bluuebunny/crossref_metadata_2025 huggingface dataset:
THE ROLE OF MUTUALITY ON THE QUALITY OF LIFE OF MID-LATE LIFE ADULTS WITH CHRONIC ILLNESS AND THEIR NURSES
Authors: Cilluffo Silvia , Lyons Karen , Bassola Barbara , Vellone Ercole , Pucciarelli Gianluca , Clari Marco , Dimonte Valerio , Lusignani Maura
Published: January 2025

Mutuality between an adult with chronic illness and their nurse has received little investigation, despite the therapeutic nature of the relationship. Qualitative research by this team has led to conceptualizing nurse-patient mutuality as an interactive process involving developing rapport and going beyond, being a point of reference, and shared decision-making/care. To inform this area of research, our team developed and tested one of the only known measures of nurse-patient mutuality. This paper reports findings from our recent multi-center study that examined the association of nurse-patient mutuality on mental and physical quality of life (QoL) of nurses and mid-late-life adults with chronic illness. A total of 192 unique dyads (Mage= 64.5 for patients and Mage=41.8 for nurses) were sampled across Italian hospitals. Nurses and patients’ perceptions of their mutuality were positively correlated (p<.001Actor partner interdependence models found significant actor effects of mutuality on mental QoL for nurses and patients; the better the patient perceived mutuality with their nurse, the better their mental QoL (p<.001); the better the nurse perceived mutuality with their patient, the better their mental QoL (p=.002). However, a significant partner effect found the better the nurse perceived mutuality with the patient, the more likely the patient was to have poor mental QoL (p<.001). There were no significant associations with physical QoL. Discussion will focus on the need for further research on the role of nurse-patient mutuality on health outcomes and health behaviors and the complex role nurse engagement can have in patients experiencing poor mental health.
APPRECIATING TIME ALONE: AGE AND SOCIAL INTERACTION OPPORTUNITIES ENHANCE EMOTIONAL WELL-BEING WHEN ALONE
Authors: Pot Anna , Carstensen Laura
Published: January 2025

Whereas long periods of solitude risk the health and well-being of older people, on the aggregate level, older people spend considerably more time alone than younger age groups and, on the whole, enjoy better mental health. In the present study, we consider time alone at the trait and state level. This study seeks to explore how relationships and spending time alone influences daily emotional experience in a sample spanning the adult life span. Drawing on data from an experience-sampling study that used a burst design at two timepoints five years apart, participants (N1=212 | N2=179) aged 21-94 (M1=54.58, SD1=21.95 and M2=56.80, SD2=21.24) reported their positive and negative emotions (19 in total) and whether they were alone or interacting with someone, five times daily for a week. Findings from mixed-effects models highlight a complex relationship between age, spending time alone and emotional well-being. Age positively relates to emotional well-being, and spending time alone is associated with a poorer emotional profile across the full participant sample. An interaction between age and being alone suggests that those older adults who spend relatively more time alone than average report a slight decline in emotional well-being. However, older adults who have more social interactions report significantly more positive emotions at the state level when they are alone, compared to other age groups. These results suggest that time alone may be appreciated with age, as long as social interactions do not become scarce. Findings contribute to our understanding of time spent alone and emotional well-being.
COGNITIVE REAPPRAISAL AND STRESS REACTIVITY ACROSS ADULTHOOD
Authors: Maras Jessica , Leger Kate
Published: January 2025

How one reacts to stressful events, termed stress reactivity, impacts health and well-being. The use of emotion regulation strategies can influence reactivity, specifically cognitive reappraisal, which has been shown to reduce reactivity. Furthermore, age can affect reactivity due to older adults’ ability to employ cognitive reappraisal strategies more readily. The current study investigated the interplay between age and cognitive reappraisal on different components of reactivity: affective, somatic and physiological. Participants (N = 139) were divided into younger (N = 89) and older (N = 50) adults with subsets receiving the cognitive reappraisal intervention (N = 71) or the control condition (N = 68). Baseline measures were obtained via questionnaires followed by a stress-inducing task to assess reactivity. The cognitive reappraisal condition received a prompt prior to the stress-inducing task telling them to think about the positive aspects of the task. Reactivity was measured via negative affect, somatic symptoms (e.g., stomach ache) and blood pressure after the task, while controlling for baseline reactivity. Preliminary findings revealed a significant interaction between age and experimental condition for systolic blood pressure reactivity (β = -0.17, p =.049). This indicates that older adults in the control condition showed decreased systolic blood pressure reactivity to the stressor. No other significant main effects or interactions were found. This unexpected finding highlights that there may be specific age groups in which engaging in cognitive reappraisal is disadvantageous to different types of reactivity and emphasizes the need for understanding for whom and when cognitive reappraisal might work best.
HOME-VISIT INVESTIGATION ON BODY SUPPORTING PROPERTIES OF DAILY PRODUCTS USING FORCE VECTOR FIELDS SENSOR
Authors: Nomura Ayano , Nishida Yoshifumi
Published: January 2025

Product accidents often occur due to poorly designed products that do not consider age-related functional changes. This study focuses on the inadequate ‘body-supporting properties’ of everyday products, which are recognized as a critical factor affecting independent living and fall prevention. To address this issue, we developed a portable system that measures and visualizes the vector fields of the hands’ body support, and we evaluated the body-supporting ability of everyday products in the home. A study was conducted to measure body-supporting movements using the developed system in 9 houses with 13 participants aged 69 to 86 years. The results of the study identified daily activities that involve body-supporting movements, such as putting on and taking off shoes and clothes, sitting and standing up, etc. The study also identified various everyday products, such as tables, footrests, fusuma (sliding doors or partitions used in traditional Japanese architecture), windows, TV racks, etc., that generate body-supporting forces. By using the proposed system to measure hand forces at multiple points, it is possible to investigate how the hands are used to hold everyday products and interact with the environment in daily life, as well as the direction in which force is applied to support the body. For example, research has shown that a body-supporting force of as little as 4 N in the horizontal direction is sufficient to maintain horizontal balance. This finding underscores the importance of considering body support in everyday environments for older people and provides valuable insights for future design improvements.
OLDER ADULTS REPORTING FEAR OF FALLING PRESENT WITH REDUCED PHYSICAL FUNCTION
Authors: Sebastiao Emerson , Siqueira Vitor , Bakare Jemimah
Published: January 2025

Falls pose a significant risk to older adults (OAs), often leading to fear of falling (FOF). This study investigated the prevalence and the impact of FOF on physical activity (PA), sedentary behavior (SB), and physical function in OAs living in a community-dwelling facility (CDF). Ninety-three OAs were included in the study. FOF was assessed using the following Yes/No question: “Are you afraid of falling”? PA and SB were self-reported, while physical function was assessed using a collection of objective tests. Data were analyzed using descriptive and inferential statistics with significance set at p< 0.05. The prevalence of FOF was found to be 47.3% (36.9%–57.9%), with no significant differences between sex (Female: 48.4% (35.8%–61.3%) vs. Male: 44.8% (26.4%–64.3%); χ2(1, N=93) = 0.104, p=0.747) or falls history (zero falls: 43.9% (30.7%–57.6%) vs. One or more falls: 52.8% (35.5%–69.6%); χ2(1, N=93) = 0.704, p=0.401). OAs reporting FOF presented with significant (p< 0.05) lower performance in all physical function tests compared to those reporting no FOF. However, after controlling for the use of assistive devices (i.e., cane), the performance in some tests (i.e., Timed Up and Go, Timed 25-foot Walk; Short Physical Performance Battery subcomponent gait) lost significance (p>0.05). No significant differences were observed for PA and SB between groups with and without FOF (p>0.05). These findings suggest a high prevalence of FOF among the studied sample, worse physical function for OAs reporting FOF, and similar levels of PA and SB between FOF groups of OAs living in a CDF.
SOCIAL ISOLATION, LONELINESS, AND DEPRESSION IN FALLS AMONG RACIALLY/ETHNICALLY DIVERSE OLDER AMERICANS
Authors: Malatyali Ayse , Wiese Lisa , Cidav Tom , Xie Rui , Thiamwong Ladda
Published: January 2025

Social isolation and loneliness affect 20%-30% of older Americans, and they increase the risk of depression, admission to nursing homes, early disability, and mortality. Poor social networks and social relations are also related to falls, but research on social isolation and loneliness in falls is limited. This study examines the association of social isolation, loneliness, and depression with falls among older Americans. Using logistic regression analyses, we analyzed data from the Health Retirement Study (2020 interviews) cross-sectionally. Measures included the HRS fall questionnaire, five-item social isolation scale, UCLA loneliness scale, and Center for Epidemiological Studies Depression scale. Our sample included 8,946 participants (age>64) with a mean age of 76. 59% of the participants were women, 26.3% living in rural, and 36% reported a fall experience in the past. The likelihood of having a fall was 10% higher in participants with higher levels of social isolation and 40% higher in participants with loneliness than those who were not socially isolated or lonely. Participants with depressive symptoms were 85% more likely to have a fall compared to participants without depressive symptoms. African Americans were 23% less likely to have a fall than Whites. The likelihood of having a fall was 19% less in men than women. Participants living in rural areas were 15% more likely to have a fall than participants living in urban areas. Further investigation into the interaction between social isolation, loneliness, and demographics is needed. Falls prevention interventions should include African Americans, women, and older adults in rural areas.
A RANDOMIZED CLINICAL TRIAL OF ONLINE SOCIAL INTELLIGENCE TRAINING FOR ADOLESCENT CUSTODIAL GRANDCHILDREN
Authors: Dolbin-MacNab Megan , Smith Gregory , Hu Luxin , Infurna Frank
Published: January 2025

Although custodial grandchildren (CG) experience multiple negative psychosocial outcomes, intervention research on this population has been virtually absent. To address this gap, we conducted a two-arm randomized clinical trial (RCT), which compared the efficacy of online Social Intelligence Training (SIT) to an attention control condition, at enhancing psychological and relational outcomes among a sample of 349 adolescent (ages 11-18 years) CG. Online surveys were self-reported at baseline (T1), post-intervention (T2), and at 3- (T3), 6- (T4), and 9- (T5) months. Latent change score analyses revealed significant differences in favor of SIT for CG internalizing difficulties (T4) and self-esteem (T2; T4). Relationally, significant differences in favor of SIT were found for CG prosocial behavior (T5) and avoidant (T2) and anxious (T2) attachment to the grandmother. Across outcomes, effect sizes ranged from.28 to.47. Although the treatment effects were modest, subsequent CART analyses identified that treatment-related change in the SIT condition was predicted by the baseline values of each respective latent outcome (effect sizes =.51 – 1.53). In turn, ANOVAs revealed that changes in latent outcomes from T1 to T2 were significantly moderated by their respective baseline values (p =.05 –.002) for externalizing and internalizing difficulties, self-esteem, and avoidant attachment to the grandmother. The only significant moderator at T5 was the baseline value of support from friends (p =.03). We conclude that RCTs which only report average treatment effects, without also investigating potential moderators of differential treatment efficacy, may underestimate true intervention impact. [Funded by R01AG054571)].
DIFFERENCES IN HOW OLDER ADULTS ARE PORTRAYED IN CHILDREN’S MEDIA
Authors: Domnick Hallory , Manternach Celine , Heinz Melinda
Published: January 2025

The purpose of this project was to analyze how older adults were portrayed in children’s media. Children are shaped by the media that they consume, and since the media often features negative or inaccurate portrayals of older adults, it has the potential to impact how children view this population. A total of 30 children’s picture books (published in the last 10 years) and 15 children’s shows on Disney+ and PBS Kids were analyzed for their portrayal of older adults. Each piece of media was analyzed for examples of: stereotypes/myths, positive and negative portrayals, and roles older adults engaged in. The most common stereotype/myth identified was that older adults frequently needed to use assistive devices (such as a cane) or were portrayed with exaggerated physical differences (deep wrinkles, white hair). Positive portrayals of older adults included grandparents being a source of physical affection and that spending time with grandparents was fun. Older adults were frequently portrayed as grandparents and rarely depicted in other roles. While grandparenthood may be a common role for older adults, older adults also occupy other roles and that should be better reflected in children’s media. However, some authors did include depictions of older adults identifying as LGBTQ+, demonstrating an awareness that older adults are also included in this community. Overall, older adults were more likely to be portrayed as loving and caring in children’s literature compared to television. PBS Kids compared to Disney+ was more likely to depict older adults positively as wise and knowledgeable.
SHARED SOCIAL ACCOUNT: UNDERSTANDING INTERGENERATIONAL COLLABORATION AND INTERACTION ON XIAOHONGSHU
Authors: Sun Tongxin , Jin Tongtong , Zhang Qiong , Liu Yuanyuan
Published: January 2025

Xiaohongshu, a social media platform in China known for lifestyle sharing through text, images, and videos, is predominantly popular among the younger generation. It has seen a remarkable uptick in older adult users in the post-pandemic era, with a notable phenomenon in “shared accounts” that feature content co-created by grandparent-grandchild pairs. These accounts have garnered significant attention for their unique intergenerational content and elicited emotional resonance within young audiences. Our study utilized a mixed-methods approach, including web scraping and interviews, to investigate the motivations and experiences underpinning the content creation process on these shared accounts. Through cluster analysis of content topics and in-depth interviews with four grandparent-grandchild pairs actively managing shared accounts, we explored their creative collaboration process and the influence of digital technology. Our research uncovered a symbiotic exchange of knowledge between generations: grandparents shared their life wisdom and experiences, while grandchildren introduced them to digital platforms and current social trends, enabling the transformation of shared narratives into media forms accessible to a wider audience. This collaborative creation process not only enhanced emotional communication within families but also fostered intergenerational social interactions externally. However, grandparents, due to their lack of perceived confidence in digital literacy, typically tended to pass control to their grandchildren for the restructuring of narratives, leading to technological disparities within the shared account. This study sheds light on the influence of technology on collaborative narratives across generations and discusses ways to advance technological equity to empower older adults in achieving self-expression and meaningful social engagement.
THE BENEFITS OF INTERGENERATIONAL REMINISCENCE AND DST ON THE WELL-BEING OF YOUNG ADULT PARTICIPANTS
Authors: Xu Ling , Fields Noelle , Daniel Kathryn , Cipher Daisha , Troutman Brooke
Published: January 2025

Objective

Intergenerational contact between older people and young adults have many benefits for both young and older generations. An intergenerational reminiscence and DST project was conducted with young adult college students calling older partners each week for 10 weeks. This study reported the benefits of this project in improving the well-being of young adult participants.

Method

A randomized control trial was used to assess the effects of the intervention. Participants of young and older adults were randomly paired and assigned to Reminiscence (n = 55) or sham (Social Wellness, n = 48) group. Data were collected at baseline, mid- intervention, at the end of the intervention. Linear mixed models (LMM) were performed to compare the Social Wellness group with the Reminiscence group on levels of loneliness, attitudes toward aging, and knowledge of Alzheimer’s’ Disease (AD) among the student participants.

Results

Results from LMM revealed no significant effects for group or time on attitudes toward aging. However, the groups significantly differed on their changes over time in loneliness. LMM revealed a significant interaction between group and time, t(101) = -3.06, p =.003. The two groups also significantly differed on their changes over time in knowledge. LMM revealed a significant interaction between group and time, t(101) = 2.51, p =.014.

Discussion

Results suggest that weekly intergenerational engagements with older adults benefit young adult college students with loneliness and knowledge of AD. Implications for research and programs in improving the well-being of young adults are discussed.
CAREGIVING OUTCOMES AMONG INFORMAL CAREGIVERS OF PERSONS WITH MULTIMORBIDITY AND DEMENTIA: A SCOPING REVIEW
Authors: Liu Ruotong , Peak Katherine D , Trubits Em , Quiñones Ana
Published: January 2025

An emerging field of research involves caregiving among older adults with Alzheimer’s disease and related dementia (ADRD) and co-occurring chronic conditions (ADRD-multimorbidity). This scoping review aims to assess, synthesize, and identify gaps in the body of literature on caregiving outcomes among informal caregivers of individuals with ADRD-multimorbidity. We adhered to the scoping review framework by Arksey and O’Malley (2005) and Levac and colleagues (2010), which encompassed five steps: 1) identify the research question(s), delineate the inclusion and exclusion criteria, 2) search for relevant studies, 3) select studies, 4) chart the data, and 5) collate, summarize, and report results. Electronic databases including Ovid Medline, CINAHL, Embase, and PsycINFO were searched to identify relevant studies. A total of 1856 articles were identified and 29 were included in the final review. The majority of studies were quantitative, cross-sectional studies. The two most commonly examined caregiving outcomes were caregiver burden and psychological wellbeing. Most research on caregiver outcomes treated care recipients’ cognitive impairment and chronic conditions separately, rather than exploring their interaction. Most studies examining caregiver burden utilized Zarit Burden Index and its variants. Specific psychological wellbeing outcomes displayed great variability across studies. Despite challenges in synthesizing the extensive variability in the way cognitive status, ADRD-multimorbidity, and caregiving outcomes were measured, included, and reported, this review underscores the intricate challenges of caregiving, especially when dealing with both cognitive impairments and co-occurring chronic conditions. This complexity underscores the need for a deeper understanding of the diverse needs facing caregivers of people with ADRD-multimorbidity.
DAILY SLEEP HEALTH AMONG WORKING INFORMAL CAREGIVERS OF OLDER ADULTS: DELVING INTO CAREGIVING DEMANDS
Authors: Cho Eunae , Chen Tuo Yu
Published: January 2025

Caregiving demands are a key stressor, but little is known about the relationship between caregiving demands and sleep health among working informal caregivers of older adults. We conducted a 5-day daily diary study to examine the relationship between caregiving demands and sleep health among working informal caregivers of older adults in Singapore (N=193). For each day, we examined ‘anticipated caregiving difficulty’ in the morning; in the evening, we assessed ‘total hours spent on caregiving,’ ‘total number of care activities (e.g., personal care, toileting, running errands),’ and ‘experienced caregiving difficulty.’ We further explored their interaction effects on sleep health. Covariates included sociodemographic status, self-rated health, depressive symptoms, and care recipients’ functional status. We found that anticipating more caregiving difficulty in the morning was significantly associated with poor sleep health in the evening on top of covariates and actual caregiving demands. We also found a significant interaction between ‘anticipated caregiving difficulty’ and ‘experienced caregiving difficulty.’ Specifically, the relationship between experienced caregiving difficulty in the evening and poorer sleep health was stronger among individuals who anticipated a lower level of difficulty that morning (1SD-lower). Individuals who anticipated a higher level of caregiving difficulty in the morning (1SD-higher) had worse sleep health in the evening regardless of the level of caregiving difficulty experienced during the day. Our findings suggest that the impacts of ‘anticipated caregiving difficulty’ on sleep health go beyond actual caregiving difficulty experienced. The mismatch between anticipated and experienced caregiving difficulty plays a role in sleep health at night.
DOES PSYCHOLOGICAL FLEXIBILITY MEDIATE CARE-RELATED STRESS ON QUALITY OF LIFE FOR DEMENTIA CAREGIVERS?
Authors: Fauth Elizabeth , Aller Ty , Gossner Jacob , Juhasz Audrey , Levin Michael
Published: January 2025

Caregivers of individuals with dementia experience care-related burden and stressful reactions to behavioral and psychological symptoms of dementia (BPSD) which can negatively impact multiple domains of life, including decreased global quality of life (QoL). Transdiagnostic interventions, such as those using Acceptance and Commitment Therapy (ACT) benefit dementia caregivers by addressing underlying mechanisms that impact depression, anxiety, QoL, and more. The transdiagnostic mechanism in ACT is psychological flexibility. The current study used pre-intervention (T1), post-intervention (T2) and 6-week followup (T3) data from a study of caregivers using a 6-session online, self-guided ACT program, tailored to dementia caregiving. Stepwise regression analyses (N=79) tested longitudinal mediation, examining if T2 psychological flexibility (CompACT; Francis et al., 2016), explained associations between T1 caregiver burden (Bédard et al., 2001) and T3 QoL (de Boer et al., 2004). A similar model used T1 stress reactivity of BPSD (Teri et al., 1992) as the independent variable, instead of burden. Based on correlations, both models controlled for whether the caregiver lived with the care receiver. Results indicate that psychological flexibility partially mediated the impact of burden on QoL, and fully mediated the impact of stress reactivity on QoL. Findings suggests that psychological flexibility may be an important mechanism in mitigating the impact that care-specific stress experiences have on global QoL. Caregivers often cannot leave this role, requiring them to learn to live with care-related stress in ways that do not damage their long-term wellbeing. Psychological flexibility is amenable to intervention and ACT offers promising solutions in dementia caregivers.
EARLY PARENT–CHILD RELATIONSHIPS, BURDEN, AND SUPPORT AMONG ADULT CHILDREN OF PARENTS WITH DEMENTIA
Authors: Wood Kristie , Chow Denise , Vu Thi Hoang , Monin Joan
Published: January 2025

Research has demonstrated that greater childhood adversity is associated with poor mental health in older adult family caregivers. Yet, it is unknown whether early parent-child relationship quality is more specifically associated with adult children’s caregiver burden and perceived support from their parents living with cognitive impairment. We examined associations between early life parent-child relationship quality, current caregiver burden, and adult children’s perceived support from their parents, among adult children of parents living with early-stage dementia. Adult children of parents living with cognitive impairment (n=144, m=47.53, sd=11.2, Non-Hispanic=92%, White=72%) completed the following self-report measures: Parental Bonding Inventory, Zarit Burden Interview, and Perceived Partner Responsiveness Scale. Multiple linear regression models revealed children who identified more care, less overprotection, and optimal parenting in their early parent-child relationships reported greater current perceived support from their parents. However, there was no statistically significant association found between early parent-child relationship quality and caregiver burden. Our findings indicate that while early positive relationship quality may be indicative of adult children’s future perceptions of support from their parents with early-stage dementia, it may not buffer against perceptions of caregiver burden. Overall, results highlight that early parent-child relationship quality may have consequences for caregiving relationships in later life. Future research is needed to explore mechanisms of early parent-child relationship quality and perceptions of support that are associated with caregiver outcomes.
OVER SIX TIMES INCREASED RISK OF SUICIDAL IDEATION IN FAMILY CAREGIVERS WITH HISTORY OF CHILDHOOD ABUSE: THE ROLE OF NEUROTICISM
Authors: Jain Felipe , Gutierrez-Ramirez Paulina , Zea Miranda , Gomez Liliana Ramirez
Published: January 2025

Despite high reported rates of suicidal ideation (SI) in family caregivers of persons living with dementia, little is known about the relationship between SI and intergenerational trauma. Those with a history of adverse childhood experiences (ACEs) such as neglect and abuse are known to have worse psychological coping skills and higher rates of mental disorders. Personality factors might be mechanistically related to SI in family caregivers, but this has never been tested. We undertook an analysis of the association between intergenerational trauma, measured with the Adverse Childhood Experience (ACE) questionnaire, and a measure of SI from the Quick Inventory of Depressive Symptoms-Self Report, in 81 caregivers of family members living with dementia. We further analyzed whether neuroticism mediated the relationship between ACE and SI. 22% of caregivers exhibited passive SI, and 69% at least 1 ACE. 89% of caregivers with SI reported intergenerational trauma (ACE >= 1), versus 63% of those without SI (p=.04). SI was 4.6x as likely in those with ACE >= 1 than in those without. The odds ratio for SI for those who had experienced childhood neglect was 4.4 (p=.05), and for those reporting childhood abuse was 6.8 (p=.01). Neuroticism significantly mediated the relationship between ACE exposure and SI (p<.05). The risk of SI in family caregivers with history of intergenerational trauma was high in this sample. The relationship between intergenerational trauma, neuroticism, and SI in family caregivers should be further explored and could represent a new treatment target to improve the efficacy of caregiver therapies.
PERCEIVED EFFICACY OF TWO NONPHARMACOLOGICAL INTERVENTIONS: A QUALITATIVE EXPLORATION OF CAREGIVERS OF DEMENTIA
Authors: Inoue Megumi , Tompkins Catherine , Ihara Emily , Layman Shannon , Lauber McKenzie , Kim Sewon , Gimm Gilbert
Published: January 2025

We will present findings from the qualitative component of an explanatory sequential design that investigated the efficacy of two nonpharmacological interventions: the Stress Busting Program (SBP) for Family Caregivers™ and a personalized music intervention for care recipients living with dementia. After implementing the 9-week SBP program focused on reducing caregiving-related stress among 97 family caregivers of persons living with dementia, we randomly assigned participants into a 4-week personalized music intervention group and a control group to examine effects on stress and well-being. Quantitative findings revealed a significant reduction in mean caregiver burden scores associated with SBP, but not for the personalized music intervention. We observed varied levels of caregiver and care recipient engagement with the personalized music intervention. To gain a deeper understanding of these results, we conducted 12 focus groups and interviews with study participants to explore caregivers’ perspectives and experiences with each intervention. Constant comparative analysis and substantive coding by two independent reviewers were employed to analyze transcripts of audio recordings with 47 caregivers, selected from the initial study cohort. The theme of bonding/connecting with group members emerged as the most effective SBP element. Also, caregivers valued the opportunity to establish a sense of community by connecting with other caregivers within SBP. However, some caregivers experienced technological difficulties with using an MP3 player for the music intervention. We will present cross-cutting themes and overall lessons learned about strategies to enhance the use of these nonpharmacological interventions.
A RETROSPECTIVE COHORT STUDY ON THE RELATIONSHIP BETWEEN FRAILTY AND HEALTH CARE OUTCOMES
Authors: Cho Jinmyoung , Salas Joanne , Scherrer Jeffery
Published: January 2025

Frailty increases vulnerability for adverse outcomes in older adults. Characterizing the prevalence and distribution of frailty can help guide healthcare service decision-making and policy. This study evaluated the association between frailty and healthcare utilization and interactions by demographic characteristics. Using electronic health records (2018-2022), we conducted a retrospective cohort study with 355,266 patients ≥65 years of age who had ≥2 ambulatory office visits in separate years in the 4-year baseline period (2018-2021). The Gilbert Frailty Index (GFI) was calculated (low vs. intermediate vs. high risk) using ICD-10 codes. One-year utilization outcomes in 2022 included high outpatient clinic utilizations (OCU), inpatient (IP), emergency department (ED), and nursing home (NH) admissions. Fully adjusted log-binomial regression models were calculated overall and by race (White vs. Black), age groups, and sex. The sample was 74.5(±7.5) years of age, 57.7% female, 89.2% White, and 13.5% categorized as GFI high risk. After adjustment for covariates, GFI high risk had the highest risk for all outcomes (RR=3.31 for IP; 2.77 for ED; 4.26 for NH; 1.60 for high OCU). We observed significant interactions by race, sex, and age for each outcome. Effects of GFI high vs. low risk were larger for White (IP, ED, & high OCU), female patients (ED & high OCU), and younger patients (IP). Conversely, the effects of GFI high vs. low risk was strongest in older patients for ED, IP and high OCU. Monitoring frailty and paying attention to patient’s demographic characteristics is needed to best estimate associations between frailty and health utilization.
BODY COMPOSITION AND ANTHROPOMETRICS OF OLDER ADULTS AT DIFFERING LEVELS OF URBANIZATION IN CHINA
Authors: Spangler Hillary , Michelson Lisa , Howard Annie Green , Tien Hsaio , Lynch David , Du Shufa , Gordon-Larsen Penny , Batsis John
Published: January 2025

Background

Less urbanized areas in China are associated with higher risk of developing frailty. We aim to identify differences in the relationship between body composition and urbanization.

Methods

Using the China Health and Nutrition Survey data in 2015, we included community-dwelling adults aged ≥60 with bioelectrical impedance data assessing fat mass and fat-free mass (body composition). Urbanization was based on a multi-component index (0-120 points) based on 12 community-level variables, with lower scores indicating lower urbanization. Latent class analysis was used to identify underlying heterogeneous patterns of body composition classes. Continuous and categorical variables were compared using Chi-squared and ANOVA tests, respectively.

Results

Of 1,424 participants, 55% were female, mean age 72.0±5.9 and BMI 23.8±3.6. Three of the five best fitting classes aligned with robust (n=517, moderate BMI, body fat, muscle), pre-frail (n=602, low BMI, low body fat, low muscle), and frail (n=211, lowest BMI, % body fat, and muscle) statuses. Urbanization index was significantly different between the five classes (p< 0.001). Urbanization index was lowest (65.1) for class that aligned with frailty; mean age 72.0 ±5.9, 54.7% female. The class aligning with robust status was associated with higher urbanization index (71.6); mean age 71.9 ±5.7, 54.6% female.

Discussion

Older adults with body composition consistent with frailty had a lower level of urbanization. Urbanization level may influence body composition in China.
FRAILTY IN INTERMEDIATE CARE FACILITIES THROUGH LIFE (LONG-TERM CARE INFORMATION SYSTEM FOR EVIDENCE) IN JAPAN
Authors: Sakai Tomomichi , Visvanathan Renuka , Jadczak Agathe Daria , Umegaki Hiroyuki
Published: January 2025

The Long-term care Information system For Evidence (LIFE) was introduced to improve care for older adults based on scientific evidence in 2021 within the Japanese long-term care insurance framework. The aim of this study was to reveal the prevalence of frailty among residents in intermediate care facilities and identify factors associated with the frailty using data collected for the emerging system. This retrospective and cross-sectional study included residents aged 65 years or above who had complete data for assessing frailty. Data was collected between April 2021 and November 2023 at 4 intermediate care facilities. Residents were classified as non-frail, frail, or most-frail using the FRAIL-NH scale by fitting variables in the LIFE data that were most appropriate for each component of the FRAIL-NH scale. Multivariable logistic regression analysis was used to explore factors associated with being most-frail using variables covering broad areas such as sociodemographic information, nutrition, oral function, and cognition. 907 residents were included for analysis; their mean age was 85.9 (standard deviation 7.2) years, and 63.7% were female. Among them, 5.7%, 33.8%, and 60.4% were categorized as non-frail, frail, and most-frail. The necessity of a dysphagia diet, easily choking, and dementia status and symptoms were shown to be significantly associated with being most-frail using the reference of not being most-frail. The current results indicate the potential for frailty assessment using data that recently started being collected routinely across Japan. Future studies of the predictive role of frailty against prognosis should promote care delivery stratified by frailty assessment.
GENDER DIFFERENCES IN THE ASSOCIATION BETWEEN FRAILTY AND HOSPITALIZATION AMONG OLDER ADULTS IN SOUTH KOREA
Authors: Choi Bokyoung , Shin Yumi , Kim Chang-O , Choi Ahreum , Choi Eunhee , Lee Hyeyeon , Jang Soog-nang
Published: January 2025

This study aimed to investigate the association between frailty and hospitalization experience among older adults in South Korea, while also exploring potential gender differences in this association. We used data from the Korean Longitudinal Study of Aging (2018-2020). Frailty was assessed using the frailty instrument (weakness of grip strength, exhaustion, and social isolation) and divided into three groups: non-frail, pre-frail, and frail. Experience of hospitalization over the past two years was measured by self-reported. Multivariate logistic regression model was applied to examine the association between frailty and hospitalization experience after adjusting for potential confounders including age, education level, and physical activity. Among aged 65 and over older adults in South Korea, the prevalence of frailty was 14.4% (N=656), and the prevalence of hospitalization over the past two years was 9.6% (N=437). Compared to the non-frail group, the frail group had a statistically significantly higher risk of hospitalization (pre-frail OR:1.63 95% CI:1.28-2.08, frail OR:2.50 95% CI:1.85-3.39) after adjusting potential confounders. However, after stratification by gender, the relationship between frailty and hospitality was still statistically significant among older women (pre-frail OR:2.00 95% CI:1.45-2.75, frail OR:3.27 95% CI:2.22-4.80), but not in men. These findings suggest that understanding gender differences in the association between frailty and hospitalization would be beneficial for reducing the care burden among older adults in South Korea. Tailoring interventions and healthcare services to address the specific needs of frail older individuals, particularly focusing on gender-specific differences, may help in preventing hospitalizations and improving overall well-being.
IMPACT OF FRAILTY AND DEMENTIA ON REHABILITATION OUTCOMES IN OLDER ADULTS SURGICALLY TREATED FOR HIP FRACTURE
Authors: Caggiu Giulia , Compagnoni Matteo Monzio , Floris Patrizia , Manna Martina , De Filippi Francesco , Passamonte Michela , Mazzola Paolo
Published: January 2025

We investigated the impact of frailty and dementia on rehabilitation outcomes after hip fracture (HF) surgery in an Italian Orthogeriatric Unit (OGU). We prospectively enrolled all patients aged ≥70 years admitted to the OGU at Sondrio Hospital (Italy) in 2011-2019, with HF requiring surgery. We administered a comprehensive geriatric assessment, including factors related to fracture and surgery. A frailty index (FI) based on 16 variables expressed frailty (FI=number of deficits/16), with which we obtained three categories: fit (FI< 0.15; reference), mild (0.15< FI< 0.34), moderate-to-severe (FI≥0.35). Among 818 participants (mean age 85.6 years, 83.3% females), 21.6% had pre-existing dementia. The average time-to-surgery was 1.9 days (77.6% in spinal anesthesia). Rehabilitation success, i.e. Rehabilitation Efficiency Index (REI)>0.5, was achieved by 70.2% of subjects. From multivariable logistic regression, factors impacting rehabilitation success were frailty (both categories), dementia (OR: 0.14, 95% CI: 0.10-0.21), and age ≥90 years (OR: 0.37, 0.21-0.64). The chances of rehabilitation success were lower for patients with dementia than for those without. Although there is no clear link between age and rehabilitation success, frailty has a decreasing influence as age increases. In nonagenarians, severe frailty does not limit rehabilitation success as much as in younger patients. Previous research showed that dementia potentially acts as a surrogate for frailty in predicting post-operative 1-year mortality after HF surgery. We show that dementia and frailty significantly influence rehabilitation success, thus early mobilization and initiation of physical therapy regardless of age should target non only frail subjects, but also those with dementia, possibly with specifically dedicated interventions.
INTERACTIONS BETWEEN FRAILTY AND SOCIAL VULNERABILITY ON THE SURVIVAL AND HEALTH TRANSITIONS OF OLDER ADULTS
Authors: Wu Heng , Song Xiaowei , Rockwood Kenneth
Published: January 2025

Frailty, an age-related state, is dominated by declining health over time, although stabilization and improvement can occur. We investigated how the accumulation of physical and social deficits interacts in health transitions and survival. Data from participants aged 65+ years in the Chinese Longitudinal Health Longevity Survey (CLHLS) 2005 cohort were analyzed (n=15613; women=57%; mean age=86.2±11.7). Participants were followed in 2008, 2011, 2014, and 2018, with their health and survival status reassessed each time. We constructed both a 47-item frailty index (FI) and a 26-item social vulnerability index (SVI). The FI included domains of morbidities, cognition, lifestyle, and disabilities; the SVI included World Health Organization-defined social determinants of health as – i.e., education, social security and inclusion, work/life/dwelling/services conditions, and early childhood development. At each follow-up, the FI strongly affected survival in a Logistic Regression model with baseline age, FI, SVI, and sex as covariates (e.g., a 1% FI increase for 14-year mortality: Odds Ratio OR=1.07, 95% CI=1.06-1.08). The SVI showed a marginally significant effect on 3-year survival (e.g., a 1% SVI increase, OR=1.01, 95% CI=1.00-1.01), and diminished at longer follow-ups. The FI also affected health transitions (Figure 1A), as did the SVI, albeit to a lesser extent (Figure 1B). In health transitions and survival of older adults, frailty increases risk and often interacts with social vulnerability. Our study underscores why we should characterize both physical and social factors to understand health and its dynamics in aging.
TRAJECTORIES OF QUALITY OF LIFE AMONG FRAIL OLDER ADULTS IN KOREA: THE ROLE OF SOCIAL NETWORK
Authors: Shin Yeonsoo , Kim Giyeon
Published: January 2025

The purpose of this study was to examine the trajectories of quality of life among frail older adults in Korea, with a specific focus on the role of social networks on quality of life. Using data from waves 1 (2006) to 6 (2016) of the Korean Longitudinal Study of Ageing (KLoSA), a total of 3,177 older adults aged 65 and older at baseline was included in analyses. This study analyzed the trajectories of quality of life in all subjects, as well as frail and non-frail groups. Furthermore, the study investigated the effect of social networks on both the intercept and slope of quality of life. Results from multiple-group latent growth curve modeling showed that the intercept of quality of life for the frail group was lower than that of the non-frail group. While quality of life showed a declining trajectory for both the overall sample and the non-frail subgroup, the frail subgroup exhibited an increasing trajectory. Moreover, participation in social activities positively affected the quality of life intercept for both frail and non-frail older adults. Interestingly, quality of life among frail older adults living alone was found to be increasing. These findings provide valuable insights into the nuanced dynamics of quality of life among frail older adults in Korea. The study underscores the importance of promoting participation in social activities among this population and suggests further research focusing on frail older adults living alone.
AN ANCHOR FOR BETTER PHYSICAL HEALTH AMONG OLDER ADULTS: POSITIVE FAMILY WELL-BEING
Authors: Liu Yuchen , Kim Dae Hyun , Wittenberg Eve
Published: January 2025

The decline in physical health among older adults corresponds to an increased need for social support and caregiving. In the Chinese context, where formal long-term care options are limited, families predominantly shoulder caregiving responsibilities. We hypothesize that the quality of these familial interactions could significantly influence older adults’ objective health. We used data from the China Health and Retirement Longitudinal Study, assessing family well-being through satisfaction with spouse and children, and measuring objective health via frailty index based on the accumulation of deficits. Our findings indicate that satisfaction with children or spouses is negatively associated with the accumulation of additional deficits, demonstrating a mean ratio (MR) of 0.80 (95% CI: 0.76-0.83) for children and an MR of 0.77 (95% CI: 0.74-0.80) for spouses. After stratifying the analysis by marital status, the association between satisfaction with children and frailty status revealed a more substantial effect size in single or unpartnered individuals (relative risk (RR): 0.74 CI: 0.68-0.81) compared to those who were married or partnered (RR: 0.81, 95% CI: 0.77-0.86). We speculate that those without a spouse or partner may rely more heavily on their children for physical support, thus developing a stronger bond and accounting for the observed larger effect size. In conclusion, positive family well-being correlates with better physical health. Implementing policies that offer financial assistance or incentives for family involvement in elderly care could mitigate financial strains and enhance health outcomes for older adults.
FREE TESTOSTERONE, SEX HORMONE BINDING GLOBULIN, AND INCIDENT FRAILTY IN MEN WITH HIV
Authors: Dias Jenny Pena , Fitzgerald Kathryn C , Shardell Michelle , Wolinsky Steven , Lake Jordan , Koletar Susan L , Basaria Shezhad , Brown Todd
Published: January 2025

Background

Older men with HIV (MWH) have a higher prevalence of frailty than matched men without HIV, but the underlying mechanisms are unclear. Testosterone (T) contributes to higher muscle (mass, strength), and it binds to sex hormone-binding globulin (SHBG), which regulates testosterone bioavailability to the tissues. Aging MWH experience increase in circulating SHBG and decline in circulating free T concentrations. We hypothesized that these hormonal changes may contribute to the development of frailty in MWH.

Methods

Free T and SHBG were measured in 306 non-frail MWH (129 robust and 177 prefrail) who had at least one frailty assessment at a semi-annual follow-up visit in the Multicenter AIDS Cohort Study. Marginal structural models were used and adjusted for covariates: age, race, education, comorbidity burden, BMI, smoking status, alcohol use, HIV parameters and loss to follow-up.

Results

Mean age at baseline was 55±5 years, (median 58 years, Q1=55, Q3=63); follow up frailty assessments visits was 8.5(SD:2.5) years. MWH with low free T (< 50 pg/ml) were more likely to become frail compared to those with free T ≥50 pg/ml (HR,1.58 (95%CI:1.12, 2.24); p-value=0.03). Low free T was also significantly associated with transition from prefrailty to frailty, [< 50 pg/ml: 47%; ≥50 pg/ml:34%], a difference of 12.4% (95% CI:2.9,24.3%). In contrast, SHBG concentrations were not associated incident frailty or transition to frailty.

Conclusion

Low free T, but not SHBG, predicted incident frailty in men with HIV at high risk of developing frailty, in particular those in the prefrail state.