bluuebunny/crossref_metadata_2025 huggingface dataset:
DIFFERENT ASSOCIATIONS BETWEEN HEART RATE VARIABILITY AND EMOTION REGULATION IN OLDER AND YOUNGER ADULTS
Authors: Liu Kathy
Published: December 2023

Heart rate variability (HRV), the beat-to-beat variation in heart rate, is proposed to index aspects of self-regulatory processes such as emotion regulation. This is due to overlapping neural regions and networks that contribute to the central autonomic and emotion regulation systems. Paradoxically, increasing age is associated with both improvement in emotion regulation and decline in HRV, and it is unclear whether and how the association between HRV and emotion regulation is influenced by aging. The earliest stages of neurodegenerative processes, such as Alzheimer’s disease-related reduction of locus coeruleus (LC) integrity, may also influence the HRV-emotion regulation relationship in older adults, as LC modulates arousal and autonomic activity in response to stress. We pre-registered a study to investigate the cross-sectional relationship between measures of emotion regulation, HRV and LC MRI integrity in a lifespan sample of cognitively normal healthy adults using the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) dataset, a large population-based cohort aged between 18-88 years (N=678). We hypothesized that any age-related differences in the association between HRV and emotion regulation would be related to reduced LC integrity in older versus younger adults. We found an inverse correlation between resting HRV and measures of emotional reappraisal in older adults, which differed significantly to younger adults, but no evidence of LC influence on this association. Our findings highlight age-related differences in the HRV-emotion regulation relationship which warrant further investigation in future studies.
HEARING LOSS AS A MODIFIABLE RISK FACTOR FOR DEMENTIA IN UK BIOBANK
Authors: Mur Jure , Leist Anja
Published: December 2023

Age-related hearing loss is a predictor of cognitive impairment and dementia. The mechanisms of the observed associations are unclear but could involve depletion of cognitive reserve, the occupation of cognitive resources, and lack of sensory input to the brain. Hearing loss may therefore represent a preventable or treatable causative risk factor for dementia. Indeed, many studies report on lower rates of cognitive decline among hearing aid users when compared to non-users. However, most investigations to date have been observational or with relatively short follow-ups, thus precluding clear interpretations of the underlying mechanism. In our study using UK Biobank data with n=502,386 participants followed up from ~2008 to 2021, we emulate a randomised clinical trial to probe the role of initiating the use of hearing aids in people with conductive hearing loss or with self-reported hearing difficulties in the diagnosis dementia. Diagnosis of dementia was ascertained through hospital and death records, and self-reports in such a way as to increase the positive predictive value. Among participants with hearing loss or hearing difficulties, 2,914 (2.1%) were diagnosed with dementia, compared to 4,982 (1.4%) in those without hearing loss or hearing difficulties. Additional results on the relationship between hearing aid use and dementia, and stratified analyses by sex/gender and ethnicity will be presented. We discuss the modifiability of hearing loss and recommend studies with longer follow-ups to determine the efficacy of hearing loss interventions in reducing the risk of cognitive decline and dementia.
WHO BECAME CLOSER TO FAMILY AFTER THE PANDEMIC?: THE ROLES OF OPTIMISM AND SOCIAL EXCHANGES
Authors: Fiori Katherine , Rauer Amy , Marini Christina
Published: December 2023

Dispositional optimism has been associated with healthy aging, as well as coping with and making meaning from life challenges. Social support plays a similarly positive role in promoting adaptation in late life and helping individuals feel closer to loved ones. During the pandemic, disruptions in older adults’ social interactions placed a high demand on both of these potential resources, challenging individuals’ ability to derive meaning from these events. Exploring data from a community sample of 136 older adults (M age = 68, range 50-91; 69% females; 93% White) assessed three times over six months during 2021-2022, we examined how optimism and positive and negative social exchanges predicted changes in attitudes about how COVID-19 shaped family life. We found that T1 optimism predicted changes in older adults’ feeling closer to their families and appreciating them more at T2 (3 months later), above and beyond T1 positive social exchanges, which were only marginally associated. Older adults who were more optimistic at T1 also reported greater declines in tension and strain in their family ties due to the pandemic at T2 - but not at T3 (6 months later). However, T2 negative social exchanges did predict increased reports of family tension and strain from T2 to T3. Findings suggest that as new COVID-19 variants emerged, benefits of optimism waned, but costs of negative social exchanges increased. These findings illustrate how personality, micro-level context (i.e., social interactions), and macro-level context may work together to shape older adults’ views of their families during the pandemic.
THE COSTS OF GENERATIVITY FOR OLDER ADULTS’ MENTAL HEALTH DURING THE COVID-19 PANDEMIC
Authors: So Christine , Fiori Katherine , Rauer Amy , Marini Christina
Published: December 2023

Generativity, the capacity to be productive, caring, and concerned with the well-being of the next generation, promotes positive mental health and posttraumatic growth in later life (Bellizzi, 2004). Generativity may be particularly important in recent years as older adults have faced the pandemic and its aftermath. For example, our previous work showed that generativity was associated with better mental health concurrently during this initial post-vaccine adjustment period (June - September 2021; So et al., 2022). The current study builds upon this work by using longitudinal evidence from a community sample of 95 older adults (M age = 68.4, range 50-91; 68% females; 93% White) to explore whether generativity predicted older adults’ anxiety, depressive symptoms, and life satisfaction six months later (December 2021-February 2022). Using structural equation modeling controlling for age, gender, and baseline depressive symptoms, we found that generativity positively predicted depressive symptoms six months later. In contrast, generativity at baseline was not associated with anxiety or life satisfaction six months later. It is possible that older adults who were more generative at baseline (when many still believed that COVID-19 pandemic would end with vaccinations) reported more depressive symptoms six months later when the highly contagious Omicron variant took over. Our findings thus underscore the complexity of the role of generativity in mental health outcomes, with associations sensitive to historical events.
FORECASTING THE FUTURE: OLDER ADULTS’ ANTICIPATED STRESSORS AND REWARDS IN THE CONTEXT OF COVID-19
Authors: Marini Christina , Basinger Erin , Stewart Meagan , Fiori Katherine , Rauer Amy
Published: December 2023

Stress research typically focuses on past/current events as opposed to future ones. We identified future anticipated stressful and rewarding events at 2 timepoints utilizing qualitative data from older adults (N = 103, Mage = 68.11, 68.9% female, 93.2% white) who participated in a study of social reintegration after vaccines were available in the US. COVID-19 cases were typically below 1 million during T1 (Fall 2021), but exceeded 5 million during T2 (Winter 2022), coinciding with the Omicron variant. This afforded the opportunity to examine anticipated stressors and rewards at timepoints with different levels of COVID-19 threat. We used content analysis to identify anticipated stressors and rewards, which fit into 13 categories (Cohen’s κ = .86-.96) and examined rates of ambivalence (i.e., same event was a stressor and reward within timepoints) and chronicity (i.e., same stressor or reward was named across timepoints). At T1, the modal stressor was own transition/change (13.6%; e.g., relocating). At T2, it was the pandemic (20.4%; e.g., family member recovering from COVID). Family/friend relationships (e.g., celebrating grandkids’ birthdays) was the modal reward at T1 (32%) and T2 (24.3%). A quarter of participants demonstrated ambivalence (T1 = 23.3%; T2 = 28.2%). Stressor and reward chronicity (22.3% and 32%, respectively) were low. Findings highlight variability in the events older adults were concerned and excited about within and across timepoints. Salience of the pandemic as an anticipated stressor ebbed and flowed alongside emerging variants, despite vaccine availability.
SOCIAL INTERACTIONS AND LONELINESS AMONG THE ADULT LIFESPAN: A COVID-19 COORDINATED ANALYSIS
Authors: Zavala Daisy , Hughes MacKenzie , Hu Rita , Ali Sumbleen , Kincaid Reilly , Ogle Destiny
Published: December 2023

The COVID-19 pandemic included physical distancing mandates. Examining responses to isolation across the lifespan during the first year of the pandemic may shed light on age differences in social interactions and loneliness during a time of uncertainty. This coordinated analysis of 2 intensive longitudinal datasets (DCF, EAS) examines social interactions, loneliness, and age during the COVID-19 pandemic. It is a component of a larger, pre-registered coordinated analysis involving traditional longitudinal and cross-sectional studies (https://osf.io/jt4wf). DCF was a diary study of 221 adults ages 21-78 years (M = 48.92, SD = 14.81) who completed online questionnaires every day for 21 consecutive days. DCF participants were drawn from across the USA via MTurk and Qualtrics. Data collection spanned Oct-29-2020 to Nov-18-2020. EAS is an ongoing ecological momentary assessment measurement burst study; data from 82 adults aged 73-96 years (M = 79, SD = 5.41) who completed a 2 week burst of 4 EMA per day between Feb-1-2020 and July-1-2020 were used in this analysis. EAS participants were recruited from registered voter lists in Bronx, NY USA. Separate multilevel models (DCF: 2 level, EAS: 3 level) were conducted with the same covariates and constraints. Between and within individuals, social interactions did not predict loneliness in DCF; older age predicted lower loneliness. In EAS, individuals with more social interactions were less lonely, males reported higher levels of loneliness and relatively younger individuals had lower loneliness following interactions. Results illustrate the value of coordinated analysis for understanding loneliness under pandemic conditions.
THE INTERSECTION OF SOCIAL DETERMINANTS OF HEALTH AND FAMILY CARE OF PEOPLE LIVING WITH DEMENTIA
Authors: Gaugler Joseph , Borson Soo , Epps Fayron , Shih Regina , Parker Lauren , McGuire Lisa
Published: December 2023

In this presentation, we will synthesize current research to illustrate the intersection of social determinants of health (SDOHs) and Alzheimer’s disease and related dementia (ADRD) caregiving, and outline how public health can support ADRD family caregivers in the U.S. There is an abundance of research that demonstrates family caregivers of relatives living with ADRD experience adverse health outcomes. In addition, family care for persons with ADRD overlaps with SDOHs. Public health actions such as improved surveillance and identification of ADRD caregivers; building and enhancing community partnerships; advancing dementia-capable health care and related payment incentives; and reducing the stigma of dementia and ADRD caregiving can enhance support and services for families. By engaging in these actions, public health practitioners could more effectively address the myriad of challenges facing ADRD caregivers most at risk for emotional, social, financial, psychological, and health disruption.
THE IMPACT OF SOCIAL DETERMINANTS OF HEALTH ON DETECTING DEMENTIA: REFRAMING HEALTH EQUITY
Authors: Chodosh Joshua , Borson Soo
Published: December 2023

Social determinants of health (SDoH) contribute to the incidence of Alzheimer’s disease and related dementia (ADRD) and to missed opportunities to reduce the impact of its symptoms. They also play a fundamental role in detection of ADRD, leading to disparities in diagnosis as well as care. Public health practitioners have an outsize role in addressing the intersection between ADRD prevalence and related SDoH, especially for persons from minoritized and under-resourced communities. We will delineate the effects of this intersectionality and the need to reframe dementia detection strategies to promote health equity, reduce related stigma, and repair the mistrust that is integral to care inequities. We will highlight the ongoing efforts of our public health partners who are committed to ensuring that dementia is detected before a crisis occurs and opportunities they offer to support the efforts of our PHCOE partners in dementia prevention and caregiving.
IMPLEMENTATION MODELS FOR FOLLOWING UP AFTER A DEMENTIA-RELATED MISSING INCIDENT
Authors: Daum Christine , Letts Elyse , McLennan Lauren , Conway Cathy , Liu Lili
Published: December 2023

The rate of persons living with dementia who go missing is a growing concern, especially those who go missing repeatedly. Drawing upon the practices of other populations such as at-risk youth, following up with persons living with dementia and their supports after an incident could reveal contributing factors and also connect people with supports to mitigate the risk for going missing again. In Canada, models for such follow-ups are limited. The purpose of this presentation is to describe two implementation models for following up with persons living with dementia and their care partners after a missing incident has occurred. We conducted 20 individual semi-structured online interviews with police and service providers in Canada and the United Kingdom to understand the scope of and approaches to following up with this population. Generic qualitative description and conventional content analysis were used. We developed a resource guide that describes these approaches and proposes how follow-ups could be consistently employed. Two focus groups with police officers and community service providers (n= 11) were conducted to obtain feedback on the guide. We are now working with community partners in two Canadian provinces to develop implementation models unique to their existing processes, resources, and systems; these models put into practice approaches in the resource guide. Our presentation will showcase the guide and the models developed in collaboration with our partners. These models can guide police organizations, Alzheimer Societies, and communities who support persons living with dementia at risk of going missing.
THE MANY FACES OF DEMENTIA IN CANADA: EXAMINING SEX, ETHNICITY, AND AGE OF ONSET IN THE LANDMARK STUDY
Authors: Armstrong Joshua , Sivananthan Saskia , Guimond Josée
Published: December 2023

With the rapidly increasing size of the dementia population, it is important to enhance our understanding of the similarities and differences that are found across the people living with condition. This work takes a closer look at the many faces of dementia in Canada by highlighting the diversity that is found within the national population projections for dementia. To conduct these forecasts, a simulation model was developed using demographic characteristics and risk factors for dementia to estimate the numbers of people living with dementia in Canada from 2020-2050. From the results of the Landmark Study, we will highlight findings related to sex, Indigenous Peoples, ethnic origins, and young-onset dementia. In 2020, 61.3% of dementia diagnoses were in females and this sex ratio is projected to stay constant over the three decades. For Indigenous Peoples of Canada, dementia numbers are estimated to increase by 273% (2020: 10,800; 2050: 40,300). People of Asian origin will increase from 8% of people living with dementia in 2020 to 24% by 2050. The changes are driven both by future immigration, and by people who have already immigrated to Canada in the past few decades. The Landmark Study also projects that there could be over 40,000 people under the age of 65 living with dementia in Canada by 2050.These findings illustrate the changing landscape of people living with dementia in Canada. These demographic characteristics, as well as other distinctions across population groups, profoundly affect the way in which dementia is experienced and their care needs.
HEARING INTERVENTION TO REDUCE COGNITIVE DECLINE: DESIGN AND FINDINGS OF THE ACHIEVE RANDOMIZED CONTROLLED TRIAL
Authors: Deal Jennifer , Reed Nicholas , Ferrucci Luigi
Published: December 2023

Epidemiologic data consistently link age-related hearing loss with accelerated cognitive decline and incident dementia in large, population-based studies. Mechanistic pathways that could underlie this association include the effects of distorted peripheral encoding of sound on cognitive load, changes to brain structure/function, and/or reduced social engagement and increased loneliness. Importantly, these pathways may be amenable to comprehensive hearing rehabilitative treatment including hearing assistive technologies (e.g., hearing aids, other integrated hearing assistive devices) and rehabilitative training. To date, however, there has never been a randomized trial that has investigated whether hearing loss treatment could reduce cognitive and other functional decline in older adults without dementia. The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) trial is a multicenter randomized control trial of 977 cognitively intact adults with untreated, mild-to-moderate hearing loss aged 70-84 years at baseline (2018-19) to determine efficacy of best-practices hearing intervention to reduce cognitive decline over 3 years (Clinicaltrials.gov Identifier: NCT03243422). This session, on behalf of the ACHIEVE Collaborative Research Group, will describe the overall design of the ACHIEVE trial including details about recruitment and implementation of both the hearing (amplification, auditory rehabilitation) and successful aging health education control interventions. We will also present the primary findings of the study – the effect of the hearing intervention vs. control on 3-year cognitive decline – as well as the effect of the hearing intervention on several pre-specified outcomes important for the health of older adults, including social engagement, mood disorders and quality of life.
DESIGN AND IMPLEMENTATION OF THE ACHIEVE HEARING INTERVENTION
Authors: Chisolm Theresa , Sanchez Victora , Arnold Michelle
Published: December 2023

The ACHIEVE trial required the development of a manualized best-practice hearing intervention designed to meet the needs of older adults with mild-moderate hearing loss. The hearing intervention (HI) was developed using an iterative process including input from a diverse professional panel and a feasibility study to confirm that expected outcomes from a best-practices, evidence-based HI would be obtained. The HI involves use of hearing aids and related technologies along with counselling, coaching and education to support self-management of hearing loss. The HI is delivered in four sessions after the completion of a comprehensive hearing evaluation. Individualized goals are developed using the Client Oriented Scale of Improvement (COSI), which guides selection of hearing aids and other technologies to meet prioritized listening needs and assessment of how well those needs are met. The most frequent COSI listening goal categories included: Conversation in Noise (n= 413; 29%), Conversations in Quiet (n= 296; 21%), and TV/Radio at Normal Volume (n= 280; 20%). Three levels of hearing aid technology differing by the number of signal processing approaches included were: Basic (n=223, 20%), Advanced (n=662, 56%), and Premium (n=283, 24%). Additional hearing assistive technologies included streaming devices, TV connectors, and remote microphones were provided. We discuss how the baseline audiological results and individualized goal setting informed delivery of the HI and how the use of manualization allowed us to maintain excellent treatment fidelity throughout the clinical trial.
ASSOCIATION OF BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS OF DEMENTIA WITH ADVERSE OUTCOMES POSTHOSPITALIZATION
Authors: Berish Diane
Published: December 2023

In hospitalized persons with dementia, behavioral and psychological symptoms of dementia (BPSD), also known as behavioral symptoms of distress, are associated with increased morbidity, long-term care admissions, and reduced care partner well-being. The Fam-FFC study provided the opportunity to examine the association between BPSD severity and adverse, post-acute outcomes (falls, emergency department transfers, hospital admissions). Logistic regression analysis examined the association of behavioral symptoms (Neuropsychiatric Inventory Questionnaire, NPI) and odds of having a fall, emergency department transfer, and hospital admission, controlling for the intervention, and caregiver and patient characteristics. NPI scores decreased from admission (M = 7.81, SD = 6.12), to discharge (M = 6.4, SD = 5.93), to two months (M = 5.38, SD = 5.91), to six-month follow-up (M = 5.08, SD = 5.94). Higher admission NPI scores were associated with greater odds of experiencing at least one fall (OR = 1.067, p = 0.042) by discharge. Higher discharge NPI scores were associated with higher odds of ED transfer (OR = 1.062, p = 0.006) and at least one hospitalization (OR = 1.06, p = 0.008) after two months. Higher NPI scores at 2-month follow-up were associated with increased odds of ED transfer (OR = 1.062, p = 0.004), experiencing at least one injury (OR = 1.055, p = 0.031), falls (OR = 1.056, p = 0.012), and hospitalizations (OR = 1.065, p = 0.004) at six months. Results underscore the importance of providing interventions to reduce BPSD as a potentially modifiable risk factor to reduce adverse outcomes.
DEMENTIA STAGING, NEUROPSYCHIATRIC SYMPTOMS, AND DIVORCE OR SEPARATION IN LATE LIFE: A CASE CONTROL STUDY
Authors: Monin Joan , McAvay Gail , Zang Emma , Wyck Brent Vander , Carrión Carmen , Allore Heather
Published: December 2023

Dementia can be difficult on marriages for many reasons, including but not limited to caregiving burden, loss of intimacy, and financial burden. This study examined the impact of dementia staging and neuropsychiatric behavioral symptoms on the likelihood of divorce or separation for older adult married couples. For this case-control study, we used data from the National Alzheimer’s Coordinating Center (NACC) Uniform dataset (UDS) versions 2 and 3. This dataset was from 2007 to 2021 and contains standardized clinical information submitted by NIA/NIH Alzheimer’s Disease Research Centers (ADRCs) across the United States (US). This data was from 37 ADRCs. We selected participants who were married or living as married/domestic partners at their initial visit. Cases were defined by a first divorce/separation occurring during the follow-up period, resulting in 291 participants. We selected 5 controls for each married/living as married case and matched on age. Conditional logistic regression estimated the association between overall Neuro Psychiatric Inventory (NPI) score and severity of NPI symptoms with case/control status, adjusted for education, the CDR® Dementia Staging Instrument score, living situation, symptom informant, sex, and race. Separate analyses were conducted for each symptom. Multiple comparisons were accounted for with the Hochberg method. Later stage of dementia was negatively associated with divorce/separation with an adjusted odds ratio. A higher overall NPI score was positively associated with divorce/separation. More severe ratings of agitation/aggression, depression/dysphoria, and disinhibition with divorce/separation were associated with greater odds of divorce/separation. Treating NPI symptoms may be away to protect relationships.
JUST THE TWO OF US? THE PSYCHOLOGICAL IMPACT OF MARITAL DISSOLUTION ON CHILDLESS OLDER ADULTS
Authors: Carr Deborah , Choi Shinae
Published: December 2023

An estimated 15% of U.S. adults ages 55+ are childless, with this proportion projected to increase among future cohorts. Of the 15 million childless older adults today, 40 percent are married – challenging the notion that childlessness is the domain of never married persons only. Little is known about the experiences of childless older adults who become widowed or divorced, and whether they suffer poorer mental health than their peers with children. Widowed and divorced persons lack the support of children yet may possess other resources or strengths as they age on their own. We use data from the 2016 and 2018 waves of the Health and Retirement Study (N = 16244) to evaluate whether parental status (childless, any living biological child(ren), stepchild(ren) only, all child(ren) now deceased) moderates the association between marital status (married, cohabiting, divorced/separated, widowed) and mental health (depressive symptoms, and social and emotional loneliness) and whether these patterns differ by gender. Multivariate moderation analyses show that childless widowed men and divorced men who lost a child to death have dramatically higher levels of social loneliness, relative to other men. Childlessness does not moderate the effect of marital status on loneliness or depressive symptoms among women. However, widowed and divorced women with stepchildren only evidence significantly higher depression and emotional loneliness. We discuss implications for understanding late-life mental health, underscoring that childlessness does not uniformly compromise mental health among unmarried persons, and that some parent-child relations (especially step-relations) may be a source of stress rather than solace.
CASE STUDIES OF A SENOR-ENHANCED CARE COORDINATION MODEL TO ADDRESS OLDER ADULT HEALTH
Authors: Robinson Erin , Curtis Elizabeth Heaton , Bacon Suzette Mizutani , Roberts Ashley , Conrow Elizabeth , Popejoy Lori , Vogelsmeier Amy
Published: December 2023

Smart technologies hold enormous potential in the early detection of activity change that may indicate illness or functional decline among older adults. However, little research currently exists on the application of such technologies to community-dwelling older adults. Our program, Age-friendly Sustainable Smart and Equitable Technologies for Aging in Place (ASSETs for AIP) uses open-source smart home technologies and consumer-grade wearable devices to monitor community-dwelling older adults recently discharged from the Show-Me Home program. We employ a novel approach; pairing technology with a care coordination team, comprised of a registered nurse, occupational therapist, and a licensed social worker. This presentation will highlight the function of this team, and how they leverage sensor-generated health information to provide care coordination. Using a clinical interface that displays the sensor-generated health data, this team provides ongoing monitoring of daily activity to identify early changes in routine that may indicate the development of a health problem. As significant changes in health data present, our clinical team works with clients to understand the change and formulate a plan of action. For example, an unexplained spike in heart rate may lead the clinician to discuss recent activity, exertion, and potential modifications in routine for a client. An increase in middle-of-the night bathroom trips may indicate a health change, for the which the client will be coached in what to communicate to their provider. Case studies from our program will be discussed in this presentation, to highlight this model of sensor-enhanced care coordination.
DESIGNING TUTORIALS TO AUGMENT MOBILITY FOR OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Charness Neil , Gray Nicholas , Kossowska-Kuhn Dorota , Na Hunui , Pervratil Michael
Published: December 2023

The Augmenting User Geocoordinates & Mobility with ENhanced Tutorials (AUGMENT) project aims to support aging adults experiencing navigation difficulties accompanying cognitive impairments due to stroke, mild cognitive impairment, and traumatic brain injury. We describe the process and principles for designing tutorials for Uber and Google Maps, two applications that can support improved mobility for those with navigation difficulties associated with cognitive impairment. Initially we examined predictors of self-reported navigation difficulty in a sample (n=300) of older adults aging normally. In the multiple regression, self-reported memory problems (beta = .35), severity of memory problems (beta=.18), and female gender (beta=.16) were the strongest predictors of wayfinding difficulty in addition to a standardized spatial orientation test (beta=.13). Finding that memory difficulties were strongly related to navigation difficulties even in normal aging implied that tutorials could not make strong demands on retention and helped define the queries for interviews in the needs assessment phase. Next, we interviewed aging adults with cognitive impairment and their care partners about navigation problems, focusing on difficulties using navigation devices and applications. We also presented screenshots of the two target apps and asked simple questions about actions that could be taken. We then designed prototype tutorials using principles such as directing attention to relevant display features by highlighting the features, minimizing extraneous workload, and providing spaced retrieval practice for interactions with the interface. We also describe the iterative design process being used to refine the tutorials and the planned summative test of tutorial efficacy.
SOCIAL DISCONNECTION, EPIGENETIC AGING, AND MOTORIC COGNITIVE RISK SYNDROME: A CAUSAL MEDIATION ANALYSIS
Authors: Qi Xiang , Belsky Daniel , Yang Yang , Malone Susan , Zheng Yaguang , Wu Bei
Published: December 2023

Social isolation and loneliness are two different aspects of social disconnection. Motoric cognitive risk syndrome (MCR), a preclinical phase of dementia, is characterized by memory complaints and slow gait. It is unclear how social disconnection relates to MCR and its underlying mechanisms. Using data from Health and Retirement Study 2012-2020, we aimed to 1) examine the association between social isolation and loneliness and MCR and 2) investigate whether accelerated epigenetic aging mediates this association. We measured social isolation and loneliness at baseline (2012-2014) and epigenetic aging in 2016 using three DNA methylation-based measures (GrimAge, PhenoAge, and DunedinPoAm38), and recorded the incidence of MCR in 2016-2020. We used Cox proportional hazard models to investigate the association between social disconnection and MCR, and counterfactual mediation analysis to examine the role of epigenetic aging. Our sample consisted of 3,287 participants without MCR, with 678 developed MCR during follow-up. Our results showed that social isolation was significantly associated with an older GrimAge, a faster aging pace (DunedinPoAm38), and higher risks of MCR (HR, 1.36; 95% CI, 1.10-1.68), while loneliness was associated with faster DunedinPoAm38 aging pace but not MCR (HR, 0.95; 95% CI, 0.79-1.14). Further, GrimAge mediated 16% of the effect of social isolation (Indirect Effect HR, 1.09; 95% CI, 1.03-1.15), and DunedinPoAm38 mediated 11% (Indirect Effect HR, 1.06; 95% CI, 1.02-1.10). Findings suggest that epigenetic aging is a biological mechanism that underlies the association between social isolation and MCR. Further research is necessary to identify strategies to reduce social isolation for dementia prevention.
BETTER TOGETHER: STRENTHENING THE AGE-FRIENDLY ECOSYSTEM
Authors: Dabelko-Schoeny Holly , Sheldon Marisa
Published: December 2023

Frameworks to make communities, universities, public health systems, and health services more inclusive and equitable for older adults and people with disabilities have expanded over the last decade. Centering the voices of older adults, these “age-friendly” initiatives have sought social change through building knowledge, changing attitudes, and developing new practices and policies in a variety of settings. Despite the similarities in values and principles across these initiatives, these models of social change have largely operated independently from one another with unique administrative structures, networks, and resources. This presentation will utilize a macro application of the KAP (knowledge, attitude, practice) theory of behavior change to identify the vast opportunity for synergies across the age-friendly ecosystem, strengthening the potential for collective impact and lasting change. Often these initiatives have overlapping and intersecting goals and would benefit from intentional alignment across the initiatives. Modeled after the National Academy of Engineering Grand Challenges and the Grand Challenges for Social Work, we propose the Grand Challenges for the Age-Friendly Ecosystem, areas in need of action and support, for transformational change in our social, educational, service, and built environments to better meet the needs of our aging society.
CHANGES IN LONG-TERM CARE ARRANGEMENTS AMONG OLDER ADULTS WITH ADRD DURING THE FIRST YEAR OF THE COVID-19 PANDEMIC
Authors: Wiemers Emily , Truskinovsky Yulya , Leggett Amanda , Hoffman Geoffrey , Freemdan Vicki
Published: December 2023

This study will examine how COVID-19 affected care needs and immediate long-term care (LTC) outcomes including paid and family care, coresidence with adult children, and nursing home use for older adults living with ADRD. For this study we use the 2018 and 2020 waves of the Health and Retirement Study (HRS), a longitudinal, nationally representative survey of individuals aged 51 and older in the U.S. To assess how long-term care arrangements changed among older adults with dementia during the first year of the COVID-19 pandemic, we first describe the needs and LTC outcomes of older adults living with dementia and examine changes between 2018 and 2020 comparing them to changes among older adults with care needs but no dementia. Then, to identify changes associated with COVID-19 (rather than secular trends due to disease progression) we compare the 2020 LTC outcomes of HRS respondents with care needs who had differential exposure to the severity of the pandemic. We proxy pandemic severity with county level COVID-19 deaths. To understand whether changes in LTC outcomes among older adults with dementia were different from the broader population of high-need older adults, we interact local COVID-19 severity with the presence of dementia in 2018. Preliminary findings indicate a retreat from paid care and increases in coresidence with adult children and receiving unpaid help but no significant differences in LTC outcomes among high need older adults with and without dementia.
FAMILY DYNAMICS IN CARING FOR PEOPLE WITH DEMENTIA DURING THE COVID-19 PANDEMIC
Authors: Choi HwaJung , Leggett Amanda
Published: December 2023

A nuanced understanding of family care dynamics (e.g., change in care availability, care network, and care involvement) is important to assess the coping mechanism in dementia care during the pandemic. We conducted an explanatory sequential mixed methods study. We examined 300 spouses and adult children of people with dementia (PWD) from the National Health and Aging Trend -- Family and Friend, surveyed for July 2020-Feb 2021 (Quantitative analysis), and conducted qualitative analyses based on one-to-one in-depth interviews with an independent sample of 40 family members of PwD (Jan-Dec 2022). Fifty-five percent lived with PwD at the time of the interview (7% moved in with PwD during the pandemic). 35% of the non-coresident family members had fewer in-person contacts with PwD during vs. before the pandemic. More than one in ten of the sample persons lost their jobs during the pandemic. Overall, family members were more likely to provide personal care and instrumental help for PwD during vs. before the pandemic. Caregiving however is more concentrated on coresident family members during the pandemic as in-person visits were limited. Flexible work situations during the pandemic were valued as they facilitated caregiving. Family members who were not directly involved in providing personal care for PwD provided emotional and instrumental support for the primary caregiver. Findings from the study will provide valuable insights into the family dynamics in dementia care during the COVID-19 pandemic, which would inform the development of intervention programs for mitigating the adverse impacts of the pandemic and beyond.
THE RELEVANCE OF SNAP PROGRAM ACCESSIBILITY FOR FOOD INSECURITY, FOCUSING ON ADULTS WITH DISABILITIES
Authors: Samuel Laura , Wright Rhonda , Varadaraj Varshini , Swenor Bonnielin
Published: December 2023

Individuals with disabilities are not only more likely than their peers without disabilities to experience food insecurity, but also encounter disproportionate barriers to Supplemental Nutrition Assistance Program (SNAP) enrollment. This study examined associations between state-level measures of SNAP enrollment accessibility (flexibility, efficiency, and accessibility in the enrollment process; and the presence of either broad-based categorical eligibility or the Combined Application Project) with SNAP participation and food insecurity levels among low-income participants (income ≤185% of the poverty threshold) aged ≥15 years in the 2021 Current Population Survey, both overall (n=19,895) and among those with disabilities (n=3,484). In multi-level models adjusted for individual and state characteristics, living in a state with broad-based categorical eligibility was associated with higher rates of SNAP participation among all low-income individuals (b= 0.300, 95% CI: 0.096, 0.505). Among those with disabilities, having greater flexibility in SNAP enrollment (b= 0.141, 95% CI: 0.007, 0.276) and living in a state with the Combined Application Project (b= 0.271, 95% CI: 0.017, 0.525) were associated with a higher likelihood of SNAP participation. Living in a state with more efficient SNAP enrollment was associated with lower food insecurity levels (b= -0.073, 95% CI: -0.136, -0.010) among all low-income individuals and having broad-based categorical eligibility was associated with lower food insecurity levels (b= -0.237, 95% CI: -0.451, -0.022) among those with disabilities. These findings highlight the importance of SNAP program accessibility to address food insecurity among all low-income Americans and suggest that enrollment barriers may differ for people with and without disabilities.
ADVERSE CHILDHOOD EXPERIENCES AS A PREDICTOR OF HEALTH BEHAVIORS IN WOMEN
Authors: Tavares Karina , Tsotsoros Cindy , Leedahl Skye , Tsotsoros Jessica
Published: December 2023

Individuals who experience adversity during childhood are at a higher risk of negative health outcomes in adulthood. This study aims to identify whether adverse childhood experiences (ACEs) influence health lifestyles throughout adulthood. This was accomplished by collecting data from 233 women aged 18-25 and 65-85 who reported either no ACEs or three or more ACEs. Demographic indicators, the 10-item ACEs questionnaire (Felitti et al., 1998), and the Health Promoting Lifestyle Profile (HPLP-II; Walker, Sechrist, & Pender, 1987) were examined. ACEs were categorized into three variables: abuse, neglect, and household dysfunction. The HPLP-II was categorized by its six subscales: health responsibility, nutrition, spiritual growth, physical activity, stress management, and interpersonal relations. When comparing the ACEs and no ACEs groups, t-tests revealed significantly different scores for overall HPLP-II and the six subcategories showing that individuals without ACEs have higher scores on health behaviors. A structural equation model was calculated using the three ACE categories and six health domains. Substantial differences were observed in the variance captured for each of the six health behavior measures. Findings indicate that abuse significantly predicts physical activity, stress management, and spiritual growth (β=-.21, -.23, -.20); neglect significantly predicts interpersonal relationships and spiritual growth (β=-.17, -.18); and household dysfunction significantly predicts health responsibility, nutrition, stress management, and interpersonal relations (β=-.20, -.22, -.10, -.17). The present investigation extends research in displaying that ACEs play a significant role in future health behaviors, with household dysfunction being the greatest predictor.
ASSOCIATION BETWEEN COUNTY TEMPERATURE AND VISION IMPAIRMENT IN A NATIONALLY REPRESENTATIVE SAMPLE OF OLDER ADULTS
Authors: Fuller-Thomson Esme , Deng ZhiDi , Fuller-Thomson Elysia G
Published: December 2023

Several small studies have associated exposure to elevated average temperature with specific vision problems. However, no large-scale studies have examined the relationship between vision impairment and average area temperature in the general population. We conducted a cross-sectional analysis of a large nationally presentative sample of older adults to further explore this relationship through secondary analysis of the American Community Survey (ACS). Data from six consecutive years of the cross-sectional survey were analyzed (2012-2017). The subsample analyzed included community-dwelling and institutionalized older adults aged 65 and older in the coterminous US who lived in the same state in which they were born (n =1,707,333). The question on severe vision impairment was “Is this person blind or does he/she have serious difficulty seeing even when wearing glasses?”. Average annual temperature data from the National Oceanic and Atmospheric Administration was combined into a 100-year average and mapped to corresponding US Census Bureau’s public use microdata areas (PUMAs) from the ACS. Higher average temperature consistently correlated with increased odds of severe vision impairment across all cohorts (i.e. age, sex, race, income, and educational attainment cohorts). Among all participants, the odds of severe vision impairment increased by 9.2% for every 5°F (2.8°C) elevation in annual average temperature (OR 1.092; 95% CI 1.088-1.097). If the association is found to be causal, the predicted rise in global temperatures could impact the number of older Americans affected by severe vision impairment and the associated health and economic burden.
DEVELOPING A COGNITIVE AND AFFECTIVE INTERVENTION FOR MILD COGNITIVE IMPAIRMENT FOR FOREIGN-BORN ARAB AMERICANS
Authors: Darwish Hala
Published: December 2023

Cognitive and affective dysfunctions are challenging clinical characteristics of mild cognitive impairment (MCI) and Alzheimer’s disease and related dementias (ADRD), which may be more prevalent among foreign-born Arab Americans. One study reported that cognitive limitations were present among 9.7% of foreign-born Arab Americans, compared to 7.4% of US-born non-Hispanic whites, blacks, and Asians. This presentation will describe the design and development of culturally valid interventions targeting cognitive and affective dysfunction in foreign-born Arab Americans with MCI and their caregivers (NIH Stage 1B). Individuals with MCI and their caregivers will receive comprehensive cognitive rehabilitation and behavioral therapies. The cognitive performance will be assessed in Arabic using a culturally valid battery, including a verbal memory Arabic test (VMAT) we developed using a systematic item selection procedure (NIH Stage 1A). During Stage 1A, cultural and psychometric validity evidence for Arabic versions of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and the newly developed VMAT was generated from a sample of 180 healthy Arabic-speaking individuals age 16-80 in Lebanon of whom 45 were 65-80 years, and 63 were retested after 2-3 weeks. Test-retest reliability and criterion-related validity were examined, and regression-based norms were derived. In Stage 1A, we also established the psychometric validity of Arabic measures of anxiety, depression, and fatigue (i.e., Hopkins symptoms checklist-25, modified fatigue impact scale) that will be used in the pilot randomized controlled trial (RCT)-stage 1B. A description of cultural adaptations and preliminary results will be discussed.
ASSOCIATIONS BETWEEN DAILY STRESSOR CONTROL AND COGNITIVE FUNCTION
Authors: Cerino Eric , McClaskey Brady , Cruz-Carrillo Yesenia , Almeida David
Published: December 2023

Perceived control is an important psychosocial correlate of cognitive health and aging. Most prior research examining this association has focused on global aspects of control, ignoring influences of more dynamic aspects of specific areas of control, such as control over daily stressors. Using data from the third wave of the Midlife in the United States study and the National Study of Daily Experiences (N=992, Mage=67.67, SD=10.34, 57.20% Female), we examined how control over different types of stressors (arguments, avoided arguments, work stress, home stress, network stress) was associated with cognitive performance. Over eight consecutive days, people reported their perceived control over stressors they had experienced. Participants also completed a telephone-based battery of tests measuring executive function (EF) and episodic memory (EM). Hierarchical regression analyses adjusted for number of daily stressors, age, sex, race, and education. The facilitative role of daily stressor control for cognitive health depended on age and the type of stressor experienced. For EF, greater control over arguments was associated with better EF (Est. = 0.07, SE = 0.03, p < .05). For EM, there was a stressor control by age interaction (Est. = 0.01, SE = 0.01, p < .05) such that greater control over home stress was associated with better EM among comparatively older adults (Est. = 0.07, SE = 0.03, p < .05). Results suggest that perceiving control over daily stressful experiences, especially arguments and home stress, may serve as a psychosocial resource for cognitive health in older adulthood.
CONSOLATION SPACES: DO THEY HELP TO MAKE SERIOUS ILLNESS, DEATH, AND LOSS DISCUSSABLE IN THE COMMUNITY?
Authors: Dury Sarah
Published: December 2023

A recent groundswell of movements and organisations is rising in Flanders, Belgium, stimulating engagement with serious illness, death, and bereavement. One result is the huge growth of public consolation spaces. However, it remains largely unknown how consolation spaces are developed, what actions are taken or how they are used. To investigate the development, meaning, their role in a neighbourhood, and the use of consolation spaces, a multi-method design was used. We first examined six different consolation spaces through focus groups. Various stakeholders took part in these, such as volunteers, members of the municipal administration, visitors to the consolation space and care staff. At the same time, an online survey aimed at the use of consolation spaces ran (N=123). Following, the consolation space initiators completed an online survey measuring specific project characteristics, observed outcomes and elements crucial to the realisation of the project (N=still running). Preliminary results indicate that consolation spaces are often created in collaboration with several organisations. The meaning of consolation spaces for people is a space where people seek silence, comfort or to feel connected. Most take or would like to take part in connecting activities linked to the consolation spaces such as consolation walks, reflection moments, planting flower bulbs, etc. People mainly visit this place alone or with a friend and this mainly on an annual basis. The connection with the neighbourhood is present within many consolation spaces. The discussion aims to critically reflect on the findings from the perspective of sustainability and systemic change within neighbourhoods.