereavement and loss of family ties, and caregiver mental health. The panel will shed light on these issues through individual presentations and dialogue.
Using the Adaptive Leadership Framework for Chronic Illness to Design a Palliative and Collaborative Intervention
Authors: Bryant Ashley Leak , Becantur Stephanie , Chan Ya-Ning , Hirschey Rachel , Baernholdt Marianne , Anderson Ruth
Published: December 2021

Our study addresses symptoms and functional management early in acute myeloid leukemia treatment using a PAlliative and Collaborative Care inTervention (PACT) delivered by clinical staff. PACT is an interdisciplinary nurse-led intervention of nursing [RN], occupational therapy [OT], physical therapy [PT] for adults ≥ 60 years of age at time of initial treatment. Finding from our preliminary qualitative work led to use of the Adaptive Leadership Framework for Chronic Illness to guide optimal engagement of the patient in self-management of symptoms and functional activities to address QOL outcomes. We share lessons learned of how the ALFCI was applied to the PACT intervention to empower patients with self-management skills to reduce symptoms and optimize function. In summary, the team and patient identify and address emotional, motivational, attitudinal barriers so that the patient can do the work required for self- management to reduce symptoms and avoid functional decline.
Impact of Vision and Hearing Impairment on Cognition and Loneliness: Evidence From the Mexican Health and Aging Study
Authors: Hreha Kimberly , Samper-Ternent Rafael , Downer Brian , Ehrlich Joshua , Downer Paige , Reistetter Timothy , Whitson Heather
Published: December 2021

Poor vision and hearing have been associated with lower cognitive function and greater social isolation (i.e., loneliness) among older adults. However, this evidence is based largely on data from non-Hispanic populations. Therefore, we investigated whether self-reported vision and hearing was associated with cognitive function and loneliness in a nationally-representative study of Mexican adults aged 50 and older in Wave 3 of the Mexican Health and Aging Study. The final sample included 12,426 participants. The majority were female (58%), and the mean age was 67. Self-reported vision and hearing status were categorized as excellent-very good [ref], good, and fair-poor. Measures for global cognition, memory, and non-memory cognition were calculated using z-scores based on nine cognitive tests. Participants who reported frequently feeling a lack of companionship, left out, or isolated were categorized as feeling lonely. All analyses controlled for age, sex, and years of education. Participants with fair-poor vision had lower global (β= -0.06, p <.01), memory (β= -0.07, p <.01), and non-memory cognition (β= -0.06, p <.01) than participants with excellent-very good vision. In addition, participants with fair-poor hearing had higher non-memory cognition (β= 0.03, p <.05) but not global cognition (β=0.02) or memory (β=0.001). Fair-poor vision (OR=1.53, 95% CI=1.25-1.87) but not fair-poor hearing (OR=1.16, 95% CI=0.97-1.38) was associated with higher odds of being lonely. Poor vision may be a potentially modifiable risk factor for lower cognition and loneliness among Mexican adults. Future research should incorporate robust measures of sensory health and investigate the longitudinal association between vision, cognition, and loneliness.
Challenges in Implementing Evidence-Based Dementia Care Programs in Community-Based Settings: ADS Plus
Authors: Gaugler Joseph , Marx Katherine , Parker Lauren , Anderson Keith , Dabelko-Schoeny Holly , Johnson Elma , Albers Elizabeth , Gitlin Laura
Published: December 2021

The Adult Day Service Plus Program (ADS Plus) augments the usual care provided by ADS programs by integrating education, referrals, and problem-solving strategies for family caregivers of persons with dementia. Utilizing a mixed-methods, hybrid effectiveness design, we were in the process of conducting a national evaluation of ADS Plus across xx geographically and culturally diverse programs across the U.S. when the COVID-19 pandemic resulted in the shutdown of almost all of the programs participating in ADS Plus. Qualitative and quantitative data collected during the evaluation suggested that a more robust incorporation of implementation domains and measures (e.g., organizational readiness to change) may have helped avoid some of the challenges related to staff training, fidelity, and other critical intervention delivery aspects. Incorporating implementation science frameworks and measures as early as possible in intervention design may have helped to overcome some of the challenges experienced in ADS Plus.
Mediating Role of Loneliness on Stigma and Depressive Symptoms Among Older Persons Living With HIV
Authors: Yoo-Jeong Moka
Published: December 2021

Studies have shown associations among stigma, loneliness, and depressive symptoms in older persons living with HIV (OPLWH) but research assessing the mediating pathway among these variables is lacking. As such, the aims of this study were to assess the association between stigma and depressive symptoms and to test the mediating effects of loneliness. A sample of 146 OPLWH (50 years of age and older) recruited from an outpatient HIV clinic in Atlanta, GA, completed a cross-sectional survey. Mediation analysis, guided by Baron and Kenny’s (1986) criteria, was conducted using Stata v14.2 to assess the direct and indirect effects of loneliness on the association between stigma and depressive symptoms while controlling for covariates (self-rated health [0=poor to fair, 1=good to excellent]; past unstable housing [0=No, 1=Yes]; and HIV disclosure status [0=to none; 1=to someone]). Loneliness mediated the association between stigma and depressive symptoms (β=0.79, SE=0.23, p < .001). The model reflected a very good fit (χ2=0.09, p=.765; CFI=1.00, TLI=1.09, RMSEA < 0.001) and explained 27% of the variance in loneliness and 33% of the variance in depressive symptoms. Stigma predicted higher loneliness, which in turn predicted more depressive symptoms. Findings suggest that addressing depressive symptoms in OPLWH may require multifaceted interventions targeting psychosocial and interpersonal factors including stigma and loneliness.
Vision Difficulty and Engagement in Care Among Aging Men Living With HIV
Authors: Abraham Alison , Tong Weiqun , Stosor Valentina , Friedman Mackey R , Detels Roger , Plankey Michael
Published: December 2021

For aging adults living with HIV (AALH) who have complex medical care needs, vision impairment may be an added burden that may lead individuals to disengage from their own medical care. We examined the relationships of self-reported vision difficulty with indicators of care engagement: 1) adherence to HIV antiretroviral therapy (ART; defined as taking ≥95% of medications); 2) self-reported avoidance of medical care; 3) self-reported tendency to ask a doctor questions about care (> 2 questions at a medical visit). A modified version of the National Eye Institute vision function questionnaire was administered at three semi-annual visits (from October 2017 to April 2018) to assess difficulty performing vision-dependent tasks (no, a little, moderate to extreme difficulty). We included 1063 AALH participants (median age 60 years, 24% Black). Data were analyzed using repeated measures logistic regression with generalized estimating equations adjusted for fixed race, and at visit values for age, education level, depressive symptoms, alcohol use, and smoking status. Compared to no vision difficulty, those reporting moderate to extreme vision difficulty on at least one task (18%) had 1.95 times higher odds (95% CI: 1.36, 2.79) of having less than optimal ART adherence and 1.92 times higher odds [95% CI: 1.06, 3.47]) of avoiding necessary medical care, but 1.6 times higher odds [95%CI: 0.93, 2.72] of asking more questions. These findings suggest that vision impairment plays a role in medical care engagement among older adults living with HIV, and may contribute to poorer management of HIV and chronic comorbidities.
Findings on Loneliness, Telehealth, and Advance Care Planning From the National Poll on Healthy Aging
Authors: Solway Erica , Kirch Matthias , Singer Dianne , Kullgren Jeffrey , Lampkin Cheryl , Keenan Teresa , Bryant Alison , Malani Preeti
Published: December 2021

The University of Michigan National Poll on Healthy Aging (NPHA) taps into the perspectives of older adults to inform health care policy and practice using a nationally representative sample of more than 2,000 adults age 50-80. Questions about lack of companionship and feelings of loneliness were tracked over three time points; 34% expressed feelings of loneliness in October 2018, 41% in June 2020, and 37% in January 2021. The NPHA also found that use of telehealth increased from 4% in May 2019 to 30% in June 2020 to 43% in January 2021. Finally, the NPHA found that 37% have completed both medical durable power of attorney and advance directive with 7% completing at least one of these documents in the first three months of the COVID-19 pandemic. These poll results can be used to inform actions by coalitions and organizations to advance state and federal policy.
Caregiving Challenges During the COVID-19 Pandemic: Findings From the National Poll on Healthy Aging
Authors: Leggett Amanda , Carmichael Alicia , Leonard Natalie , Jackson Jeannette , Solway Erica , Kirch Matthias , Singer Dianne , Gonzalez Richard
Published: December 2021

The COVID-19 pandemic posed new challenges for caregivers. This study examines the prevalence of pandemic care challenges (e.g., decreasing care to reduce virus spread, difficulty accessing medical care) and their associations with caregiver mental health and interpersonal well-being in a nationally representative sample of 311 caregivers who participated in the June 2020 National Poll on Healthy Aging. We consider seven care challenges and supports as key predictors of caregiver mental health (care-related stress, self-reported mental health, three depressive symptoms) and interpersonal well-being (lack of companionship, isolation) in bivariate tests and ordinary least squares regressions. Each care challenge/support was endorsed by between 13-23% of caregivers. Difficulty getting needed medical care was the most predictive challenge associated with increased caregiver stress, depressive symptoms, and worsened interpersonal well-being. All care challenges predicted an increase in caregiver stress. Effective caregiver tools and supports must consider changing policies and care needs, especially during a pandemic.
Efforts by the National Alliance for Caregiving
Authors: Whiting C Grace
Published: December 2021

The National Alliance for Caregiving (NAC) conducts research, does policy analysis, develops national best-practice programs, and works to increase public awareness of family caregiving issues. In addition to national research and advocacy, NAC provides technical assistance to a national network of caregiving coalitions representing nearly 30 states. NAC recognizes that family caregivers provide important societal and financial contributions toward maintaining the well-being of those in their care. The need to support the nation’s nearly 53 million family caregivers and sustain them as the backbone of our chronic and long-term care system is a central issue in national and state efforts to reform healthcare, especially in light of the challenges presented by the COVID-19 pandemic. This presentation will provide information on the current status of these national and state efforts.
Impact of Structural Ageism on Greater Violence Against Older Persons: A Cross-National Study of 56 Countries
Authors: Chang E-Shien , Monin Joan , Zelterman Daniel , Levy Becca
Published: December 2021

Violence directed against older persons is recognized as a global health problem. However, structural drivers for violence remain under-studied. This country-level ecological study aimed to examine a previously unexplored link between structural ageism and violence against older persons. Following extensive structural stigma literature, structural ageism consisted of two components: (1) discriminatory national policies related to older persons’ economic, social, civil, and political rights, gathered from global databases including UN, WHO, and others; and (2) societal-level prejudicial social norms against older persons, measured by negative attitudes toward older persons by the World Values Survey. Two components were z scored and combined such that higher score indicated greater structural ageism. Prevalence rates of violence per 100,000 persons aged 70 and over in each country were drawn from the Global Burden of Diseases Study. Final analysis included 56 countries, representing 63% of the world’s aging population aged 60 and over across all six WHO regions. As predicted, structural ageism was significantly associated with the prevalence rates of violence in multivariate models (β =205.7, SE=96.3, P=.03), after adjusting for country-level sociodemographic and health covariates. Three sets of sensitivity analyses supported the robustness of our findings. That is, structural ageism did not predict other types of violence and other types of prejudice did not predict violence against older persons. Public health and population-based violence prevention policies may benefit from a targeted approach that tackles the harmful effects of structural ageism.
Mental Disorders Forecast Alzheimer’s Disease and Related Dementias in 1.7 Million New Zealanders
Authors: Richmond-Rakerd Leah , D'Souza Stephanie , Milne Barry
Published: December 2021

Neurodegenerative conditions, including Alzheimer’s disease and related dementias (ADRD), have an outsized impact on disability and loss of independence in older adults. As such, there is a growing need to identify modifiable risk factors for ADRD at the population level. We conducted a nationwide administrative-register study to investigate mental disorders as a potential preventable risk factor for later-life ADRD. Data were drawn from the New Zealand Integrated Data Infrastructure, a collection of whole-of-population administrative data sources linked at the individual level by a common spine. We identified all individuals born in New Zealand between 1928-1967 and followed them for three decades (N = 1,711,386; observation period = 1988-2018; age at baseline = 21-60 years). Diagnoses of mental disorders were ascertained from public-hospital records. Diagnoses of ADRD were ascertained from public-hospital records, mortality records, and pharmaceutical records. Individuals with a mental disorder were at elevated risk for developing Alzheimer’s disease and related dementias relative to those without a mental disorder. This prospective association was evident in both men and women, across age, and after accounting for pre-existing physical diseases. If associations are causal, ameliorating mental disorders could extend population healthspan and reduce the societal burden of neurodegenerative diseases.
Healthy Lifestyle and Social Network Prolong Disability-Free Survival in Older Adults With Diabetes
Authors: Shang Ying , Wu Wei , Dove Abigail , Guo Jie , Welmer Anna-Karin , Rizzuto Debora , Fratiglioni Laura , Xu Weili
Published: December 2021

Aim: We aimed to estimate the extent to which diabetes shortens disability-free survival, and identify which factors may prolong disability-free survival in older adults with diabetes. Methods: A total of 2,216 disability-free participants aged ≥60 were followed up to 15 years. Diabetes was ascertained through antidiabetic drug use, medical records, or HbA1c ≥ 6.5%. Disability-free survival was defined as the survival until the occurrence of disability. Data on behaviours (healthy vs. unhealthy), leisure activities (active vs. inactive), and social network (moderate-to-rich vs. poor) were collected at baseline. A favourable (vs. unfavourable) lifestyle profile was defined as the presence of at least one of healthy behaviours, active engagement in leisure activities, and/or moderate-to-rich social network. Data were analysed with Cox regression and Laplace regression. Results: During the follow-up, 1,345 (60.7%) participants developed disability/death. Diabetes was related to the outcome (HR 1.29, 95% CI 1.06–1.57), and shortened 2.15 (1.02–3.27) years of median disability-free survival. Additionally, disability-free survival (95% CI) was shortened by 3.29 (1.21–5.36), 3.92 (2.08–5.76) and 1.66 (0.06–3.28) years for participants with diabetes plus unhealthy behaviours, inactive leisure activities, or poor social network, respectively (reference: no diabetes plus healthy behaviours, leisure activities, or moderate-to-rich social network). Among participants with diabetes, a favourable profile led to a non-significant HR of 1.19 (0.93–1.56) for disability/death and prolonged disability-free survival by 3.26 (2.33–4.18) years than those with unfavourable profile. Conclusions: Healthy lifestyle and/or moderate-to-rich social network attenuates the risk of diabetes on disability/death and prolongs disability-free survival in people with diabetes by 3 years.
COVID Vaccine Rollout for Older Adults in Japan
Authors: Wada Tadashi
Published: December 2021

It has just started in Japan. We will provide detailed information later. The symposium has experts from 8 countries. We will use an interview and dialog format, instead of presentations.
Stress Is a Latent Construct: Exploring the Differential Experience of Stress Among Black Older Adults
Authors: Brown Lauren , Garcia Catherine , Reeves Alexis , Pamplin John , Mitchell Uchechi
Published: December 2021

While evidence highlights the detrimental health consequences of stress exposure for Black Americans, the impact of stress exposure on health varies by the stressor, individual appraisal and coping mechanisms examined. In this study, we aim to explore the differential effects of chronic stress exposure by means of latent class analysis on mental and physical health. Data come from 800 Black older adults ages 52+ from the 2006 Health and Retirement Study. A set of items that include stress exposure, appraisal and coping were used to assess chronic stress burden on anxiety, depressive symptoms and chronic conditions to identify stress and health clusters. Analysis revealed four subgroups, each demonstrated a typological response pattern with the most pronounced health consequences for high stress exposure, appraisal and few or no coping mechanisms. Results show an alternative approach to examining the stress-health link by using a combined person- and variable-centered approach.
ESPO and Academy for Gerontology in Higher Education Section Symposium: A New Normal in Teaching? Incorporating Unconventional and Creative Ideas Into Gerontology Curriculum
Authors: Bouchard Lauren , Su Yan-Jhu , Gugliucci Marilyn
Published: December 2021

This symposium is intended to highlight novel, applied examples and classroom activities in gerontology curriculum. In accordance with the AGHE gerontological education competencies, these authors will provide insightful and fun connections to arts/humanities, popular culture, technology, and current events to inspire conversation, interest, self-reflection, and empathy in the classroom. The first author will discuss social media (e.g., TikTok) as a segue to difficult classroom conversations regarding negative stereotypes and ageism in society. Presenter two will discuss cross-field educational connections between music education and gerontology. Next, presenter three will put present a unique activity regarding technology, homeownership, and retirement with a competitive flair. Presenter four utilizes documentary to encourage empathy in nursing. Finally, presenter five will present a timely class debate regarding United States political office and ageism that is sure to create lively and relevant conversation.
Favorite Activity and Implications for Cognition, Mental Health, and Function in Persons With and Without Dementia
Authors: Regier Natalie , Parisi Jeanine , Perrin Nancy , Gitlin Laura
Published: December 2021

Little is known about the impact of engagement in personally meaningful activities for older adults. This study examines the impact of engagement in one’s favorite activity on cognitive, emotional, functional, and health-related outcomes in older adults with and without dementia. Data were obtained from 1,397 persons living with dementia (PLWD) and 4,719 cognitively healthy persons (CHP) participating in wave 2 of the National Health and Aging Trends Study (NHATS). Sociodemographic characteristics were examined by cognitive status. A multivariate analysis of variance indicated that, for PLWD, engagement in favorite activity was associated with greater functional independence and decreased depression (F(6,1201)=3.01, p<.01, Wilks’s Λ=.985, partial ƞ2=.015). For CHP, engagement in favorite activity was associated with greater functional independence, decreased depression and anxiety, and better performance on memory measures (F(6,4107)=11.46, p<.001, partial ƞ2=.016,). Findings suggest that engagement in personally meaningful activities may have significant and distinct benefits for persons with and without dementia.
How to Publish: Guidance From GSA’s Journal Editors
Authors: Meeks Suzanne
Published: December 2021

Each year he GSA publications team sponsors a symposium to assist authors who wish to publish in GSA’s high impact and influential journals. The first part of the session will include five brief presentations from the editors of The Gerontologist, Innovation and Aging, and the Journals of Gerontology Series A and B plus GSA’s managing editors. We will integrate practical tips with principles of publication ethics and scholarly integrity. The topics will be as follows: (1) Preparing your manuscript: strong and ethical scholarly writing for multidisciplinary audiences, (2) common problems that affect peer review, (3) addressing translational significance and fit to journal expectations, (4) transparency, documentation, and Open Science; and (5) working with Scholar One. Following these presentations, we will hold round table discussions with editors from the GSA journals portfolio. At these round tables, editors will answer questions related to the podium presentations and other questions specific to each journal. Intended audiences include emerging and international scholars, and authors interested in learning more about best practices and tips for getting their scholarly work published.
Defining Translational Significance in Gerontology
Authors: Albert Steven
Published: December 2021

Innovation in Aging requires a statement from authors on translational significance. This requirement forces authors to consider the implications of their research for changing some component of aging. How does the research address a challenge posed by aging bodies, minds, relationships, or societies? The editorial board has developed criteria for assessing translational significance. Translational research must meet at least one of three criteria. It (i) must predict or explain a health or behavioral outcome, (ii) be advanced enough in deployment or development to assess these effects, and (iii) have a clear pathway to large-scale program delivery or change in clinical practice. The criteria rule out some kinds of submissions, such as scale development, single-case studies, or reviews of literature. We use these criteria to structure each article’s required translational significance statement. Rethinking translation may help focus research across the full set of GSA journals.
Profile of Parent-Child Well-Being in Immigrant Families
Authors: Li Mengting , Le Qun , Dong XinQi
Published: December 2021

Earlier caregiving research focused on psychological well-being of either caregivers or care recipients, while less is known about the caregiving pattern with optimal outcome for both caregivers and care recipients. Data were from the PINE and PIETY studies, with 804 parent-child dyads. Depressive symptoms were measured by PHQ-9 with a cutoff of 5 distinguishing happy or depressed. Parent-child dyads were divided into four groups: happy-parent-happy-child (HPHC, n=572, 71.1%), depressed-parent-happy-child (DPHC, n=139, 17.3%), happy-parent-depressed-child (HPDC, n=65, 8.1%), and depressed-parent-depressed-child (DPDC, n=28, 3.5%). Multinomial logistic regression was used to compare the sociodemographic differences among the groups. Compared to the HPHC group, the DPHC group had older parents, more mother-child dyads and lower-income children, the HPDC group had more female children. However, there was no significant difference between the HPHC and the DPDC group. Future research could explore the predictors of parent-child well-being to inform intervention strategies.
Disaster Vulnerability in Long-Term Care: The Importance of Social and Organizational Connections
Authors: Peterson Lindsay , Dobbs Debra , June Joseph , Dosa David , Hyer Kathryn
Published: December 2021

The risks to older adults in nursing homes (NHs) and assisted living communities (ALCs) exposed to disasters are evident in prior research. However, little research has been conducted to understand the factors related to facilities’ vulnerability. This research examined NH and ALC experiences during Hurricane Irma in 2017. Qualitative interviews were conducted with representatives of facilities (N=100), transcripts were analyzed using Atlas.ti version 8. Team members met to reach consensus on codes and major themes and subthemes, which they analyzed using a conceptual model designed to identify factors related to the disaster vulnerability in long-term care (LTC). We found physical factors (e.g. location, physical characteristics) are important, but physical strength is not enough. Multiple social/organizational factors are critical. Results indicate managing a major disaster and protecting LTC residents involve social and organizational connections across a range of groups from staff and family members to emergency mangers and neighborhood associations.
VA Connection Plans: A Whole Health Intervention to Promote Social Connections for Older Veterans
Authors: Peeples Amanda , Hack Samantha , Muralidharan Anjana
Published: December 2021

The Connection Plan intervention was created as a brief intervention to assist older adults experiencing social isolation during COVID-19. Based in Cognitive Behavioral Therapy (CBT), it is designed to help older adults create a “Connection Plan” to cope with distress related to social isolation. In 1-2 sessions, interventionists work with the older adult to create a Connection Plan with three parts: Mind (ways to change negative thoughts), Body (ways to change unpleasant body sensations), and Connections (ways to increase social engagement). Through soliciting feedback from key stakeholders (Veterans and VA clinicians), the Connection Plan intervention was adapted for the VA context. This paper will present this process of creating the VA Connection Plans manual, as well as associated efforts to disseminate the intervention to 900 VA staff and deliver it to 600 older Veterans with (age 50+) and without (age 65+) serious mental illness.
VA Compassionate Contact Corps: A Phone-Based Intervention for Veterans Interested In Speaking With Peers
Authors: Sullivan Jennifer , Gualtieri Lisa , Campbell Maura , Davila Heather , Pendergast Jacquelyn , Taylor Prince
Published: December 2021

The VA Voluntary Service has developed and implemented a new social prescription program called Compassionate Contact Corps which was created during the COVID-19 pandemic when in-home volunteers could no longer enter Veterans’ homes. The program targets Veterans who are lonely, socially isolated or seeking additional social connection. Volunteers and Veterans are matched based on common interests. Trained volunteers provide support by making periodic phone calls. Program referrals are made from VA providers in several clinical programs (e.g. Home-based Primary Care). To date, CCC has been implemented in more than 80 sites in the VA, with 310 volunteers, 5,320 visits, and 4,757 hours spend with Veterans.
Recruitment and Retention Framework for a Timed-Activity Intervention Among Older Latinos With ADRD
Authors: Perez G Adriana
Published: December 2021

Latino participation in ADRD research is essential to advance cognitive health equity. We present results of an adapted framework to increase recruitment and retention of older Latinos with ADRD and caregivers (CGs) in a timed-activity intervention. Framework factors include 3 structures with strategies informed by a Latino Community Advisory Board. For Characteristics of Study Processes, we included linguistically equivalent data collection procedures/measures, scheduled at times most convenient for participants/CGs. Participants were called weekly for questions/guidance with procedures. Intervention sessions built-in additional time to embed Latino cultural values: familismo, personalismo, confianza and respeto. Study Team Infrastructure, included bilingual/bicultural members/students; and trusted community partners to assist with participant referrals. For Preferences and Beliefs Toward Research, we conducted a series of focus groups to understand beliefs about “memory health” and perceptions of ADRD risks. Strategies yielded effective results. We reached our recruitment goal; started a wait-list of interested participants; had zero (n=0) attrition.
Social Engagement and Depressive Symptoms Among Middle-Aged and Older Adults in India
Authors: Banerjee Kasturi , Baker Tamara
Published: December 2021

Social networks and family support are known to have benefits for many older adults globally, and India is no exception. However, the exact nature of the impact of these factors on depression in the Indian population remains largely unexplored. Considering the aging Indian population and changing socio-cultural landscape, it is important to identify the role of social engagement and neighborhood factors in the mental health needs of these older adults. To address this need, this study aimed to identify predictors of depressive symptoms among individuals aged 45+ years from four states in India. Data were taken from the Longitudinal Aging Study in India (LASI) pilot survey in 2010, focusing on the influence social activities, family factors and neighborhood satisfaction variables have on depressive symptomatology. A hierarchical multiple regression analysis was conducted and found that residing in a southern state (Karnataka and Kerala) (β=.178, p<0.05); lower life satisfaction (β= -.261, p<0.05); having more living children (β=.110, p<0.05), less frequently or never visiting friends and relatives (β=.079, p<0.05) and not liking the neighborhood (β=.072, p<0.05) were predictors of depressive symptoms. These findings are consistent with limited extant literature on the importance of family and social engagement as predictors of depressive symptoms in this population. Future research should focus on qualitatively examining the interaction between depressive symptoms and social engagement within this population, thereby helping develop targeted interventions, measure outcomes and long term, community engagement-based prevention programs.
The 2008 Recession and Biological Health: Psychological Well-Being and Social Disadvantage Modify Vulnerability
Authors: Kirsch Julie
Published: December 2021

Racial minorities and educationally disadvantaged experienced more housing loss, unemployment, and financial strain during the 2007-2009 Great Recession. These hardships may heighten stress and amplify persistent and growing health inequities, which were further worsened by the recent COVID-19 pandemic. It is therefore essential to identify factors that contribute to individual differences in vulnerability so that more effective interventions can be implemented, especially in older adult populations who may face unique economic hardships tied to age discrimination. According to the reserve capacity model, higher levels of psychosocial resources, including psychological well-being, can protect against the negative health outcomes related to heightened stress exposure. This study tested the intersections between recession hardship, pre-existing vulnerability defined as racial and educational disadvantage, and psychological well-being as predictors of biological indicators of chronic allostatic load. Chronic allostatic load was assessed with cardiovascular reactivity and recovery to acute mental stress and systemic inflammation (basal indicators of C-reactive protein and interleukin 6). Biological data came from a national sample of adults known as the Midlife in the US Study (MIDUS; age = 25-75, N=863) that completed assessments after the recession. Multiple regression models revealed that more widespread recession hardship predicted greater biological dysregulation. Tests of three-way interactions revealed that the association between recession hardship and biological dysregulation was strongest among respondents with combined disadvantages of low educational status and low levels of psychological well-being. This study connected a major economic event to individual variation in health vulnerability and identified potential biological pathways to future disease outcomes.
Social Relationships in Older Adulthood and Links With Psychological and Physical Well-Being
Authors: Willroth Emily , Hill Patrick
Published: December 2021

Positive social relationships are fundamental to psychological and physical well-being across the lifespan. This symposium showcases rigorous daily-diary and longitudinal investigations that (a) examine change in social relationships and loneliness in older adulthood, and (b) investigate links between social relationships and psychological and physical well-being outcomes in older adulthood. First, we present results from a coordinated analysis of three longitudinal studies demonstrating that loneliness tends to increase across the second half of life (Talk 1). Second, we share converging evidence that suggests positive social relationships tend to decline with age. In turn, these longitudinal changes in loneliness and social relationships predict later physical health outcomes (Talk 2). Together, these findings suggest that positive social relationships tend to decrease and loneliness tends to increase with age, resulting in physical health costs. In the second half of the symposium, we turn to research on how positive social relationships may promote psychological well-being, and in turn, better physical health in older adulthood. Using daily diary data, we demonstrate that on days when older adults report more positive social interactions, they also report feeling more sense of purpose (Talk 3). Finally, we show that higher sense of purpose and more positive change in sense of purpose in midlife prospectively predicts better physical health in older adulthood (Talk 4). Together, the research presented in this symposium reveals normative declines in social relationships in late life, while also highlighting the potential health benefits of increasing positive social relationships in older adulthood.
Maintaining Sense of Purpose in Midlife Predicts Better Physical Health
Authors: Willroth Emily , Mroczek Daniel
Published: December 2021

Having a sense of purpose in life is fundamental to psychological and physical well-being. Despite the myriad benefits of purpose, it may be difficult to hold onto purpose as people age and experience fewer future-oriented goals. The present research used reliable change indices to estimate change in sense of purpose during midlife in three diverse samples. On average, sense of purpose declined slightly with age in all three samples. Next, we used linear regression to examine associations between sense of purpose levels and sense of purpose change and later self-reported physical health outcomes. Consistent with our preregistered hypotheses, higher sense of purpose predicted better health in the two larger samples and more positive sense of purpose trajectories better health in all three samples. Together, these findings suggest that both having a sense of purpose and holding onto it may be important for physical health in middle to older adulthood.
Age-Related Change in the Daily Stressor Reactivity Across 20 Years of Adulthood
Authors: Almeida David , Mogle Jacqueline , Rush Jonathan
Published: December 2021

Affective reactivity to everyday stressful events has been shown to be an important predictor of poor mental and physical health. The purpose of this study was to examine longitudinal changes in daily stress across 30 years of adulthood as a critical first step for understanding aging-related trends in daily stress. We used data from the National Study of Daily Experiences (NSDE) to calculate exposure and reactivity to daily stressors collected during telephone interviews over the course of 8 consecutive days. These daily assessment bursts were conducted in 1997, 2007, and 2018. Data were comprised of 33,931 daily interviews from 2,880 adults ages 25-74 at the first burst. Results indicated decreased stressor reactivity over time but this decrease was greater for younger adults. Discussion will focus on how examining change in daily stress processes is critical for illuminating stress and health.
Change in Daily Negative Affect Across 20 Years
Authors: Charles Susan , Piazza Jennifer , Rush Jonathan
Published: December 2021

The current study examined levels of daily NA among people (N=413) who participated in three waves of the National Study of Daily Experiences (~1996; ~2008; ~2017). At each wave, participants reported how often they had experienced six negative emotional experiences every day for eight consecutive days. Cross-sectional analyses at each time-point show age-related decreases in NA. Trajectories over time, however, were moderated by age (Est = .006, SE = .002, p = .001), revealing a curvilinear pattern. Among people who were 25-50 years-old at the first wave, daily NA decreased over time, with decreases more pronounced among the younger adults. For people at least 50 years-old at the start of the study, daily NA increased over time, with the slopes steepest for older adults. Findings indicate that cross-sectional and longitudinal age-related patterns in NA differ when examining data collected from 1996 to 2017.
Development of a Comprehensive Chinese Successful Aging Scale: Incorporating the Viewpoints of Older Adults
Authors: Chung Edwin K H , Yeung Dannii
Published: December 2021

Inspiring by Martinson and Berridge’s (2015) systematic review, the current definition of successful aging (SA) fails to acknowledge the laypeople’s conceptualization of SA. Adopting a mixed-method approach, two studies were conducted with the aim of soliciting older adults’ perceptions of SA and to develop a multidimensional instrument for assessing SA. Study 1 was a qualitative study and 27 community-dwelling older adults (Mage=68.07 years, SD=7.10, range=60–83; 56.3% females) were interviewed. Interview transcripts were analyzed, and seven themes were emerged. An initial item pool for the Successful Aging Scale (SAS) was then established based on these themes as well as those in the SA literature, such as acceptance and independence. Study 2 was a survey study which was conducted among 414 community-dwelling older adults (Mage=64.50 years, SD=4.01, range=60–82; 55.3% females) to identify optimal items for constitution of the SAS. Exploratory factor analysis revealed a 12-factor solution, accounting for 62% of the variance. The 12 factors are adequate health, perceived constraints, flexible attitudes toward life, acceptance of age-related change, life embracement, active engagement, harmonious family, supportive friendship, civic awareness, social contribution, living independently, and adaptive coping strategies. The 12 factors exhibit similar strength of associations with most of the well-being measures, but certain factors show stronger correlation with depressive symptoms and social relationship, suggesting the uniqueness of each factor. Overall, the SAS demonstrates promising psychometric properties. These findings disclose that the older adults’ perceptions of SA could cover broader dimensions than those in Rowe and Kahn’s model (1997).
The Use of Concept-Mapping to Structure the Cultural Adaptation of Educational Curricula for Latino Older Adults
Authors: Piedra Lissette , Howe Melissa , Montoya Yadira , Hofer Molly
Published: December 2021

Culture, embedded in language and reflected in colloquial expressions, influences behaviors and cognitive constructs that affect health. To reach Latino older adults, health promotion efforts should include congruent cultural aspects—such as relevant metaphors, values, and proverbs—that will resonate with their cognitive constructs. However, this content should also be situated within a broader social context. For community-dwelling Latino older adults, this means considering their care systems and the multiple stakeholders within. In this paper presentation, we describe an innovative, interdisciplinary collaboration to culturally and linguistically adapt existing Illinois Extension curricula to meet the needs of Latino older adults and their families living in Cook County, which includes Chicago and its neighboring suburbs. We will demonstrate how concept-mapping (CM) studies can be used to structure the cultural adaptation of educational curriculum to a Latino audience. Specifically, we describe these CM studies, which asked how multiple stakeholders and Latino older adults living in the Chicagoland area defined positive aging provided empirically-grounded direction for our 11-member steering committee, composed of investigators, service leaders, and Latino older adults. We also will describe how the current project deepens relationships in the community that facilitate dissemination efforts to Latino older adults.
Whose Decision Is It? Perspectives on Agency Involvement in Determining Paid Caregivers' Roles in Dementia Care
Authors: Reckrey Jennifer , Watman Deborah , Tsui Emma
Published: December 2021

Individuals living at home with dementia often rely on a team of caregivers and health care providers. Yet little is known about how the role of paid caregivers within this team is determined. We identified patients with moderate to severe dementia (n=9) and conducted individual interviews with their care teams (family caregiver, paid caregiver, physician) (n=27) to explore perspectives on paid caregiver roles. Participants disagreed on who determined the paid caregiver’s role. Agencies were perceived to set limitations on the scope of care (particularly by physicians) but agency care plans were often seen as inadequate and failing to capture important nuances of care. Most family caregivers believed they should guide what paid caregivers did in the home, while most paid caregivers reported relying on their own experience and knowledge. Understanding and addressing these differing perceptions is critical to improving the quality of paid care in the home.
Rethinking Employer Communication and Support for Home Care Aides: A Case Study of Pandemic Group Support Calls
Authors: Tsui Emma
Published: December 2021

This case study explores an employer-initiated biweekly group support call for home care aides implemented by a large New York City-based home care agency during the COVID-19 pandemic. Specifically, we investigate how agency staff used information gathered through these calls to intervene into existing agency communication and support systems for aides. Our single-site case study analyzes detailed notes from almost 100 support calls that took place between April 2020 and March 2021, as well as interviews with agency staff from communications, human resources, nursing, and other departments that support aides. We compare and contrast new communication and support mechanisms advanced in conjunction with these calls with agency systems pre-pandemic. Our findings suggest that while calls were initially targeted toward providing emotional and operational support, staff also advocated for more systemic supports. We discuss the sustainability of these new efforts, as well as ongoing barriers and gaps.
The Silent Majority: Aging With HIV
Authors: Nash Paul , Perkins Molly
Published: December 2021

Those over the age of 50 represent the majority of people living with HIV (PWH), most of the HIV research, prevention and service retention work is targeted at ‘at-risk’ communities under age 50. Given this diverse and growing population, intersections of age with HIV need to be prioritized. This focus would actively increase quality of care and life experience for older PWH and the growing numbers transitioning into old age. Using local, national, and international data, this symposium will highlight the unmet social needs of older PWH. Presentations will provide evidence of unmet need, decreased self-esteem, enhanced health burden, and the damaging nature of stigma. Given the impact of COVID-19 globally, the data will further demonstrate the need to support immunocompromised older PWH. Older PWH are a marginalized community and the effects of COVID-19 have been disproportionately severe. With the adverse health outcomes experienced because of COVID-19 and intersectional stigma, it is important to understand the support structures that are and are not in place for older PWH. Advance care directives make up an integral part of future planning, especially for those living with chronic health concerns, yet little research has previously evidenced the steps taken by OPWH. Finally, using data from sub-Saharan Africa, emotional and instrumental social support sufficiency will be described to highlight the unmet needs of these older PWH. Our discussion will focus on the need for policies and programs to support this growing segment of the HIV population with increasingly diverse and unmet needs.