bluuebunny/crossref_metadata_2025 huggingface dataset:
Failing to Plan Is Planning to Fail: Utilization of Advance Care Directives in Older Adults Living With HIV
Authors: Nash Paul , Nguyen Annie , Egbert Anna , Brennan-Ing Mark , Karpiak Stephen
Published: December 2021

Advance Care Planning (ACP) makes up an integral part of the care continuum, especially for those living with chronic conditions such as HIV. Little research exists to understand how intersections of race, gender, sexuality and gender identity combine to influence the choices made by older adults living with HIV regarding ACP. The Research on Older Adults with HIV (ROAH) 2 study collected data from across the US and investigated the incidence and range of ACP amongst those 50+ living with HIV. Correlational analysis indicated that being White was significantly related to having at least one directive (R=0.070, p=0.035) where being African American correlated negatively with several forms of ACP. Additionally, there were also significant relationships between being Transgender, being gay, and being a woman as to the engagement with ACP options. Further analysis explored the impact of finance, self-rated health and social support networks.
WLS-ILIAD: New Longitudinal Resource for Cognitive and Dementia Data
Authors: Asthana Sanjay , Herd Pamela , Williams Victoria
Published: December 2021

One of the distinctive strengths of WLS is the availability of Henmon-Nelson IQ scores on all participants while in high school, followed by prospective collection of data through cognitive batteries of varying size and sophistication. Launched in 1993, the initial longitudinal cognitive testing included 8 abstract reasoning items followed by the administration of larger cognitive batteries in 2004 and 2011 comprised of a 10-item word recall test, digit ordering task, phonemic and category fluency, as well as repeated and new items from the WAIS-R similarities task first administered in the 1993 survey. In 2018, with R01 funding from NIA, the scope of cognitive testing expanded significantly and includes administration of a phone-based cognitive screening measure, and a comprehensive in-person neuropsychological assessment for individuals identified at risk for dementia targeting a range of cognitive domains, including memory, language, attention, visuospatial abilities, and executive functioning.
Transitions to Long-Term Residential Care Settings
Authors: de Boer Bram , Verbeek Hilde , Gaugler Joseph
Published: December 2021

During their life course, many older adults encounter a transition between care settings, for example, a permanent move into long-term residential care. This care transition is a complex and often fragmented process, which is associated with an increased risk of negative health outcomes, rehospitalisation, and even mortality. Therefore, care transitions should be avoided where possible and the process for necessary transitions should be optimised to ensure continuity of care. Transitional care is therefore a key research topic. The TRANS-SENIOR European Joint Doctorate (EJD) network builds capacity for tackling a major challenge facing European long-term care systems: the need to improve care for an increasing number of care-dependent older adults by avoiding unnecessary transitions and optimising necessary care transitions. During this symposium, four presenters from the Netherlands and Switzerland will present different aspects of transitions into long-term residential care. The first speaker presents the results of a co-creation approach in developing an intervention aimed at preventing unnecessary care transitions. The second speaker presents an overview of interventions aiming to improve a transition from home to a nursing home, highlighting the clear mismatch between theory and practice. The third speaker presents the impact of the COVID-19 pandemic on transitions into long-term residential care using an ethnographic study in a long-term residential care facility in Switzerland. The final speaker discusses the results of a recent Delphi study on key factors influencing implementing innovations in transitional care. The discussant will relate previous findings on transitional care with a U.S. perspective.
The Meaning of Age: In a Context of Eldercare and Substance Use
Authors: Harnett Tove , Jonson Hakan
Published: December 2021

Some people age with substance abuse and social problems and several countries provide members of this population with a type of arrangement referred to as “wet” eldercare facilities. These facilities provide care for people who are judged as unable to become sober, in some cases with a lower age-limit at 50 years. The aim of this study was to investigate the meaning of age for judging the fit between the person and the arrangement. The study was based on interviews with 42 residents, 10 case workers and 21 staff members at five facilities in Sweden. Respondents were asked about the relevance of age and if the facility should include younger people as well. Some staff argued that younger people should be excluded since they could not have the history of multiple failures in treatment that was a prerequisite for admission. Regarding the low age-limit, substance abuse was said to accelerate the process of ageing so that a person aged 50 could be considered 20 years older and in need of eldercare. Residents had a tendency to equate age with activity and argued that people below the age of 50 were active and energetic and the inclusion of younger people would lead to disturbance of the calm pace of the facilities. Given that facilities have been described as “end-stations”, it was puzzling that few respondents linked the question of admitting younger person to the matter of giving up ambitions to make the person sober.
The Cost-Effectiveness of Non-Drug Interventions That Reduce Nursing Home Admissions for People With Dementia
Authors: Jutkowitz Eric , Alarid-Escudero Fernando , Shewmaker Peter , Gaugler Joseph , Pizzi Laura
Published: December 2021

Although people generally want to age in their community, individuals living with dementia are likely to move to a nursing home. In randomized trials, psychosocial interventions reduce the risk of people living with dementia transitioning to a nursing home, but the cost-effectiveness of these interventions is unknown. We used an evidence-based mathematical model to simulate a place of residence (community or nursing home) for people living with dementia. Our model also predicts time caregiving, health care costs, and quality of life. We modeled the reduction in nursing home rate (i.e., hazard ratio (HR) treatment effect) identified from two trials of non-drug interventions for people living with dementia and their caregiver. Using trial data, we account for the disease stage of when interventions are implemented. Specifically, we modeled MIND (HR: 0.63; 18-month effect), an in-home intervention for people with mild-moderate dementia, and the NYU Caregiver Intervention (HR: 0.53; 42-month effect), which is for people with moderate dementia. We evaluated each intervention’s cost-effectiveness relative to usual care for the duration of the intervention from a societal perspective. The MIND and NYU Caregiver Intervention resulted in $23,900, and $6,600 costs savings relative to usual care, respectively. The model predicted an improvement in the quality of life for people living with dementia for both interventions. The largest cost saving was attributed to reductions in family nursing home spending. Medicare and Medicaid received modest cost savings but are likely to be tasked with paying for these interventions.
Use of Tangible, Educational, and Psychological Supportive Services Among Chinese American Dementia Caregivers
Authors: Liu Jinyu , Lou Yifan , Cheung Ethan Siu Leung , Wu Bei
Published: December 2021

Background and Objectives: Though many studies have examined the service utilization of dementia caregivers, there is limited empirical evidence from Asian Americans and the lack of incorporating community resources and sociocultural factors in this field. Guided by the Andersen's Behavioral Model of Health Services Use (ABM), we aimed to understand whether and how predisposing, enabling and need factors were associated with utilizing multiple types of services among Chinese Americans dementia caregivers. Research Design and Methods: We collected survey data from 134 Chinese dementia caregivers in New York City. Logistic regression models were conducted to test the associations between predisposing, enabling and need factors and the likelihoods of using tangible (home health aide, adult daycare, respite care), educational (lectures and workshops), and psychological (peer support groups and psychological counseling) services. Results: Consistent with prior literature, caregiver’s knowledge about services, caring tasks, length of care and burden and care recipient’s physical and cognitive deteriorations, were significantly associated with higher possibilities of using multiple types of services among these Chinese American dementia caregivers. Three sociocultural factors, including residing in Chinatowns, availability of alternative family caregivers and diagnosis of cognitive deterioration, were also associated with higher likelihoods of using educational or psychological services. Discussion and Implications: The findings extended the existing literature on service utilization of caregivers by highlighting the importance of distinguishing types of services and the necessity of considering sociocultural factors in future research and practice.
Interdisciplinary Team for MEDSReM-2 and Decision Support Through Pharmacology of Aging Principles
Authors: Lee Jeannie , Insel Kathleen , Nicholas J , Albadawi Amani
Published: December 2021

The interdisciplinary team members with distinct and complementary expertise working collaboratively to advance MEDSReM to MEDSReM-2 will be introduced. The decision support functionality in MEDSReM-2 application (app) is to guide older users on making decisions about missed doses. MEDSReM-2 medication formulary was created to include safe hypertension medications for older adults. Pharmacology of aging, including Pharmacokinetic and Pharmacodynamic principles, along with published studies and expert peer reviews, were used to create an algorithm for safe window of time to take the missed medications. We will present the processes for developing the decision support algorithm for the MEDSReM-2 App and how this guide will be communicated to the users to inform their decision making about missed doses. Interdisciplinary collaboration including pharmacy, nursing, cognitive aging, and technology development that was crucial for designing and implementing decision support within the MEDSReM-2 app for older users will be shared.
Developing Instructional Support for MEDSReM-2 Through Human Factors Design Principles
Authors: Mitzner Tracy , Harris Maurita , Blocker Kenneth , Trinh Mimi
Published: December 2021

Appropriate instruction is critical for ensuring the MEDSReM-2 system (i.e., smartphone app, blood pressure monitor, online portal) will be easily and effectively used and will, therefore, be more likely to be adopted. We will present our iterative processes for developing instructional support for MEDSReM 2 using human factors design principles (e.g., task analyses, comparative analyses, expert evaluation of mock-ups with screen flows). The instructional supports include user manuals, videos, as well as instructions within the MEDSReM 2 app. We will also highlight design principles used to empower the user and the benefits of using an interdisciplinary approach (i.e., gerontology, cognitive psychology, educational psychology, design, community health) to develop instructional support for older adult users.
Using HRS-ONET Linked Data to Study Subjective and Objective Mismatch Between Work Demands and Capacity at Older Ages
Authors: Helppie-McFall Brooke , Sonnega Amanda , Fisher Gwen
Published: December 2021

Mismatch between demands of work and workers’ ability to meet those demands may play an important role in retirement decisions. This presentation extends earlier work using Health and Retirement Study data linked to O*NET to develop measures of discrepancy between individual’s own reports of physical and mental abilities and 1) their perceptions of the physical and mental demands of their jobs and 2) O*NET ratings of the physical and mental demands of their jobs. In particular, we utilize newly available linked information using 2010 Census codes and 2019 O*NET ratings that reflect more current jobs. We then examine the impact of each type of mismatch (subjective and objective) on retirement timing. Overall, we find a stronger connection between subjective mismatch relative to objective mismatch. We discuss implications of this finding in terms of the value of the O*NET linkage and potential interventions aimed at extending working lives for positive aging.
Aging of a Model Minority: A Diachronic Analysis of Two Quantitative Research Studies on Aging of Japanese in New York
Authors: Toyama Itsuko , Nakashima Taeko
Published: December 2021

This is a diachronic analysis of two quantitative research studies on the aging of Japanese and Japanese Americans living in Greater New York. How have older Japanese individuals, who once have been referred as “model minority,” lived and aged in Greater New York? All the data in this paper are based on the first research study conducted in 2006 and the second in 2018 (Ethical approval reference number 6, 2018). This paper reveals both the social transitoriness and the cultural immutability of the Japanese elderly community in Greater New York. The following is a summary of the findings: (1) a growing Japanese American community with US citizenship, higher academic qualification, and better communication competency has been observed. (2) The allowable range of private expense to hire personal caregivers has been widened. (3) Not only the concerns and anxieties for later lives but also the plans and preparations for aging are much the same. (4) The elderly are provided with culturally specific care (with regard to language, food, and concept of care)—even allowed to live with other Japanese people—and the needs of caregivers who can understand Japanese culture are satiated. (5) Almost half of those in the community find it difficult to eliminate the possibility of returning to Japan, and some of them have already chosen to migrate back to Japan.
Meeting Needs of Diverse Older Adults and Caregivers During Public Health Emergencies: What Can We Learn From COVID-19?
Authors: Bayne Alycia , Singer Rachel , Spradley Candace , Isaacs Lauren , Jeffers Eva , Olivari Benjamin , Matthews Kevin , Whitton Alaina
Published: December 2021

With support from the CDC Foundation and technical assistance from the Centers for Disease Control and Prevention, NORC at the University of Chicago conducted studies to examine the needs and concerns of older adults and unpaid caregivers during COVID-19, including their trusted sources of COVID-19 information and available public health interventions. Methods included a nationally representative survey of 1,030 adults aged 50+ years using computer-assisted telephone and web interviewing; online focus groups with older adults and caregivers in Spanish and English; a survey and interviews with stakeholder organizations; secondary analysis of U.S. caregiver surveys; analysis of public social media posts; and searches of peer-reviewed and grey literature in Spanish and English to identify interventions. Results suggest that needs and concerns differed among older adult subpopulations, including racial and ethnic minority populations, people with lower incomes, rural and tribal populations, people with limited English proficiency, and people with disabilities as well as caregivers. Older adults perceived news media, the internet, and healthcare providers as important resources for COVID-19 information, although trusted sources varied by race and ethnicity, urbanicity, and income. Findings suggested the need to increase awareness of existing public health interventions and resources to support older adults and caregivers during public health emergencies like COVID-19. Strategies for tailoring communication for diverse older adults and caregivers include partnering with national organizations, leveraging community-level infrastructure, and disseminating information through trusted sources. Studying the needs of older adults and caregivers during COVID-19 can inform future public health emergency response priorities.
Diversity, Equity, and Inclusion in Gerontological Research Mentoring and Methodologies
Authors: Rooks Ronica , Mingo Chivon , Mingo Chivon
Published: December 2021

With a rapid increase in our nation's diversity and in particular the diversity of the aging population, research focused on the well-being and quality of life for all older adults is imperative. Within GSA, The Minority Issue in Gerontology Advisory Panel is charged with providing support to the membership that ultimately will yield an increase in the quantity and quality of research related to minority aging issues. Therefore, understanding best practices for minority-focused gerontological research and gerontological education curriculum is warranted. The advancement of the field is predicated on the ability to have trained professionals with skills and competencies that effectively meet the needs of a diverse aging population. This symposium will include a presentation highlighting practical strategies for strengthening gerontology research by intentionally incorporating anti-racist methodological approaches. The second presentation will consist of recommendations on how to support, promote, and advance gerontology education in a manner that increases the diversity of those pursuing a research or an applied career in this area of study. Presenters will share an overview of the literature, findings from program implementation focus groups, and recommendations for tailoring strategies to fit your intended audience. This session will prove beneficial as we make strides to ensure that diversity, equity, and inclusion remain a core value and an inherent practice of all gerontology professionals.
Population Aging and Multicultural Diversity in the United States: Implications for Older Consumers’ Needs and Expectations
Authors: Miller Julie , Patskanick Taylor , D'Ambrosio Lisa , Coughlin Joseph
Published: December 2021

Looking ahead to 2030 and beyond, the United States will be both older and more multicultural than presently. To explore the impacts and characteristics of an increasingly diverse population beginning to age, the MIT AgeLab conducted online focus groups in August 2020 (n=92) with ethnically diverse participants ages 40-69 on topics related to household composition, use of technology and digital engagement. Regarding household composition, Black and Latinx participants were more likely to report living with grandchild(ren), and Asian, Latinx, and White participants were more likely to report living with a parent(s) or parent(s)-in- law. Latinx participants often described ways in which caregiving for aging parents was a cultural value, but many participants who had raised children in the United States but who were not born in the United States themselves described cultural gaps in family attitudes that had sometimes widened across the generations. While all participants were using some technology, due to the coronavirus pandemic, digital tools were being used more widely than ever before. Racial/ethnic identity groups were more similar than different in terms of their responses to questions around consumer digital engagement. There were notable differences in overall trust in technology across racial/ethnic groups, with Asian participants reporting the highest average overall level of trust in technology and Multiracial participants reporting the lowest. Looking ahead, the intersection of aging and growing racial/ethnic diversity in the United States will yield a wider array of consumer needs and expectations.
Effects of Loneliness and Social Isolation on Cognitive Health: Latest Perspectives and Future Directions
Authors: Ng Ted , Yu Kexin , Lubben James
Published: December 2021

Loneliness and social isolation as antecedents of cognitive decline have received substantial attention in recent research. This symposium addresses this year’s conference theme of aging in the “new normal”. The COVID-19 pandemic has highlighted the negative impacts of loneliness and social isolation on older adults’ health and wellbeing. This symposium includes studies that shed light on the relationships between loneliness, social isolation and cognitive health using a multidisciplinary approach, and provide recommendations and future directions for advancing this research area. The first presentation examines cardiovascular biomarkers as potential mechanisms that mediate the longitudinal relationship between loneliness and cognitive decline with the HRS dataset. The second presentation examines several social isolation indicators and their effects on cognitive decline in a Canadian longitudinal study. Using the US ADRC longitudinal study of aging, the third study shows the effect of loneliness on cognitive health in older adults pre- and post-onset of the COVID-19 pandemic. The symposium concludes with a literature review of the different measures employed to operationalize the constructs of loneliness, isolation, which resulted in heterogeneous study findings on their influences on the risk of developing dementia. This review calls for consistent measures to produce comparable evidence on the health consequences of loneliness and isolation. In all, this symposium reports and reviews the latest evidence on the association between social isolation, loneliness and cognitive health amidst the ongoing COVID-19 pandemic. It also echoes the conference theme of transforming disruption to opportunities in aging health service and research.
ESPO and Butler-Williams Scientific Symposium: Disrupting Health Disparities and Transforming Care of Older Adults
Authors: Jones Patricia , Justice Jamie , Thorpe Roland
Published: December 2021

The NIA’s Butler-Williams Scholars Program and GSA’s ESPO Section are united in providing career development opportunities in a manner that promotes leadership, diversity, and inclusivity. Our emerging scholars are called to examine health inequity and overcome barriers by continuous and incremental improvements (disruption) or dramatic change (transformation) to improve health and access to care for our diverse aging population. Among the chief concerns of our aging population are disparities in health associated with race/ethnicity, experience, sociocultural and socioeconomic factors. GSA’s early career professionals and 2020 alumni of the prestigious NIA Butler-Williams Scholars Program address these issues. Dr. Karen Moss will discuss new findings from a study of African American caregivers of persons living with dementia. Dr. Jasmine Travers will present on mitigating disparities in access to long-term services and supports among older adults. Dr. Maricruz Rivera-Hernandez, will present current work on aging and care delivery or health of Hispanic older adults, including impact of COVID19 in Hispanic groups. Dr. Marc Garcia will present on interaction of race/ethnicity, nativity, and gender with key social and economic factors on health, COVID19, and aging. Finally, Dr. Shana Stites will present on social challenges in advancing diagnosis and treatment of Alzheimer’s disease dementia. The featured talks by rising stars deepen our understanding of the influence of health disparity so we can disrupt inequity and transform systems of care across our diverse aging populations.
The Impact of COVID-19 Across Nursing Homes That Disproportionally Serve Minority Residents
Authors: Rivera-Hernandez Maricruz , Kumar Amit , Roy Indrakshi , Karmarkar Amol , Erler Kimberly , Rudolph James , Baldwin Julie
Published: December 2021

The Coronavirus-2019 (COVID-19) pandemic has disproportionally affected communities of color and older adults in the United States. Nursing homes (NHs) have reported over 130,000 COVID-19 deaths (or one-fourth of all US deaths) circa March 2021, a high share of the nation’s total death count (CMS COVID-19 NH Data). These inequities partially driven by barriers to care, segregation and structural racism have resulted in the unequal impact of COVID-19 across NHs (Li et al., 2020). In this presentation, I will describe NHs that disproportionally care for minority residents and the effect of NH composition on COVID-19-related mortality and outcomes. In 2020, minority older adults were less likely to have access to high quality facilities. From June – August, NHs with a high proportion of minority residents reported higher COVID-19 mortality rates per 1000 residents. Equal access to high quality of care across the life-course among racial and ethnic groups is needed.
The Intersection of Race and Ethnicity, Nativity, and Sex on Cognitive Trajectories of Older Adults in the United States
Authors: Garcia Marc , Tarraf Wassim
Published: December 2021

We used longitudinal data from the Health and Retirement Study (1998-2016) to estimate sex-specific age-graded changes in global cognition and memory among White, Black, and U.S.- and foreign-born Latino adults 51 years and older. Among males, racial/ethnic and nativity differences in cognitive function were mainly evident at younger ages, particularly for Blacks compared to Whites. We found no evidence to support male racial/ethnic or nativity differentials in trajectories of cognitive aging. For women, older Blacks and U.S.-Born Latinas, and to a lesser degree foreign-born Latinas, had lower cognitive function at younger ages. However, White women showed more pronounced cognitive aging in comparison to U.S.- and foreign-born Latinas. Results applied to both global and memory outcomes. Our findings support calls for nuanced considerations of racial/ethnic and nativity effects on cognitive aging and ADRDs. Continued monitoring of differential cognitive aging trends is warranted as the vascular and neurologic sequelae of COVID-19 manifests.
Home Care Services for Seniors: A Typology of Instruments and Administrative Burdens in Industrialized Countries
Authors: Marier Patrik , Dickson Daniel , Lee Kyuho
Published: December 2021

This contribution has two key objectives. First, inspired by earlier studies in comparative welfare state and in (social) gerontology, we develop a conceptualization of autonomy that is rooted in its social dimensions. This concept is then deployed to assess its policy considerations within the field of home care, both with regards to access and generosity in 21 industrialized countries. Second, this contribution performs a comparative assessment of the key factors resulting in a prioritization of the social dimensions of home care and social services in long term care. This study involves an-depth analysis of policy instruments deployed by public authorities to enhance the (social) autonomy of older adults, complemented with interviews with policy makers in diverse home care policy settings (Canada, France, South Korea, Sweden, and the United States). As such, this study features an evaluation of the presence of social elements in the definition and supply of care needs across 21 countries. It leads to the construct of a social dimensions of autonomy index based upon these instruments and the budgetary prioritization of home care within long term care policies. Among core findings, one discovers broader access and more generous funding when home care responsibilities are firmly embedded at the local level.
Associates of Perceived Quality of Life in Chinese Older Adults Living With Cognitive Impairment
Authors: Gao Xiang
Published: December 2021

This study examined perceived quality of life in Chinese older adults living with cognitive impairment in a group of urban Chinese older adults and explore its associations with caregivers’ characteristics. Questionnaires were administered in person to 300 caregiver-care recipient dyads from three urban communities in mainland China in 2019. The 40-item Alzheimer’s Disease-related Quality of Life tool asked caregiver respondents to indicate care recipients’ life conditions. Higher levels of caregiving burden (β = -0.19, p < 0.01) and more depressive symptoms (β = -0.19, p < 0.01) amongst caregivers were significantly associated with lower quality of life of care recipients. The results suggested that reducing caregivers’ burden and depressive symptoms are essential to promote quality of life of care recipients. Formal support from health professionals, service organizations, and communities are urgently called for to promote the wellbeing of Chinese families affected by cognitive impairment.
Neighborhood Cohesion and the Mental Health of Multimorbid Older Adults: CLSA Path Analysis Through Loneliness
Authors: Gan Daniel R Y , Wister Andrew , Best John
Published: December 2021

More older adults with multimorbidity are aging in place than ever before. Their mental health may be affected by housing and neighborhood factors. In this paper, we use structural equation modelling (SEM) to examine how the physical environment influences life satisfaction and depressive symptoms in two separate models. We included social environment (i.e., social support, social participation, walking) and loneliness as intermediate variables. Data were drawn from baseline and the first follow-up (after 3-4 years) of the Canadian Longitudinal Study on Aging (CLSA). Participants were N=14,301 adults aged □65 with □2 chronic illnesses. Good model fit were found after controlling for age, sex, education and baseline values (TFI=1.00; CFI=1.00; RMSEA<0.001; SRMR<0.001). The total effects of housing quality (Btotal=0.08,-0.07) and neighborhood cohesion (Btotal=0.03,-0.06) were weak but statistically significant in the expected direction. Together, the intermediate variables explained 21-31% of the total effects of housing quality and 67-100% of the total effects of neighborhood cohesion. Loneliness explains 27-29% of the total effects of physical environment on mental health, whereas walking explained a mere 0.4-0.9% of their total effects. Walking did not mediate between housing quality and mental health outcomes. Overall, the results support our path analysis framework: physical environment -> social environment -> loneliness -> mental health. Our model provided excellent explanations of the effects of neighborhood cohesion, especially on life satisfaction. If these associations reflect causal effects, community-based age-friendly interventions should focus on neighborhood cohesion and loneliness to promote the well-being of older adults who are aging in place with multimorbidity.
Immune Surveillance of Senescent Cells
Authors: Lowe Scott
Published: December 2021

Cellular senescence involves a stable cell cycle arrest and a secretory program that modulates the tissue environment. In cancer, senescence acts as a potent barrier to tumorigenesis and, though many cancers evade senescence during the course of tumor evolution, ionizing radiation and conventional chemotherapy can, to varying degrees, induce senescence in tumor cells leading to potent anticancer effects. Conversely, the aberrant accumulation of senescent cells can reduce regenerative capacity and lead to tissue decline, contributing to tissue pathologies associated with age or the debilitating side-effects of cancer therapy. Our laboratory studies mechanisms of cellular senescence with the ultimate goal of developing strategies to modulate senescence for therapeutic benefit. We have focused on how senescent cells trigger immune surveillance to facilitate their own elimination or, when that fails, how synthetic immune cells (i.e. CAR T cells) can be directed to eliminate senescent cells. Recent advances in understanding senescent cell surveillance by the immune system will be discussed.
Cell Senescence as a Mediator of Age-Dependent Brain Inflammation
Authors: Schafer Marissa , Zhang Xu , Pearsall Vesselina , LeBrasseur Nathan
Published: December 2021

Cellular senescence and inflammation are interconnected causes and consequences of tissue aging. Here, we implemented orthogonal approaches to study their interaction in steady-state mature and aged mouse brain. Using single cell sequencing, we identified a putative senescent microglial population, which increased in abundance with age and was characterized by increased expression of p16 and chemotactic senescence associated secretory phenotype (SASP) factors. Using p16-INK-ATTAC transgenic mice to eliminate p16ink4a-positive senescent cells and mass cytometry, we show that p16ink4a-positive cell targeting reduced the abundance of activated inflammatory cells in the aged female brain. Age-dependent declines in executive cognitive function were improved following transgenic p16ink4a-positive cell targeting, and executive function robustly correlated with inflammatory brain cell composition in females. Collectively, our findings demonstrate fundamental differences in the age- and sex-dependent brain inflammatory landscape and implicate p16ink4a-positive senescent cell targeting as a therapeutic strategy to attenuate age-related inflammation and cognitive decline.
Factors Associated With State Mandate of Nursing Home Staff Testing During COVID-19
Authors: Simpson Elizabeth , Miller Edward , Wylie Molly , Beauregard Lisa , Nadash Pamela , Gusmano Michael
Published: December 2021

COVID-19 has presented challenges for nursing homes (NHs) and other congregate living settings which serve older adults at high risk for morbidity and death from the virus. This study identified factors associated with states’ adopting a mandate for regular staff testing for COVID-19 in NHs. Potential correlates included state government ideology and capacity, NH supply and demand, prevailing economic conditions, existing state policies, and NH characteristics. Findings indicate that percent for profit NHs is most strongly associated with adoption of a state staff testing mandate. Governing capacity (average legislative salary), percent population at risk for COVID-19, and existing public policy (percent Medicaid spending devoted to long-term services and supports (LTSS) were also associated with the probability of adoption. Based on these results, states with more proprietary facilities and greater capacities for government action, investment in Medicaid LTSS, and at-risk populations were more likely to mandate regular staff testing in NHs.
Nutrition, Oral Health, and Chronic Diseases Inextricably Linked
Authors: Marshall Teresa
Published: December 2021

The 2020-25 Dietary Guidelines identified dental caries as a diet-related chronic disease of major importance. Preventing dental caries and other oral infectious diseases is critical to maintaining an individual’s capacity to chew food, consume nutrient-rich diets, and sustain optimal nutrition status. Pain and infection from dental caries complicates consumption of adequate amounts of fruits, vegetables, dairy, and lean protein recommended in the Dietary Guidelines. Nutrition and dietary intake can affect the development and integrity of oral cavity and progression of oral diseases. Increased snacking throughout the day in place of three-meals daily raises the risk of obesity and dental caries throughout the life cycle. Older adults who make routine oral health preventive practices, such as brushing, cleaning between teeth, drinking fluoridated water, and chewing sugarfree gum to increase saliva flow can reduce dental caries and oral infectious diseases. Professionals must also consider the impact of sugar-sweetened beverages and sugar intake.
Attachment, Emotion, and Physiological Coregulation Among Elderly Mothers and Their Adult Daughters
Authors: Jain Elizabeth , Labouvie-Vief Gisela , Lumley Mark
Published: December 2021

Examination of physiological coregulation among marital partners suggests a dynamic interplay between partner physiology. Further, attachment dimensions of anxiety and avoidance mediate this coregulation during conflict. This study examined the role of attachment and race in predicting physiological coregulation for mothers and their adult daughters during emotional discussions. A sample of 23 African American and 17 Caucasian mother-daughter pairs (aged 26 to 83) completed interview sessions and Relationships Questionnaires. Pairs engaged in discussions (neutral, conflict, happy), while monitoring heart rate. HR difference scores were computed between pairs (bps; 0 meant no difference). Multiple Regressions revealed attachment anxiety and avoidance predicted HR variation between pairs for the neutral and happy discussions, differently by racial group (F(7,33)=3.297, p < 0.01). For African American women, increased anxiety predicted increased HR variation during neutral and happy discussions, whereas for Caucasian women, increased avoidance predicted increased HR variation. However, during conflict anxiety singularly predicted increased HR covariation (b = 5.03, p = 0.01), for both groups. Low anxiety and low avoidance predicted physiological coregulation (lower HR variance between pairs). Increased anxious attachment predicted partner dysregulation (increased HR variation between pairs) across all 3 discussions, moderated by avoidance for the Caucasian women. Results suggest attachment plays a role in regulating physiology under emotional stress, and that there may be important cultural differences in this relationship. Further examination will explore the dynamic interplay between attachment and physiological coregulation across adulthood and later life.
Longitudinal and Age-Related Implications of Primary and Secondary Control for Happiness
Authors: Toyama Masahiro
Published: December 2021

While previous research addressed two distinct types of happiness, including hedonia and eudaimonia, the longitudinal associations of primary and secondary control with these happiness constructs had not been fully studied. The present study aimed to contribute to the literature by examining these associations and their age differences. Using data from the second and third waves of the Midlife in the United States (MIDUS; N = 4,963, aged 28 to 84 at baseline), the present study conducted structural equation modeling analyses to examine whether primary and secondary control predicted residualized changes over around a decade in the latent constructs of hedonia and eudaimonia and whether there were age differences in these associations. The results indicate that while only primary control predicted change in eudaimonia overall, the associations of primary and secondary control with changes in hedonia and eudaimonia differed by age. Particularly, in comparing these effects for younger and older individuals, primary control predicted increases in eudaimonia only for younger individuals, whereas secondary control predicted decreases in hedonia for younger individuals but predicted increases in eudaimonia for older individuals. Considering these findings, the importance of primary and secondary control for happiness may vary between adults of different ages, which is possibly due to their life priorities that may change with age. The present study suggested potential directions of future research further examining the role of primary and secondary control for happiness and exploring potential interventions to promote happiness, for example, by modifying primary and/or secondary control for adults of different ages.
Meaningful Engagement of Residents With Dementia in Assisted Living: The Role of Direct Care Workers
Authors: Morgan Jennifer Craft , Ciofi Joy , Kemp Candace , Hill Andrea , Bender Alexis
Published: December 2021

Meaningful engagement has important implications for quality of care for persons living with dementia. Yet, little research has focused on direct care workers’ (DCWs) role in facilitating engagement opportunities for residents in assisted living. Using data from our ongoing NIA-funded study, “Meaningful Engagement and Quality of Life among Assisted Living Residents with Dementia,” we describe DCW approaches to engaging residents and the factors that influence the use and successful application of these approaches. Focal residents (N=33) were followed at four diverse assisted living communities for one year. Data includes care partner interviews (N=100), including 28 DCWs and 1560 hours of field observation data. DCWs interviewed had between 2 months and 12 years’ experience in their current position and were mostly African American and/or immigrant women of color. Findings suggest that DCW-resident interactions are key opportunities to engage residents in a meaningful way and can facilitate positive, trust-based relationships. This analysis elaborates on our previous work identifying four approaches: knowing the person, connecting with and meeting people where they are, being in the moment, and viewing all encounters as opportunities. We identified factors affecting opportunities for, and experiences with, meaningful engagement between residents and DCWs, including community staffing, consistent assignment, scheduling, DCW training and tenure, and community resources. We conclude with implications for practice emphasizing how elaboration of these approaches can inform the development of DCW training, opportunities for career advancement, and integration of approaches consistently into daily practice in an effort to support meaningful engagement of residents living with dementia.
The Final Mile: Evaluating eHealth and mHealth Utilization Among Older Adults
Authors: Krebs Mary
Published: December 2021

While health endures as a term to describe looking after oneself, looking after loved ones, and receiving care, the added component of electronic technology has emerged to affect all levels of health care delivery. Despite the prevalence of digital health and empirical evidence strongly supporting improved outcomes--the final mile--as it is sometimes called, is the sustained patient engagement with eHealth and mHealth we have yet to achieve. This research identifies a gap in the literature for understudied characteristics of digital health adoption, use affecting the aging population in the U.S., and contributes a deeper understanding of the key barriers to use of health-related technology. A mixed-methods research approach explores prevalent barriers to digital health utilization by older adults through a pre-post data collection strategy to empirically test an educational health-related intervention rooted in the Technology Acceptance Model. This validated analytic framework represents a decision ‘core’ as a user pathway for actual use. Evaluation of score data utilized a quantitative test of group means while thematic coding was employed for qualitative analysis. The results from this study are two-fold. The work strongly suggests specific barriers to adoption and use, confirming a distrust and reluctance to engage. However, additional evidence, both quantitative and qualitative illuminates substantive skills, positive perceptions, hopeful attitudes, as well as the rationale for use of available digital resources. Findings suggest future research would benefit from expanded use of the two-pronged approach to foster health-related technology engagement.
Discrimination and Risk of Incident Disability in Older African Americans
Authors: Lange-Maia Brittney , Lamar Melissa , Leurgans Sue , Buchman Aron , Barnes Lisa
Published: December 2021

Discrimination is linked to poor health outcomes, but most studies examine young or midlife populations. We assessed associations between discrimination and disability in African Americans. The Detroit Areas Study Everyday Discrimination Scale quantified experiences of interpersonal mistreatment. Separate Cox-proportional hazards models tested the associations between baseline discrimination and incident mobility, activities of daily living (ADLs), and instrumental activities of daily living (IADLs) disability, adjusting for age, sex, education, BMI, smoking, depressive symptoms, and vascular diseases. At baseline, 441, 674, and 469, participants were initially free of mobility, ADL, and IADL disability, respectively, and 257, 185, and 269 new cases of mobility, ADL, and IADL disability were observed over approximately 8.5 years. Discrimination was associated with higher risk of ADL disability (hazard ratio: 1.03 per 1-point higher discrimination score, 95% confidence interval: 1.00-1.06) but no other disability type. Everyday discrimination is associated with risk of ADL disability.
Integrated multiple transcriptomes in oviductal tissue across the porcine estrous cycle reveal functional roles in oocyte maturation and transport
Authors: Jang Min-Jae , Lim Chiwoong , Lim Byeonghwi , Kim Jun-Mo
Published: December 2021

Understanding the changes in the swine female reproductive system is important for solving issues related to reproductive failure and litter size. Elucidating the regulatory mechanisms of the natural estrous cycle in the oviduct under non-fertilisation conditions can improve our understanding of its role in the reproductive system. Herein, whole transcriptome RNA sequencing of oviduct tissue samples was performed. The differentially expressed genes (DEGs) were identified for each time point relative to day 0 and classified into three clusters based on their expression patterns. Clusters 1 and 2 included genes involved in the physiological changes through the estrous cycle. Cluster 1 genes were mainly involved in PI3K-Akt signaling and steroid hormone biosynthesis pathways. Cluster 2 genes were involved in extracellular matrix-receptor interactions and protein digestion pathways. In Cluster 3, the DEGs were downregulated in the luteal phase; they were strongly associated with cell cycle, calcium signaling, and oocyte meiosis. The gene expression in the oviduct during the estrous cycle influenced oocyte transport and fertilization. Our findings provide a basis for successfully breeding pigs and elucidating the mechanisms underlying the changes in the pig oviduct during the estrous cycle.