bluuebunny/crossref_metadata_2025 huggingface dataset:
DEVELOPING A RAI-MDS 2.0 BEHAVIOR-BASED PAIN ASSESSMENT SCALE FOR LONG-TERM CARE RESIDENTS WITH ADVANCED DEMENTIA
Authors: Knopp-Sihota Jennifer A
Published: November 2019

In Canadian and many international long-term care (LTC) facilities, pain assessment frequently relies on data from the Resident Assessment Instrument – Minimum Data Set 2.0 (RAI-MDS). The RAI-MDS produces a two-item scale, measuring both pain frequency and pain intensity. This scale correlates well with self-reported pain in cognitively intact LTC residents, but despite repeated testing, is less valid for use in residents with more advanced cognitive impairment who are unable to self-report their pain. In this study we aimed to develop and validate a behaviour-based pain assessment scale for long-term care residents using data available in the RAI-MDS. To construct our initial scale, we reviewed the literature and compiled a list of observable indicators of pain (e.g., grimacing) and linked these with 28 similar items available in the RAI-MDS. Using Delphi techniques, we further refined this to 20 items. We then evaluated the psychometric properties of our scale using two independent, representative samples, of urban LTC residents in Western Canada. Exploratory factor analyses were conducted in sample one (n=16,282) and confirmatory factor analyses (CFA) were then conducted in sample two (n=15,785) in order to test, and confirm, our model. A two-factor solution was identified grouping RAI-MDS items into subscales 1) change in status (e.g., new onset restlessness) and 2) behaviours (e.g., crying). Commonly recognized model fit indices were acceptable suggesting the adequacy of the two-factor solution. Results provide preliminary support for the use of behavioural-based pain assessment scale using RAI-MDS data. Further evaluation and validation of our scale is warranted.
PALLIATIVE AND END-OF-LIFE CARE TO THE LGBT COMMUNITY
Authors: Stein Gary L , Berkman Cathy
Published: November 2019

The lesbian, gay, bisexual, and transgender (LGBT) community experiences discrimination and stigma in accessing health care and social services – including palliative, hospice, and long-term care – across cultures and countries. Health care providers may fail to recognize, acknowledge or address disparities in care. Providers and institutions may be uncomfortable with gender and sexuality issues, and often fail to inquire about sexual orientation and gender identity. It is estimated that there are approximately 2.7 million LGBT adults in the U.S. age 50 and older and approximately 1.1 million age 65 and older. In the UK, an estimated 5-7% of the population identify as LGBT; there are between 600,000 and 840,000 LGBT adults aged 65+. With the projected increased number of older adults and improved treatments that extend the life of seriously ill individuals, even greater numbers of LGBT older adults, and their families, will require palliative and end-of-life in the coming years. Researchers in the US and UK have found that LGBT older adults living in the community and in long-term care facilities experience inadequate, disrespectful, and abusive care due to their sexual orientation and gender identity status. They fear being open about their identities, not receiving equal or safe treatment, and having their family of choice and designated surrogates disrespected or ignored by health care staff. This symposium will describe the experiences of LGBT individuals and their family members, and compare commonalities and differences faced by LGBT communities in the US and UK in accessing palliative and end-of-life care.
DOMAIN-SPECIFIC AGE STEREOTYPES AND ADULTS’ PERCEIVED FUTURE TIME EXPERIENCES
Authors: Ko Han-Jung , Cheng Yen-Pi
Published: November 2019

Experiencing ageism has been shown to affect older adults’ outlook for the future (Barber & Tan, 2018). However, ageism is a multi-faceted construct in addition to positive and negative age stereotypes. In this study, we examined to what extent domain-specific age stereotypes are related to different aspects of a person’s perceived future time experiences. A total of 646 participants (aged 18 to 83) were recruited from a U.S. mid-Western public university for an online anonymous survey. Age stereotypes were assessed in eight life domains of family, friends, religion, leisure, lifestyle, finance, work, and health (Kornadt & Rothermund, 2011). Future time experiences were assessed in four aspects, including perceived openness and concreteness of future, acceptance of life’s finitude, preoccupation with the past, and experiences of obsolescence (Brandtstädter & Wentura, 1994). Age stereotypes in the family domain were associated with one’s perceived openness and concreteness of future and preoccupation with the past. The religion and financial domains were both associated with perceived openness and concreteness of future and acceptance of life’s finitude. Moreover, the older the participants were, the more they accepted life’s finitude. Surprisingly, none of the domains significantly predicted one’s perceived future experiences of obsolescence. Unlike the common finding that people hold negative age stereotypes due to physical and mental declines, age stereotypes in the health domain did not predict any aspects of the future time experiences. Our findings highlight the importance of distinguishing ageism across domains in order to improve one’s perceived future time experiences.
QUALITY OF LIFE AND PERCEIVED NEEDS AMONG OLDER ADULTS RECEIVING LONG-TERM SERVICES AND SUPPORTS
Authors: Rivera Eleanor , Hirschman Karen , Naylor Mary
Published: November 2019

Long term services and supports (LTSS) are vital for older adults with physical and cognitive disabilities. LTSS can be provided in settings such as nursing homes, assisted living, or via community-based services. The aim of this study is to describe the perceived needs for older adults new to LTSS, examine whether those needs are met in the first three months of LTSS, and determine the relationship with quality of life (QoL). This secondary analysis included data from 470 older adults new to LTSS (average age: 81, 71% female, 51% white, 35% black, 20% Hispanic.) The main outcome of QoL was measured using a single item (“How would you rate your overall quality of life at the present time?”). Perceived needs included supportive equipment devices, transportation, physical therapy, and social activities. Analyses at baseline and three months included t-tests, ANOVAs and simple regression modeling. LTSS recipient reported needs at baseline were: 29% supportive equipment, 31% transportation, 20% physical therapy, and 25% social activities. Those who reported needs at baseline had a lower QoL than those who reported no needs (for all). At three months reported needs decreased by an average of 6% (range: 3%-10%). QoL ratings were associated with changes in physical therapy and social activities needs at three months. The implications of these results related to LTSS recipients’ QoL in the first three months of services, with emphasis on physical therapy and social activities needs, is an opportunity to be more person-centered in delivery of care.
GERONTOLOGICAL PEDAGOGY: PASSION, PARADOX, AND PROMISE
Authors: Hahn Sarah J , Karasik Rona J
Published: November 2019

Gerontology programs in the United States are on the decline despite the need for trained professionals who can serve a growing aging population (Pelham, Schafer, Abbott, & Estes, 2012). For many students, a gerontology course may be their only formal exposure to the concepts of aging. The development of gerontological pedagogy is important, but there is limited knowledge about what is being taught around the nation and to what extent course content reflects the current scope of the discipline. This symposium explores the role of individual instructors, the larger environment, and the efforts of organizational level criteria (i.e., AGHE standards to advance the field) to promote higher-quality gerontological education. The first presenter reports dissertation findings that examined college students’ self-perceptions of aging and how stereotypes impact them even after taking an introduction to gerontology course. The second presenter discusses the need for service-learning and community engagement in gerontology, while reporting on theoretical and practical suggestions, as well as potential pitfalls to avoid. The third presenter reports on student evaluations in a Master of Science program before and after the implementation of the Association for Gerontology’s proposed competencies. And our final presenter provides insights on applied perspectives and pedagogical approaches in and out of the classroom, including pitfalls and possibilities. Our discussant brings our ideas together to report on the discipline of gerontology and our potential to advance to the next level of pedagogical strategies.
THE INFLUENCE OF REVISING AN ONLINE GERONTOLOGY PROGRAM ON THE STUDENT EXPERIENCE
Authors: Dassel Kara B , Felsted Katarina , Eaton Jacqueline
Published: November 2019

The University of Utah’s Gerontology Interdisciplinary Program (UUGIP), a fully online program recently aligned all courses to meet the 2014 Academy of Gerontology in Higher Education (AGHE) “Gerontology Competencies for Undergraduate and Graduate Education” and to meet best practices in online teaching. These efforts led to the GIP Masters of Science program being recognized in 2017 by AGHE as a Program of Merit as well as a publication in the AGHE Journal of Gerontology & Geriatrics Education (Dassel, Eaton, & Felsted, 2018). In an effort to further this work, we analyzed student evaluations in core Master of Science program courses prior to and following these program revisions, assessed by qualitative and quantitative evaluation data from two semesters immediately prior and two semesters immediately following revisions. This presentation will discuss results, implications, and future applications of this analysis.
PARTNERED EVALUATION OF LONGITUDINAL IMPACT OF STAR-VA: IMPLICATIONS FOR PROGRAM SUSTAINABILITY
Authors: Karel Michele J , Minor Lisa A , Jedele jenefer M , Intrator Orna , Curyto Kim J
Published: November 2019

Between 2013 and 2018, 86 Community Living Center (CLC) teams received STAR-VA training and consultation and implemented the intervention. Program evaluation has consistently demonstrated that STAR-VA Veteran training cases experience significantly decreased frequency and severity of target behaviors, symptoms of depression, anxiety, and agitation. VA Central Office leaders responsible for ongoing STAR-VA implementation and evaluation sought to understand the program’s systemic impact on important outcomes, if outcomes are maintained, and factors influencing variation in sustained adherence to STAR-VA. This presentation will describe the rationale for and methods used to develop a valid quality improvement metric to assess behavioral symptoms of dementia, to compare Veteran- and site-level outcomes at trained and untrained CLCs, and to identify factors associated with sustained STAR-VA implementation. This partnered evaluation, combining quantitative and qualitative methodologies, is critical for informing operational strategies for promoting STAR-VA and supporting its sustained implementation in VA CLCs.
RATIONALE FOR ASPREE DISABILITY-FREE SURVIVAL PRIMARY OUTCOME AND OVERVIEW OF PRIMARY OUTCOME RESULTS
Authors: McNeil John
Published: November 2019

Disability-free survival (DFS), defined as survival free of disability and dementia was the primary outcome measure of the ASPREE clinical trial. As previously reported, there was no benefit of low dose aspirin on the primary end point of dementia, physical disability or death, but bleeding risks were increased. In total, 1,835 participants reached the primary endpoint, confirmed amongst approximately 3,000 who had triggered for one of the end-points. Dementia was the most labor intensive component of DFS. Several previous primary prevention aspirin studies had identified a reduction of vascular events counterbalanced by an increase in serious bleeding, leaving the question of net outcome to an intuitive decision. DFS was chosen because it balances the positive and negative effects of a preventive drug such as aspirin. It also encapsulates the primary purpose of a preventive drug in older people i.e., to prolong a healthy lifespan rather than prevent a defined disease.
COMMUNITY ENGAGEMENT AND SERVICE LEARNING: PROMISING PEDAGOGICAL PRACTICES FOR TEACHING GERONTOLOGY
Authors: Kruger Tina M
Published: November 2019

In terms of studying human development, gerontology is unique in that most college students have not experienced this aspect of the life course yet. While personal experience cannot be generalized, our students can at least relate to the idea of being a child, an adolescent, and a young adult. What they cannot do it relate to the experience of being old, and they may have limited contact with the older adult population, with the exception of grandparents, who tend to be viewed differently from older non-relatives. One way to facilitate students connecting with the older adult population is through community engagement or service-learning (CE/SL) projects. Such projects are ripe for facilitating learning, but there are also potential pitfalls to consider. Here we discuss the need for CE/SL in gerontology, theoretical and practical suggestions, and potential pitfalls to avoid.
THE GSA PRESIDENTIAL SYMPOSIUM — STRENGTH IN AGE: HARNESSING THE POWER OF NETWORKS
Authors: Cohen Harvey J
Published: November 2019

GSA is a network of disciplinary components each of which is a network composed of members. This large system possesses powerful emergent properties that are realized at many interdisciplinary interfaces. The GSA Presidential Symposium mirrors this by bringing together rapporteurs from our disciplinary presidential symposia who will summarize the major findings of these symposia. The Behavioral and Social Sciences presidential symposium explores the use of social networking by aging adults, the media and technologies utilized, and the impact of these trends on health and well-being. The Biological Sciences presidential symposium examines multiple layers of biological networks as predictors of systemic aging. The Social Research Policy and Practice presidential symposium dissects the reciprocal relationship between broad environmental contexts and social networks throughout life and ways in which this relationship can be used to optimize the aging experience. The Health Sciences presidential symposium reports on the improvement of perioperative care of older adults achieved through harnessing the partnership and collaboration of all disciplines involved in this care. The Academy of Gerontology in Higher Education presidential symposium discusses ongoing initiatives that build networks to shape age-friendly programs and policies at universities, international collaborations, and competency-based gerontology education. The Humanities and Arts presidential symposium investigates the synergy between museums and aging, both of which are represented as networks. A discussion between the presidential symposia rapporteurs with audience participation will ensue to identify common, overarching themes and to spark approaches to important, interdisciplinary problems in gerontology. • Kelly Niles-Yokum, Academy for Gerontology in Higher Education, Education Networks: Strengthening of Gerontology and Geriatrics through Connectivity • Kristine J. Ajrouch, Behavioral and Social Sciences Section, The Ties That Bind: The Influence of Social Media and Technology in the Lives of Older Adults • George L. Sutphin, Biological Sciences Section, Expanding the Geroscience Network • Luigi Ferrucci, Health Sciences Section, Optimizing Surgical Care for All Older Adults • Kate de Medeiros, Humanities and Arts Committee, Museums and Aging: Novel Network Opportunities to Support Optimal Aging • Emily Greenfield, Social Research Policy and Practice Section, Harnessing Social Networks to Optimize Environmental Contexts for Diverse Aging Experiences
DEPENDENCY IN ACTIVITIES OF DAILY LIVING: THE ROLE OF MULTIDIMENSIONAL FRAILTY AND PROTECTIVE FACTORS
Authors: Zijlstra G A Rixt , Vorst Anne van der , Op het Veld Linda P M , Witte Nico De , Schols Jos M G A , Kempen Gertrudis
Published: November 2019

Most older adults prefer to “age in place” and maintain independent regarding activities of daily living (ADL). Dependency in ADL might be caused by frailty. This study explored the relationship between multidimensional frailty and ADL dependency, and if protective factors, derived from a systematic literature review, moderate this relationship. A longitudinal study with a 24-month follow-up was performed among 1,027 community-dwelling older adults. Multidimensional frailty was assessed with the Tilburg Frailty Indicator, and ADL dependency with the Groningen Activity Restriction Scale. Other measures included socio-demographic characteristics and seven protective factors against ADL dependency, such as physical activity and non-smoking. Logistic regression analyses showed that frail older people had a twofold risk of developing ADL dependency in comparison to non-frail older people after 24 months (OR = 2.12, 95% CI = 1.50-3.00). Analyses with interaction terms indicated that the selected protective factors against ADL dependency did not signiﬁcantly moderate this relationship. Nonetheless, higher levels of physical activity and having suﬃcient ﬁnancial resources decreased the risk of becoming ADL dependent in the overall sample (OR = 0.67, 95% CI = 0.46-0.98 and OR = 0.49, 95% CI = 0.35-0.71, respectively). In conclusion, multidimensional frail older people are at higher risk of developing ADL dependency and the studied factors against ADL dependency did not signiﬁcantly moderate this relationship. To develop prevention strategies for ADL dependency and facilitate aging in place, future studies might explore the relationship between each specific frailty domain and ADL dependency, and the role of (other) moderating factors.
CHANGES IN RELIGIOUSNESS AMONG OLDER ADULTS FOLLOWING CANCER DIAGNOSIS
Authors: Murphy Tonia K , Wilton Sara , Blackmar Amanda , Thompson Edward H , Futterman Andrew
Published: November 2019

This study aims to identify the changes in individuals’ religious beliefs after receiving a cancer diagnosis. Open-ended religious development interviews were completed with 278 older adults (aged 55 to 102) in the northeast United States. Of these 278, 16 of the interviewees had received a cancer diagnosis within the previous two years. These older adults who report a cancer diagnosis describe few changes in their overall religiousness. On the contrary, these individuals describe longstanding, generally consistent patterns of religiousness that began early in life, most often related to their family upbringing. While most of these cancer-diagnosed individuals have sustained their religious involvement over time, a few have rejected or substantially modified their religious involvement for reasons unrelated to their recent diagnosis (e.g., most often due to marrying someone of a different faith tradition). In addition, those who received a cancer diagnosis describe their religious involvement primarily in terms of its emotional and social reward. These individuals report little complexity of religious belief - little questioning, little doubt in religious doctrine. Instead they report a straightforward, deep, comforting religious belief. This is in contrast to frequent critical comments on religious belief and behavior reported by healthy older adults in our sample. Such findings are in keeping with previous research that describes a more extrinsically oriented religious involvement among older adults who are ill or vulnerable. We discuss these findings in light of both social selectivity theory (E.g., Carstensen, 1992) and stress and coping theory (Lazarus & lazarus, 2006).
DO PSYCHOLOGICAL AND SOCIAL FACTORS MODERATE LINKS BETWEEN CARDIOVASCULAR HEALTH AND COGNITION IN LATER LIFE?
Authors: Yorgason Jeremy B , Hill Melanie S , Wellar Hailey , Erickson Lance , Gale Shawn
Published: November 2019

Cardiovascular health is related to cognition in later life (Samieri, 2018). Psychological factors, such as depressive symptoms, have been linked with cardiovascular health (Thomas, Kalaria, & O’Brien, 2004). Marital quality, an important indicator of social connection, has been linked with cardiovascular response (Seider et al., 2009), and both depression and marital satisfaction are linked with a quicker recovery from heart attacks (Keller, 1998). Depressive symptoms and marital quality may buffer links between cardiovascular health and cognitive functioning. The purpose of this study was to examine cardiovascular links with cognition, in connection with depressive symptoms and marital quality. Using data from 864 participants of the Life and Family Legacy study (Mean age = 61.78), we examined predictors from 2010 in relation to cognition measured in 2017/2018. Word recall and computation subscales of the Minnesota Cognitive Acuity Screen (MCAS) were used to assess cognitive functioning. Results from multiple regression models indicated that after controlling for age, gender, education, income, and marital status, having hypertension and higher depressive symptoms were predictive of word recall. Lower depressive symptoms were also predictive of higher computation scores. Depression did not moderate links between cardiovascular health and cognitive functioning. Among married participants (n=632), positive marital quality had no main effect nor moderating association with cardiovascular health predicting cognitive functioning. Further research is needed to better understand how biological, psychological, and social factors interact to affect cognition in later life. Longitudinal work should track these associations in context of cognitive changes with aging.
PURPOSE IN LIFE PROTECTS AGAINST COGNITIVE DECLINE AMONG OLDER ADULTS
Authors: Kim Giyeon , Shin Su Hyun , Scicolone Monica , Parmelee Patricia A
Published: November 2019

Objective: This study examined whether having a sense of purpose in life protects against cognitive decline among older adults and whether purpose in life moderates the relationship between selected risk factors (age, sex, and race/ethnicity) and cognitive abilities. Methods: This was a longitudinal analysis of existing secondary data of adults (N = 11,557) aged 50 or older using the 2006 −2012 waves of the Health and Retirement Study. The study measured purpose in life, cognitive functioning score, and various covariates. Results: Growth curve modeling revealed that, after adjusting for covariates, purpose in life was positively associated with participants’ total cognition scores. Purpose in life significantly moderated the relationship between age and race/ethnicity and cognitive decline. Further, purpose in life was a protective factor against cognitive decline for those who were older and black. There was no significant interaction between purpose in life and sex. Conclusion: Having a purposeful life protects against cognitive decline in older adults, and the associations varied by age and race/ethnicity, but not by sex. Potential ways to increase purpose in life are discussed in a clinical context.
THE ROLE OF PRINT EXPOSURE IN SUPPORTING COGNITIVE ABILITY AMONG OLDER ADULTS
Authors: Liu Xiaomei , Stine-Morrow Elizabeth A L , McCall and Giavanna S
Published: November 2019

Reading is an activity that has long been thought to have beneficial effects on cognitive ability, however, little is known about the effects of long-term reading engagement on cognition among older adults. Pre-test data are reported from an ongoing study of the effects of a literacy-based intervention on cognition among older adults. Participants (66.7% female) ranging from 60 to 79 years of age with education ranging from 11 to 19 years were administered a battery of measures, including print exposure checklists, which are objective indices for assessing long-term reading-related activities, as well as cognitive assessments. A composite measure of print exposure was based on the Author Recognition Test, Magazine Recognition Test, Non-fiction Author Recognition Test, and Fiction Recognition Test (alpha=.92). Cognition was assessed in a comprehensive battery, including measures of verbal ability, working memory, episodic memory, and verbal fluency (alpha=.83). Print exposure was marginally related to self-reported time spent reading (r=.27, p.4), suggesting criterion-related validity. Age-related declines were not evident for any of our cognitive measures in this sample, t(46)’s.8, and there was a modest increase in reading engagement with age (r=.36, p=.01). Controlling for verbal ability, print exposure had a significant positive influence on global cognition (standardized beta=0.38, p=.01); however, these effects were specific to episodic memory and verbal fluency, t(46)>2, p<.05. These preliminary findings are suggestive of selective cognitive benefits from continued literacy engagement in reading in later life.
BEHAVIORAL INTERVENTIONS FOR COGNITION AND EVERYDAY FUNCTION: A SYSTEMATIC REVIEW
Authors: Sprague Briana N , Freed Sara A , Webb Christina E , Phillips Christine B , Hyun Jinshil , Ross Lesley A
Published: November 2019

Behavioral interventions to improve cognitive function in older adults are widespread and can vary from theatre classes to cognitive training programs targeting one domain. However, the effectiveness in maintaining different cognitive domains varies greatly both across and within intervention types. To date, no systematic reviews have synthesized findings across more than a few types of interventions (e.g., cognitive vs. exercise). This systematic review examined nine types of behavioral interventions and the respective transfer to 18 cognitive domains and everyday function. The 2017 search yielded 75 unique eligible articles comprising of educational, theatre, mindfulness, cognitive, exercise, video game, and combination interventions. In general, there was limited evidence of consistent transfer from behavioral interventions to untrained cognitive domains. Few studies examined education, theatre, mindfulness, or video game interventions, leaving inconclusive results about their effect on cognitive function. Nine studies evaluated transfer to everyday function and found that both process- and strategy-based cognitive training conferred benefits up to 10 years posttest. These results suggest that while there is weak-to-moderate evidence of far transfer from behavioral interventions to untrained cognitive domains, it may be more important to examine far transfer to measures more indicative of older adult everyday life. Furthermore, it highlights the necessity to continue long-term follow-up. While there were notable limitations of the extant literature, including inconsistent use of terms such as active control or inadequate intervention description, there were strengths such as the recent implementation of factorial designs. Implications for future research and practice will be discussed.
EFFECT OF PHYSICAL EXERCISE ON COGNITION IN ADULT DAY PARTICIPANTS
Authors: Stucki Bradford , Katz Ben , Briganti Jonathan , Schepisi Ila , Jarrott Shannon
Published: November 2019

Aerobic exercise has been demonstrated to be one of the most effective means of improving cognition in older adults. However, less is known about how exercise programs may improve cognition in older adults participating in Adult Day Service (ADS) programs. We analyzed a ten-year longitudinal data set from the Virginia Tech ADS center. We limited our analyses to individuals for whom we had two time points of the Mini-Mental Status Exam (MMSE) (n=142; average age = 78.48; 63 female, average days at center = 347; SD=432.71). Participants in the center completed approximately 30 minutes of physical exercise each day of attendance. The exercise regimen was largely composed of aerobic chair exercise, stretching, and lifting. Facilitator ratings of engagement with the exercise activity between the two test administrations were used to create an average engagement score for each participant. Multiple regression analyses were conducted using engagement as a predictor and change in MMSE as an outcome; no significant relationship was identified between exercise engagement and change in cognitive status. However, a moderation analysis conducted with diagnosis of Alzheimer’s disease (AD) or dementia as a predictor, change in MMSE as an outcome, and exercise engagement as a moderator revealed a significant moderation effect (p = .001). Greater exercise engagement was associated with improvements on the MMSE, but only for individuals without a diagnosis of AD or dementia. Given that many ADS programs serve individuals both with and without AD or dementia, these findings may inform more personalized exercise interventions at ADS centers.
STABILITY AND CHANGE IN DEPRESSIVE SYMPTOMS AND COGNITION FOR CENTENARIAN COHORTS
Authors: Lee Gina , Martin Peter
Published: November 2019

The purpose of the study was to examine the stability and change of cognition and depression levels and how they predict each other over time. Participants of the Health and Retirement Study who survived to centenarian status (N = 331) were included in this study. The total cognition summary score and the CES-D summary score of depressive symptoms were used to conduct four cross-lagged regression analyses from wave 2 to wave 6. Age was used as a covariate. Results indicated that the stability coefficients for depressive symptoms and cognition from wave 2 to wave 6 were high. Depressive symptoms at wave 2 significantly predicted change in cognition at wave 3, whereas depressive symptoms at all other waves did not predict change in cognition in the next wave. Cognition did not predict changes in depressive symptoms for any wave. Age as a covariate predicted change in cognition in each following wave, particularly from wave 2 to wave 5. The coefficients without stability for depressive symptoms and cognition from wave 2 to wave 5 predicted each other significantly over time, except for the last wave. In conclusion, cognition and depressive symptoms predict each other over time, but they do not predict each other if stabilities are included in the analyses. Further research needs to examine the stability and change in depressive symptoms and cognition including more waves in order to examine whether cross-lagged effects fade or continue in very late life.
THE ASSOCIATION OF OBJECTIVE FINANCIAL DECISION MAKING WITH FINANCIAL LITERACY, EDUCATION, AND MATH SKILLS
Authors: Sunderaraman Preeti , Ho Sarah , Stern Yaakov , Cosentino Stephanie
Published: November 2019

Rationale: Financial decision-making (FDM) is a critical ability with implications across the adult life-span. In healthy adults, demographic and cognitive factors impact FDM. However, the impact of these factors on FDM has yet to be fully investigated. The aim of the current study was to understand the extent to which demographics (age, education, sex), financial literacy (crystallized ability), and mathematical ability (fluid ability) influence FDM. Participants and Methods: The sample, recruited from a larger ongoing study, consisted of 73 adults; mean age=61.31 (13.76) years, mean education=15.68 (2.61) years, 59.5% female, 58% Caucasian. FDM was measured using the Financial Competence Assessment Inventory, financial literacy using a standard set of 23 questions, and math skills using WAIS-III Arithmetic, WRAT-IV Math and Cognitive Reflection Test. Results: Only variables that were significantly associated with FDM in bivariate analysis were selected for the multiple regression analysis. After adjusting for multicollinearity, stepwise multiple regression analyses revealed that the overall model with 3 predictors (education, financial literacy, WAIS-III Arithmetic) was significant (F =23.64, p < .001) and explained 50.7% of the variance in FDM. Education and WAIS-III Arithmetic predicted FDM to a higher extent than financial literacy. Conclusions: The finding that education and fluid ability has a relatively higher impact on FDM as compared to crystallized ability is important. As one ages, fluid abilities decline more rapidly than crystallized abilities. This may be one explanation for why FDM ability worsens with age. To increase confidence in these findings, future research should test these models using age-stratified analyses.
AFFECTING COGNITION: HOW DO POSITIVE AND NEGATIVE AFFECT PREDICT THE FUTURE COGNITIVE PERFORMANCE OF MIDLIFE ADULTS
Authors: Lee Jungmin , Troutman Sara B W , Gertel Victoria , Molenaar Peter , Almeida David M
Published: November 2019

The purpose of the present study is to examine whether positive affect and negative affect can predict the changes in cognitive abilities, assessed by episodic memory and executive functioning, during the transition to late adulthood. Using the longitudinal data from the national survey of midlife development in the United States (MIDUS), this study implements a cross-lagged panel model to test the significance of two pathways; one from affect to cognition and the other in the opposite direction. The results show the three main findings: First, the relationship between affect and cognition is unidirectional in which only positive affect and negative affect during the first occasion significantly predict episodic memory in the second occasion. Second, regardless of the type of affect, higher levels of both positive and negative affect predicts worse episodic memory and this tendency is more prominent in older adults. The combined results emphasize the benefits of using affect as a predictor of changes in the specific types of cognition and suggest using the longitudinal model to account for complex relationships between these psychological constructs.
PROMOTING AND ATTRACTING STUDENTS TO CAREERS IN AGING SERVICES
Authors: Heinz Melinda
Published: November 2019

Three student focus groups were conducted at residential, center, and online university locations (N = 15) to investigate interest and understanding of careers in gerontology and exposure to aging issues. Students majoring in health services administration, psychology, and human services were recruited and given an honorarium for participating. Sessions were recorded and transcribed with two researchers independently coding to identify themes. Center and online participants were more likely to be non-traditional students. Eighty-seven percent of participants were female, 13 percent were male. Ages ranged from 19 to 34 (M = 23.4). Eighty-seven percent were upperclassmen. This study is unique as most research has investigated aging issues with traditional aged students. Center students reported aging issues were discussed in courses outside of their majors, whereas residential students stated issues did not receive attention outside of gerontology classes. Online students stated discussions depended on the class. Common deterrents for not considering careers in gerontology were concerns about performing “physical cares” or coping with death anxiety. Few considered what a career in gerontology looked like outside of nursing homes. To increase awareness, some students felt “gerontology classes should be mandatory.” Students felt taking field trips to modern nursing homes “changed their perspective,” from medical model facilities. All participants reported little exposure to older adults or gerontology as a viable career path in high school. With the rapidly aging population, we suggest incorporating a “Careers in Aging” unit in high schools to increase awareness of gerontology opportunities.
LATER-ADULTHOOD TRAUMA REENGAGEMENT IN VIETNAM VETERANS WITH PTSD: FINDINGS FROM A PROGRAM EVALUATION PROJECT
Authors: Malley Kelly A O , Bamonti Patricia M , Graham Kirsten , Smith Ronald , Gurevitch Jacqueline , Kaiser Anica Pless
Published: November 2019

As Veterans age, they may experience an emergence or exacerbation of stress symptomatology. Later-Adulthood Trauma Reengagement (LATR) is an intervention that provides psychoeducation on the LATR process, teaches mindfulness and coping, facilitates trauma re-integration, and fosters meaning-making in late life. This program evaluation project evaluated the LATR group offered in the Geriatric Mental Health Clinic at VA Boston. Twenty-one Vietnam Veterans with PTSD symptomatology were referred to the group between 2017-2018. Fifteen completed the 10-week group, and 12 completed pre- and post-intervention assessments and offered feedback. At the conclusion of the group, Veterans reported a decrease in depressive and PTSD symptoms. Of the 4 Veterans who endorsed suicidal ideation at the start of the group, 3 reported a decrease post-group. Veterans endorsed slightly more positive appraisals of their military service. Veterans reported that the group offered support, connection, and a sense of belonging with other Veterans, helped increase coping, and increased insight into thoughts, feelings, and behaviors. A suggested improvement to the group was to offer more sessions. Eleven Veterans sought continued mental health services following the group; three newly sought trauma-focused interventions. Four Veterans reported that their trauma-related symptoms were resolved and declined referral. Veterans found the LATR group helpful as evidenced by reduction in symptoms and responses to open-ended questions. A small number sought additional trauma-focused treatment; others reported that their symptoms were resolved and did not require additional treatment. Findings support the continued offering of the LATR group within this clinical setting.
MOTIVATION TO LEARN, LITERACY, NUMERACY, AND LATER-LIFE ADULT EDUCATION PARTICIPATION IN THE U.S.
Authors: Yamashita Takashi , Cummins Phyllis , Millar Roberto J , Sahoo Shalini , Smith Thomas J
Published: November 2019

The objective of this study is to examine the associations between the motivation to learn, basic skills (i.e., literacy and numeracy), and organized formal and non-formal adult education and training (AET) participation among middle-aged and older adults in the U.S. Rapid technological advancement and globalization requires that adults engage in lifelong learning to actively participate in society. However, little is known about the roles of motivation to learn and basic skills in AET participation among aging adults in the U.S. We obtained restricted data from the 2012/2014 Program for International Assessment of Adult Competencies, and included adults aged 50 years and older (n = 2,580) in the analysis. Structural equation models were used to examine (1) any AET, (2) formal AET and (3) non-formal AET participation as a function of the latent construct of motivation to learn, literacy and numeracy scores (0 – 500), and covariates. Per the confirmatory factor analysis, the motivation to learn latent construct was a valid measure among the older adults. Results from the structural equation models showed that the motivation to learn (b = 0.35, p < 0.05), literacy (b = 0.05, p < 0.05) and numeracy (b = 0.03, p < 0.05) are all positive predictors of non-formal AET participation. However, only motivation to learn (b = 0.47, p < 0.05) is associated with formal AET participation. Findings from this study inform future interventions as well as policy changes to promote specific types of organized AET programs among the aging populations in the U.S.
A MIXED-METHODS EVALUATION OF A 20-YEAR SENIOR MENTOR PROGRAM FOR MEDICAL STUDENTS
Authors: Kilaberia Tina R , Ratner Edward , Englund June
Published: November 2019

The purpose of this mixed-methods evaluation is to demonstrate the success from the past 20 class years of continuous use of senior mentors to teach geriatrics to approximately 3400 Year 1 and Year 2 medical students in a home visit model. Using a pre-test post-test design (N=131), we evaluated student satisfaction, self-confidence in various geriatrics assessments, and performance on an Objective Structured Clinical Evaluation (OSCE). We additionally conducted a formal qualitative evaluation of students’ open-ended reflections (N=97) across three years, from 2016-18, on what they learned. In addition, relying on the principles of community-based research, we collaborated with a volunteer senior on all aspects of this evaluation, and included a community of seniors at a large urban senior care high-rise to enhance our interpretive validity by asking seniors to reflect on a set of representative quotes for each qualitative theme. The senior mentor home visit model demonstrated high satisfaction, improved self-confidence in geriatric assessment, attainment of competencies, and improvement in attitude scores. With regard to the qualitative portion of the evaluation, six themes about learning were recognized: (1) how to perform an interview and exam in a home setting, (2) how life for seniors is different than students expected, (3) the value of physical infrastructure and amenities in senior housing, (4) the importance of senior’s community, including family, neighbors, spiritual community, (5) challenges with aging, and (6) strengths among seniors in coping with such challenges while maintaining individual agency.
FAMILY AND SOCIAL NETWORKS FOR AGE-RELATED PLANNING CONVERSATIONS: CHARACTERISTICS AND VARIABILITY
Authors: Chen Emily K
Published: November 2019

Informal advance care planning (IACP) – that is, conversations with surrogate decision-makers about wishes for health care or end-of-life preferences – have been identified as equally if not more important than legal documentation for achieving a high-quality end-of-life experience. Fairly high rates of adults report having had these conversations; this is especially true of people who are older, sicker, or who have had caregiving experience. However, relatively little is known about the content and characteristics of these conversations, such as who people are talking to, what triggers the conversation, and what is actually said. This paper reports findings from interview-based research that asked 38 middle-age and older adult respondents (ages 55 to 74) about conversations related to several areas of age-related planning, including planning for health care needs and wishes about end-of-life. The interactive interview protocol used the open-source EgoWeb software to elicit information about age-related planning conversations, family and social networks, and who within those networks served as conversation partners for the various topics. We will share results of the analysis of the networks and conversation topics. We found that some individuals more readily engage in discussions about future planning across topics than others, but that part of this is driven by the readiness of their family and friends to engage in these topics. This suggests that targeting individuals to increase rates of IACP has limitations when family and friends are resistant, and that dyadic interventions may be appropriate in some cases.
CAREGIVER BURDEN, BENEFIT, AND PERCEPTIONS OF END-OF-LIFE CARE QUALITY
Authors: Luth Elizabeth A , Pristavec Teja
Published: November 2019

End-of-life care quality (EOLCQ) gauges our success in providing quality care to dying individuals. EOLQC measures rely on reports from bereaved family members who provide care for dying loved ones, but analyses seldom account for how caregivers’ experiences influence their EOLCQ perceptions. Caregivers frequently experience burden, which is linked to poor health outcomes and may negatively bias EOLCQ reports. Individuals may also perceive caregiving benefits that can offset deleterious burden effects, but potentially encourage overly positive EOLCQ perceptions. This paper links National Study of Caregivers (2011) and National Health and Aging Trends Study (2011-2016) data, using regression analysis and a sample of 380 EOL caregivers to examine how caregiving burden and benefits perceptions shape and moderate EOLCQ reports. Caregiving burden is unrelated to EOLCQ in adjusted models. Benefits are associated with marginally greater odds of being informed about the dying person’s condition and reporting their personal care needs were met. Burden and benefits moderate these two measures. Despite benefits, low burden caregivers report they were informed about the dying person’s condition with 90% probability. Regardless of burden, high benefits caregivers report the same with 90% probability. Low burden and benefits caregivers report met care needs with 90% probability. High burden and benefits caregivers have 90% probability of such reports. Given these reports are used in formal hospice care evaluations by CMS, additional research should explore why caregiving burden and benefit are associated with some EOLCQ measures and why individuals reporting high burden and benefits provide more positive EOLCQ appraisals.
END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS
Authors: Shryock Kelly , Dickens Jacinta , Thomas Anisha , Meeks Suzanne
Published: November 2019

Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.
FREQUENCY OF CONTACT AMONG FAMILY MEMBERS AND END-OF-LIFE CARE PLANNING
Authors: McDarby Meghan , Kozlov Elissa K , Carpenter Brian
Published: November 2019

The purpose of the current analysis was to examine how contact between adult children and their older parents may relate to having end-of-life care conversations. We analyzed responses from adult children (n = 66) of 36 older adults (65+) who participated in an intervention to improve family communication. Children reported the frequency of their in-person and phone contact with parents. They also completed the Conversations about Care Arrangements Scale (alpha = 0.95), 8 items that measure the extent to which adult children have discussed plans about future care with their parents (1=have not talked at all, 5=talked extensively). We calculated a composite from all 8 items (potential range 5-40). Participants reported that they had, on average, not talked extensively with their parent about plans for future care (M = 18.7, SD = 8.22). Overall, 42.4% of children reported that they visited their parent one time or less per year. Children reported speaking on the phone with their parent an average of 4.74 times per week (SD = 6.80, range = 0-30) and initiating an average of 2.59 of those calls (SD = 3.82, range = 1-20). Frequency of weekly phone conversations between child and parent was significantly associated with having talked more extensively about future care plans (r = 0.25, p < 0.05), as was frequency of phone calls initiated by the adult child (r = 0.29, p < 0.05). Frequency of in-person visits to parents was not significantly associated with conversations. Infrequent contact may limit opportunities for care conversations.