bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Age Views on Cognition: Experimental, Longitudinal, and Ecological Momentary Findings
Authors: Wahl Hans-Werner , Levy Becca , Meisner Brad , Gröppel-Klein Andrea , Robertson Deidre , Sabatini Serena , Lücke Anna
Published: December 2020

Research on the impact of age views on cognition has seen a strong momentum in recent years, fitting the stereotype embodiment theory prediction that the stereotypes taken in from a culture can impact older persons‘ cognition. These studies utilize experimental, longitudinal, and ecological momentary assessments (EMA), as well as a wide reach of cognitive outcomes. This symposium starts with two experimental studies. One demonstrates that negative age stereotypes reduce cognitive processing in older consumers (Gröppel-Klein et al.). A second study strives to better understand the pathway by which age stereotypes influence cognitive outcomes by focusing on dysregulation of reward-seeking behaviors and the downregulation of the dopaminergic system (Robertson et al.). We next explore two longitudinal studies that reveal differential relations among views of aging and various cognitive indicators. The first study found that older persons with more positive age beliefs are less likely to develop dementia even in a high-risk gene subpopulation of older adults (Levy et al.). The second study examined the association between awareness of age-related changes and cognitive scores (Sabatini et al.) Finally, Lücke et al. examine in their EMA study with 6 measurement occasions per day across 7 days that such a fine-tuned seems not to clearly support a linkage among subjective age and working memory for which beginning but not consistent evidence has been reported previously. Brad Meisner will discuss contributions in the light of meta-analytic finding revealing that older persons‘ negative age stereotypes can impair whereas their positive age stereotypes can improve cognitive performance.
Activity Diversity in Detecting Ambulatory Cognitive Deficits
Authors: Hyun Jinshil , Lee Soomi , Katz Mindy , Scott Stacey , Sliwinski Martin , Lipton Richard
Published: December 2020

We examined whether participating in various daily activities (i.e., activity diversity) is associated with cognitive deficits measured by smartphone-based tests. Older adults (n=235; 70-91yrs) completed surveys 6 times/day for 14 days reporting on participation in 11 different activities (e.g., volunteering, physical activity), followed by brief ambulatory processing speed (PS) and working memory (WM) cognitive assessments. Activity diversity score was calculated using Shannon’s (1948) entropy method. Individuals’ average ambulatory PS and WM across all assessments were categorized into tertiles (i.e., high/mid/low performance). Results from multinomial logistic regression suggested that a 1SD increase in activity diversity was associated with increased odds of being in the high (better) vs. low performance tertile in PS (OR=2.1, 95%CI=[1.21, 3.51], p=.008). Activity diversity was not associated with WM. Given that cognitive deficits in PS occur earlier in the cognitive impairment process, activity diversity may be a sensitive marker for detecting very early stages of impairment.
Cognitive Functioning, Gender, and Marital Quality Among Older Married Couples: A Dyadic Approach
Authors: Gallagher Elizabeth , Stokes Jeffrey
Published: December 2020

Older spouses influence one another in myriad ways, and dyadic effects of marital quality on health and well-being have been well-established. However, little attention has been paid to dyadic implications of cognitive functioning, including for spouses’ perceptions of the relationship itself. This study examines associations of older husbands’ and wives’ cognitive functioning with both partners’ reports of four marital quality outcomes. Structural equation modeling analyzed data from 1,414 opposite-sex couples drawn from the 2016 wave of the Health and Retirement Study. Findings revealed that (a) wives’ poorer cognitive functioning was associated with wives’ reporting greater closeness and higher ratings of enjoying time with a spouse, whereas (b) husbands’ poorer cognitive functioning was associated with wives’ reporting greater marital strain, lower marital support, lower closeness, and lower ratings of enjoying time with a spouse. This suggests that cognitive functioning/impairment has dyadic consequences for marital quality, which are highly gendered.
Grandparents Raising Grandchildren in Appalachia: An Examination of Available Services
Authors: Stucki Bradford
Published: December 2020

Previous research indicates that higher numbers of grandparents raising grandchildren live in Appalachia, relative to the rest of the United States. These grandparents may have diverse needs that could benefit from services. When grandparents cannot access needed services, their well-being can be negatively affected. Using the “2017 GrandFacts: State Fact Sheets for Grandfamilies” for the 13 states defined as being part of Appalachia by the Appalachian Regional Commission, this study examined the types and availability of local services by Appalachian sub-region. Excluding state and federal public benefits, most common service types were emotional support, information and referral, financial assistance, and education. Least common service types included grandchild special health needs, legal services, and early childhood intervention. For service availability, four of the five Appalachian sub-regions had no services in over 65% of their counties. South and North Central Appalachia regions had no services in over 90% of their counties. Part of a symposium sponsored by the Grandparents as Caregivers Interest Group.
Two Dimensions of Social Exclusion: Economic Deprivation and Dynamics of Loneliness During Later Life in Europe
Authors: Myck Michal , Waldegrave Charles , Dahlberg Lena
Published: December 2020

We contribute to the discussion on social exclusion by examining the relationship between material conditions and loneliness in a sample of individuals aged 50+ in the Survey of Health Ageing and Retirement in Europe (SHARE). In its 5th wave, the survey was extended to include specific items related to economic and social deprivation. We use this extended information on material conditions and examine how it correlates with the level and dynamics of a composite loneliness measure at the time of wave 5 and between wave 5 and 6 of the survey (undertaken in 2013 and 2015, respectively). In order to isolate the effect of material deprivation on loneliness, regression analyses include an extensive set of control variables. The analyses show a strong and significant relationship between material deprivation and both the level of loneliness and deterioration in the loneliness status.
The Positive Legacy of Vision Loss: Pathways to Posttraumatic Growth
Authors: Tanner Corinna , Caserta Michael , Guo Jia-Wen , Clayton Margaret , Bernstein Paul , Kleinschmidt Julia
Published: December 2020

This mixed method study describes posttraumatic growth (PTG) accruing form experience with vision loss caused by severe age related macular degeneration (AMD) and explores relationships between depression, social support, and cognitive processing, on the path to PTG. Research describing the psychological and social issues surrounding AMD has focused on negative outcomes. However, learning from highly challenging experiences, such as vision loss, can offer benefits. In this study, these included an increased sense of personal strength, increased spirituality, and empathy for others (all domains of PTG). 89 participants with severe vision loss (mean age = 85.3 years, age range = 74–98 years) completed the interviewer-administered composite questionnaire, which identified elements of Tedeschi and Calhoun’s model of PTG. Relationships between variables were examined using path analysis. Findings were contextualized with data from 15 qualitative interviews. Findings underscored the importance of supportive others and deliberate cognitive processing in the path to PTG.
Concurrent and Enduring Alignment of Married Partners’ Shared Beliefs and Markers of Aging
Authors: Mejia Shannon , Giasson Hannah , Smith Jacqui , Gonzalez Rich
Published: December 2020

Beliefs about aging are grounded in social experience. This study considers the extent to which married older adults’ shared beliefs about aging and markers of aging maintain a concurrent and enduring association with their partners’ beliefs and markers of aging. Data from the 2010/2012 and 2014/2016 waves of the Health and Retirement Study provided measures of husbands’ and wives’ (3,779 couples) positive and negative beliefs about aging and internal (Cystatin C) and external (grip strength) markers of aging. Latent dyadic models parsed beliefs and markers into partners’ individual and shared variance. Longitudinal analysis showed concurrent associations between shared beliefs and markers of aging to be stable over four years. Meanwhile, the enduring processes that connect beliefs and markers over time were best characterized as bidirectional. The study provides evidence that, within older couples, beliefs about aging are shaped in part through partners’ co-experience of each other’s biological aging.
Social Processes in Late-Life Suicide
Authors: Necka Elizabeth
Published: December 2020

Suicide is the tenth leading cause of death in the United States, and social isolation – either real or perceived – is one of the primary risk factors for a suicidal attempt (Calati et al.,2019). Late adulthood is characterized by both rapid increases in both social isolation (Cornwell,2011) and loneliness (i.e., perceived social isolation; Hawkley, Wroblewski, Kaiser, Luhmann, & Schumm,2019), which enhance risk of mental disorders (Santini et al.,2020), as well as by suicide rates that are higher than in any other age group (SAMSHA,2017). What are the mechanisms by which social isolation confers risk (and social connection confers resilience) to suicidal thoughts and behaviors in aging, and what promising interventions exist for addressing social impediments in older adulthood? What barriers exist to providing services to socially isolated older adults contemplating suicide, and what are the public health implications of social isolation and suicide in late life? This symposium will feature talks on the role of social motivation and empathy in the development of (or resilience to) suicidal ideation in older adults, on interventions that draw upon the Interpersonal Theory of Suicide and utilize social engagement and digital ‘mHealth’ services to reduce late-life social isolation, depression, and suicidal ideation, and on National Institute of Mental Health funding priorities and efforts to address suicide. After attending this session, participants will be able to articulate mechanisms by which social isolation confers risk for suicide in older adulthood and to identify opportunities and obstacles for effective intervention implementation.
The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes
Authors: Metzelthin Silke , Zwakhalen Sandra , Resnick Barbara
Published: December 2020

Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium
Keep Moving Toward Recovery! Function-Focused Care in Hospitalized Stroke and Geriatric Patients
Authors: Ginkel Janneke de Man-van , Verstraten Carolien , Schuurmans Marieke , Metzelthin Silke , Reitsma Johannes , Schoonhoven Lisette
Published: December 2020

Many hospitalized patients experience decline in functional status. Function Focused Care (FFC) has demonstrated to improve patients’ functional status in long-term care. In a stepped wedge cluster trial in 893 hospitalized geriatric and stroke patients, we investigated the effectiveness of FFC compared to usual care (FFC: n=427, UC: n=466) on ADL and mobility. We measured the Barthel Index and the Elderly Mobility Scale, and analysed using a mixed-model multi-level method. At discharge, 3 month and 6 months, the mean difference (MD) was in favour of FFC, although at none of the time points the level of significance was reached: the MD for ADL was respectively: 0.79 (95%CI: -0.98-2.56), 0.43 (95%CI: 0.10-1.79), and 0.57 (95%CI: -1.34- 2.48). For mobility, the MD was respectively 0.89 (95%CI: -1.01-2.80), 0.78 (95%CI: -1.18; 2.75), and 1.09 (95%CI: -0.88-3.07). Although the results are inconclusive, FFC shows a tendency to improve ADL and mobility in hospitalized patients. Part of a symposium sponsored by Nursing Care of Older Adults Interest Group.
Understanding the Relation Between Sleep and Health in Adulthood: Daily Experiences to Long-Term Health Outcomes
Authors: Chai Hye Won , Almeida David , Lee Soomi
Published: December 2020

An increasing number of studies evinces the significant role of sleep in health outcomes including physical symptoms, cardiometabolic functioning, and chronic health conditions. To further advance the field’s knowledge on sleep and health in adulthood, it is necessary to have an integrative understanding of this topic that pulls together short-term determinants to long-term health consequences of sleep. As such, this symposium places diverse aspects of sleep across multiple contexts, ranging from predictors and consequences of sleep in daily life to the role of sleep in long-term changes in health across adulthood. The first paper by Lee and colleagues examines the role of daily positive and negative events as precursors of concurrent and next-day sleep duration. The second paper by Joo and colleagues addresses the moderating role of nightly sleep duration in the association between daily stressor severity and intensity of headaches. The third paper by Chai and colleagues explores how the association between daily emotional well-being and cardiometabolic syndrome differs by sleep deficiency and by age. The fourth paper by Sin and colleagues focuses on daily affective vulnerability to short sleep duration as a risk factor for developing chronic conditions 10 years later. The final paper by Reither and colleagues assesses within-person changes and between-person differences in restorative sleep and their associations with body mass trajectories across 15 years. The discussant, Dr. Soomi Lee, will integrate key points from the studies, discuss the utilization of diverse measurements of sleep, and address considerations for future research on sleep and health.
Diurnal Cortisol Profiles and Veteran Status
Authors: Piazza Jennifer , Landes Scott , Dmitrieva Natalia
Published: December 2020

Although veterans typically have better health and lower mortality risk than nonveterans earlier in life, a crossover occurs in later life, resulting in comparatively poorer health and higher mortality risk in older age. Alterations in biomarkers of physical health could be an initial indicator of this crossover. The current study uses data from the second wave of the Midlife Development in the United States (MIDUS) survey. Previously validated cortisol profiles (Dmitrieva et al. 2013) were used to categorize participants (N = 1101, age range: 33-88) into normative and non-normative groups, that were examined in relation to veteran status. Results revealed a significant age by veteran interaction (β = .0331, p = .038), indicating that older veterans were less likely to belong to the normative profile group than non-veterans and younger veterans. Results demonstrate the need to explore underlying physiological mechanisms linking military service with poorer health in later life. Part of a symposium sponsored by the Aging Veterans: Effects of Military Service across the Life Course Interest Group.
What Saves the Day?: Identifying Protective Factors That Buffer the Negative Effects of Daily Stressors
Authors: Hong Joanna , Huo Meng , Hoppmann Christiane
Published: December 2020

Older adults frequently experience daily stressors and are at increased risk of adverse health consequences. Emerging studies have focused on factors that may buffer older adults’ well-being and strengthen their resilience to stress. This symposium adds to this burgeoning literature and presents studies that identify a wide range of such stress-buffering factors, including individual characteristics and daily social and emotional experiences. Huo et al. considered older adults’ empathy and found that more empathic individuals tended to use constructive strategies but not destructive strategies when coping with interpersonal tensions. When daily tensions occurred, more empathic individuals were also better at maintaining their mood. Kim et al. showed that older adults’ marital status influenced their irritable encounters with grown children. Although irritable encounters were associated with increased daily negative mood, this link varied by parents’ marital status. Hong et al. assessed the link between daily stressors and negative affect among older adults with varying levels of loneliness. They found that positive interpersonal encounters were particularly protective for lonely older adults’ daily affect. Leger et al. further examined the buffering effects of trait level and same-day positive emotions during times of stress. Higher trait and same-day levels of positive emotions reduced negative emotions on the day following a stressor. Together, findings might inform future interventions aimed at increasing the daily experience of older adults. Dr. Hoppmann will serve as the Discussant and summarize the theoretical and methodological contributions of these studies. She will discuss challenges in this field and directions for future research.
All Is Good, but Not Really: Daily Reports of Satisfaction With Home- and Community-Based Services
Authors: Savla Jyoti , Roberto Karen , Knight Aubrey , Blieszner Rosemary , McCann Brandy Renee , Hoyt Emily
Published: December 2020

An extensive body of literature documents correlates of and barriers to health service use, yet much less is known about satisfaction with home- and community-based services for persons with dementia (PwD). Daily diary data from 122 rural caregivers (CG) of PwD (814 daily diaries) were used to assess everyday service use experiences. At the last diary interview, CG identified areas where service use expectations were and were not being met. CGs reported problems with services used on fewer than 5% of study days (e.g., service provider was delayed because of car trouble). In contrast, 82% of CG identified areas where service expectations were not being met. Their most common concerns were lack of control over service availability and lack of adequate training among service providers. Recommendations for alternative ways for capturing service use satisfaction will be offered, and implications for theory and practice will be discussed.
How Barriers and Facilitators in the Community Environment Shape Opportunities for Healthy Aging With Disability
Authors: Clarke Philippa , Forchheimer Martin , Charara Lynn , Wolgat Ellen , Meade Michelle , Tate Denise
Published: December 2020

Due to advances in medical care and technology the average age of people living with early-acquired spinal cord injury (SCI) is increasing. Approximately 40% of adults with SCI are over age 65. However, the cumulative effects of living with a SCI for many years make aging with SCI different from those “aging into disability”. For example, unstable employment histories and the premature onset of secondary health conditions can create unique challenges for adults aging with SCI. Barriers and facilitators in the community environment play an important role for their ability to maintain health, engage in society, and participate in social roles. Data from a mixed methods study of ~200 adults (age 45+) aging with SCI, will be presented to demonstrate the impact of specific environmental barriers and facilitators and to stress the importance of understanding the complex dynamics of person-environment fit to fully support adults aging with and into disability. Part of a symposium sponsored by the Lifelong Disabilities Interest Group.
Design, Utilization, and Impact of Smart Voice Interventions in Older Adults
Authors: Huisingh-Scheetz Megan , Hawkley Louise , Cotten Shelia
Published: December 2020

Smart voice (voice-first) devices such as Amazon Alexa or Google Home devices use speech as the primary input method and employ artificial intelligence to “act” on spoken commands. Smart voice devices are thought to reduce technology use barriers for older adults because older users can utilize a skill they already have (talking) rather than learning a new skill (typing). Therefore, smart voice may be a promising technology vehicle for delivering social and functional resources and for assessing health in the home of older adults and their caregivers. However, very little clinical research has been conducted to understand the unique design considerations, utilization, potential impact, and limitations of smart voice applications in older adults. This symposium will 1) describe research methods and results of user-driven design of smart voice materials and programming in older adults; 2) quantify the utilization and potential impact of “EngAGE,” a smart voice-based program delivering socially-motivated exercise, on functional outcomes and summarize perceived benefits and challenges to use among older adult and caregiver participants following a feasibility study; and 3) detail key findings and policy implications following pilots of “Community Hub,” a data collection voice application to detect social isolation, and “Social Check-in,” programs leveraging smart voice to aid in older adult socialization.
Live Discharge From Hospice: Experiences of Patients, Families, and Staff
Authors: Utz Rebecca , Clayton Margaret , Supiano Katherine
Published: December 2020

Hospice services can provide patient stabilization and improved quality of life, making the patient ineligible for continued hospice. Using focus groups and in-depth interviews, we explored how patients, families, and hospice staff experience, anticipate, and cope with “live discharge” from hospice. Nurses and administrators tried to prepare families for the possibility and unsettling reality of live discharge, yet the aides who worked most closely with families remained unaware of regulations dictating an impending live discharge. Reactions of families ranged from excitement, when patient was selected for clinical trial, to more common expressions of frustration, as they lost access to the staff, coordinated services, and medications only covered under the Medicare hospice benefit. Families also reported relationship stressors and decisional uncertainty associated with longer than expected patient life. Families still needed and wanted hospice services, with most agreeing they would return to hospice after the patient declined and became eligible again.
The Roles of Communication, Collaboration, and Social Support on Dyadic Mental Health in the Context of Chronic Pain
Authors: Lyons Karen
Published: December 2020

Drawing on the Theory of Dyadic Illness Management, the study examined the roles of communication, collaborative decision-making and social support on the mental health of 177 couples living with chronic pain. Couples ranged in age from 26-81 years of age; mean age for partner with chronic pain = 55.01 (SD=11.53) and partner without chronic pain = 57.45 (SD=12.50). Using multilevel modeling and controlling for pain severity, pain interference, time since diagnosis, age, shared activities and relationship quality, communication and collaborative decision-making played significant roles in predicting mental health of both members of the couple. Comparative dyadic analysis showed that couples with optimal dyadic mental health had significantly better communication, less concealment, greater collaboration and greater levels of support than couples with poor or incongruent dyadic mental health. Discussion will center on the roles of collaborative illness management behaviors in optimizing dyadic mental health in the context of chronic illness. Part of a symposium sponsored by Dyadic Research on Health and Illness Across the Adult Lifespan Interest Group.
Older Adults’ Receptivity to Spousal Health Support: A Qualitative Analysis
Authors: Rauer Amy , Lopez Ruth Palan , Pigg Ashley
Published: December 2020

Romantic partners play a powerful role in promoting each other’s well-being, particularly later in life. Although there is a robust literature documenting how spouses tend to respond to each other’s health issues (e.g., support, control), there has been a surprising dearth of studies examining how receptive spouses are to these overtures. To reveal how older couples react to each other’s health support attempts, we used a qualitative approach to analyze transcripts of 64 older, married, heterosexual couples observed discussing each other’s health issues. Thematic analysis revealed older couples responded to spouses’ health support strategies in four different ways: 1) listening (individuals actively listened); 2) accepting (individuals welcomed spousal efforts); 3) deflecting (individuals redirected conversation away from health); and 4) rejecting (individuals dismissed and refused spousal intervention). Given the rise in late-life caregiving, identifying the very different responses that are evoked when partners intervene in each other’s health warrants further investigation. Part of a symposium sponsored by Dyadic Research on Health and Illness Across the Adult Lifespan Interest Group.
Bidirectional Associations Between Activity Diversity and Sleep
Authors: Lee Soomi , Charles Susan , Almeida David
Published: December 2020

Activity diversity is important for psychological well-being and cognitive functioning. Yet, little is known about the relationship between activity diversity and sleep. This study examined how overall and nightly sleep health are associated with activity diversity. Participants (N=1841) from the Midlife in the United States Study II provided activity data for 8 days. We constructed overall and daily activity diversity scores. A composite score of overall sleep health across 8 dimensions and nightly sleep duration were measured. Analyses adjusted for sociodemographics, total activity time, and positive/negative affect. Participants with poorer sleep health overall had a lower activity diversity. On days following nights with short (<6hrs) or long (>8hrs) sleep duration, participants engaged in fewer-than-usual activities. Conversely, fewer daily activities also predicted long (but not short) sleep duration. Our results suggest cyclical associations between poor sleep health and activity diversity day-to-day, which, may accumulate over time to form a bidirectional relationship.
The Relationship Between Hippocampal Volume and Activity Diversity
Authors: Urban-Wojcik Emily , Lee Soomi , Charles Susan , Almeida David , Davidson Richard , Schaefer Stacey
Published: December 2020

The hippocampus, implicated in learning, memory, and spatial navigation, is one of the few brain structures that demonstrates neurogenesis across the lifespan. Hippocampal volume (HV), then, may be a marker of exposure to and engagement with novel events and environments, which may in turn be related to cognitive functioning. The present study examined the relationship between HV and activity diversity (AD), which characterizes the range and evenness of participation in daily activities. In 52 participants who completed the daily-diary and neuroscience projects of the Midlife in the United States Refresher study, greater levels of AD across an 8-day period were related to greater HV averaged across the left and right hemispheres when adjusting for overall brain volume, total activity time, time between projects, and relevant sociodemographic variables, b=1128mm3, t(43)=2.54, p=.015. These findings may point to a mechanism through which AD has been related to better cognitive and mental health outcomes.
Associations of Cytomegalovirus and Muscle Weakness in Older Adults: Results from the Health and Retirement Study
Authors: Duchowny Kate , Noppert Grace
Published: December 2020

Muscle weakness, measured by grip strength, is associated with disability, physical functioning and mortality; however, the sociobiologic underpinnings of muscle weakness are poorly understood. Immune response to cytomegalovirus (CMV), as measured by immunoglobulin G (IgG) antibody levels, is often used as a marker of immunosenescence with higher antibody levels suggesting accelerated immunosenescence. Previous research has shown immune response to CMV across the life course is socially patterned with disadvantaged groups having higher antibody levels across the life course. Thus, the primary objective of this study was to examine associations between CMV IgG antibodies and grip strength in a nationally representative cohort of older adults, and the role of social factors in these associations. Using data from the Health and Retirement Study (N= 4,251; Mean Age= 67.4 years), we employed gender-stratified weighted linear regression models to estimate the mean difference in grip strength associated with tertiles of CMV IgG response controlling for age, race/ethnicity (White, Black and Hispanic) and educational attainment. For men, higher IgG antibody levels were associated with decreased mean grip strength. For example, men in the highest level of IgG antibody had a grip strength of 37.67 kg (95% CI: 36.30, 39.05) compared to men seronegative to CMV with a grip strength of 38.96 kg (95% CI: 38.18, 39.74). For women, there was little difference in grip strength by CMV IgG response. Our findings suggest accelerated immunosenescence may be an important predictor of reduced grip strength in older adults, and critical to understanding social disparities in grip strength.
Classification of Aggressive Behaviors Based on sEMG Feature Extraction and Machine Learning Algorithm
Authors: Kim Youngjun , David Uchechukuwu , Noh Yeonsik
Published: December 2020

New surface electromyography (sEMG) feature extraction approach combined with Empirical Mode Decomposition (EMD) and Dispersion Entropy (DisEn) is proposed for classifying aggressive and normal behaviors from sEMG data. In this study, we used the sEMG physical action dataset from the UC Irvine Machine Learning repository. The raw sEMG was decomposed with EMD to obtain a set of Intrinsic Mode Functions (IMF). The IMF, which includes the most discriminant feature for each action, was selected based on the analysis by Hibert Transform (HT) in the time-frequency domain. Next, the DisEn of the selected IMF was calculated as a corresponding feature. Finally, the DisEn value was tested using five different classifiers, such as LDA, Quadratic DA, k-NN, SVM, and Extreme Learning Machine (ELM) for the classification task. Among these ML algorithms, we achieved classification accuracy, sensitivity, and specificity with ELM as 98.44%, 100%, and 96.72%, respectively.
Preventing Cardiometabolic Disease in HIV-Infected Latino Men: The Happy Older Latinos Health Promotion Study
Authors: Jimenez Daniel
Published: December 2020

Older Latinos living with HIV have been disproportionately affected by the epidemic and experience compounded health disparities that have deepened over time. Eighteen Latinos living with HIV with a mean age of 60.3 years (SD=6.4) were enrolled in the Happy Older Latinos are Active (HOLA), a community health worker-led, multicomponent, health promotion intervention. Participants were assessed at three time points on measures of cardiometabolic risk and psychosocial functioning. We evaluated the feasibility of recruitment, retention, acceptability, and implementation of HOLA. In 4 months, we met our enrollment target with <5% of eligible participants refusing participation. Participants attended over 70% of sessions and 1 participant was lost to follow up. These results indicate that HOLA is an innovative health promotion program that is uniquely tailored to address the multiple concerns that are prevalent in this community (cardiometabolic risk, psychological distress) in a nonstigmatizing and culturally acceptable manner.
Achieving Healthcare Equity: Disparities in Diagnosis, Quality of Care, and Outcomes Among People With Dementia
Authors: Rivera-Hernandez Maricruz , Kumar Amit , Kumar Amit
Published: December 2020

Alzheimer’s disease and Related Dementia (ADRD) is a significant public health problem and improving the quality and efficiency of care for older adults with ADRD is a national priority. Approximately five million older adults in the United States, including 50% of nursing home residents and 20% of community-dwelling elderly, have ADRD or probable dementia. Although, the number of minorities affected by ADRD growing at an alarming rate, the diagnosis of ADRD and supportive care for this condition are more likely to be delayed among racial/ethnic minority groups. Given the need to ensure equity of care among racial and ethnic groups, there is a pressing need to understand disparities in diagnosis, access and quality of care among racial and ethnic groups with ADRD, specifically using nationally representative data. This symposium will feature four presentations that provide novel insight regarding racial disparities among people with ADRD in the community-, institution-based post-acute, and long-term settings. Individual presentations will describe 1) racial and ethnic differences in risk and protective factors of dementia and cognitive impairment without dementia; 2) racial and ethnic disparities in high-quality home health use among persons with dementia; 3) Within- and between-nursing homes racial and ethnic disparities in resident’s outcomes for people with ADRD; and 4) racial differences in transition to post-acute care and rehab utilization following hip fracture related hospitalization in patients with ADRD. Finally, there will be a discussion regarding policy and clinical implications, as well directions for future research.
Adult Protective Services’ Intervention on Elder Abuse: Using Standardized Measures for Outcomes
Authors: Liu Pi-Ju , Conrad Kendon , Wilber Kathleen
Published: December 2020

Adult Protective Services (APS) investigates and substantiates vulnerable adult abuse, neglect, and exploitation (ANE) cases. The frontline social service agency also refers or provides needed services to ANE victims. Outcomes of APS has been scarce, with definitions of outcomes varying from study to study. Using a pretest-posttest design, we partnered with San Francisco and Napa APS to measure changes of ANE harm from case investigation (pretest) to case closure (posttest) using standardized measures called the Identification, Services, and Outcomes (ISO) Matrix. Forty-five APS supervisors and caseworkers used the ISO Matrix on 2,063 cases during the six-month pilot demonstration. Dr. Pi-Ju (Marian) Liu will examine findings on changes of ANE harm and APS services that effectively decreased ANE harm. Responding to 2020’s Annual Scientific Meeting theme “Turning 75: Why Age Matters”, ANE harm and APS services will be compared between younger APS clients age 18-64 and older ones above the age of 65. Dr. Zachary Hass will discuss allegation, abuse severity assessment, services provided, and outcomes across racial and language groups. Dr. Kendon Conrad will present reliability and validity of the ISO Matrix and a shorter version useful for APS practice. Ms Sara Stratton will review unusual cases with outlier ISO Matrix scores to inform researchers’ implementation and practitioners’ use of standardized measures. Dr. Kathleen Wilber, our discussant, will reflect on the use of standardized measures in APS and its impact on both practice and research based on the four presentations.
Science and Self: Aging as Woven
Authors: Kivnick Helen
Published: December 2020

Gerontology is a field both scientific and practice-based. Aging, the subject of this field, is an experience in which all human beings participate. But scientific pillars of objectivity, quantifiability, control, and external validity have long mitigated against gerontological scholars effectively moving back and forth between professional scholarship and practice, on the one hand, and personal experience, on the other. Qualitative research approaches, informed by the humanities and arts, utilize alternative ways of knowing that, when added to positivistic science, enable us to construct a body of gerontological knowledge that is robust and useful, and that also incorporates wisdom. Aging, wisdom, and integrality—these all matter. Although often mischaracterized, Erikson’s theory of healthy psychosocial development throughout the life-cycle (Erikson, Erikson, & Kivnick, 1986) weaves these constructs together in ways that can meaningfully inform professional and personal experiences of gerontology. This presentation illustrates one aging gerontologist’s engagement with such weaving.
Applied Scholarship in LGBTQ Aging: Implications for Policy and Practice
Authors: Oswald Austin , Fabbre Vanessa
Published: December 2020

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) elders have shown considerable strength while aging in a society predicated on heteronormative and binary expectations for gender and sexuality. The life trajectories of LGBTQ older adults are shaped by discrimination and stigmatization, and the embodied resistance that comes with demanding their full participation and recognition in society. This symposium highlights the innovative scholarship of emerging scholars in the field of LGBTQ aging who are engaging in diverse substantive and methodological investigations. The first study takes a comparative cohort approach to explore differences in stressors and depressive symptomatology between younger and older sexual minorities, highlighting the significance of cohort effects among LGBTQ people. The second paper uses data from the Health and Retirement Study to examine anticipated nursing home placement needs between LGB and heterosexual adults with suggestions to better prepare aging service networks. The third describes the influence of state legislature mandating LGBTQ-sensitivity training by examining differences in provider baseline knowledge and attitudes toward LGBTQ older adults in two states, one mandating LGBTQ-sensitivity training and one not. The final paper highlights findings from a multi-methods study that explores how long-term care workers, managers, and administrators respond when staff, visitors, or residents challenge LGBTQ rights for religious and moral reasons. Although substantively and methodologically varied, these studies all demonstrate the importance of applied scholarship that builds knowledge in support of policies and practices that promote equity among LGBTQ individuals across the life course. Rainbow Research Group Interest Group Sponsored Symposium.
Honoring Choice in Grief Through Expressive Arts With Long-Term Care Residents
Authors: Olson Michelle
Published: December 2020

Death in long-term residential care homes is a common occurrence, yet it is often taboo and strongly avoided. Staff and residents often express deep connections to one another in these settings, but when death occurs, there is often little to no support, training or space to share these feelings. This session will discuss the findings of Dr. Olson’s multicase, arts-based research from the elder voices of those who face these losses. Perceptions such as disenfranchised grief and ageism were revealed in this study as well as positive expressions such as love, kindness and acceptance. The shared findings will include poetry and artwork that was created within this research study. Utilizing the creative arts can assist in the expression of these complex and abstract human emotions, instill a sense of comfort and community and empower honor these lives and friendships.
A Place for Us: A Unique Experience That Provides a Creative and Social Experience for People With Dementia
Authors: Mittelman Mary , Harris Amy
Published: December 2020

A Place for Us meets weekly in community locations for a half day and is run by a recreation therapist who is also an artist, offering an opportunity to connect with others through participation in creative projects. We have found that collaborating in creating a piece of art, such as a collage provides a context for socializing. Since the program began in 2017, we provided this opportunity to 83 caregivers. The program has broad appeal and has included both men (54%) and women (46%) and people from many racial and ethnic backgrounds: 62.3% white, 13 percent African American, 7% Latino and 5% Asian. Our experience suggests that Interacting through collaborative projects utilizing what has been called, “The creative brain,” offers people with dementia an opportunity to feel at ease in this social setting. A Place for Us allows people to interact socially while engaging in a pleasant and normative activity.
Melatonin Use for Sleep in Assisted Living
Authors: Peketi Punita , Zimmerman Sheryl , Miller Stephanie , Wretman Christopher , Preisser John , Sloane Philip
Published: December 2020

Sleep problems are common among residents of assisted living (AL) communities, and in other settings, melatonin is used to promote sleep. However, melatonin use in AL is unknown; because it may have side-effects, this knowledge gap is concerning. To address this question, data were collected across 250 AL communities in seven states; analyses used weights whereby data were scaled to represent the entirety of the states. The majority of communities prescribed melatonin (82%), albeit to a minority of residents (9%). Prescribing was more common for those with anxiety, sleep-wake disorders, dementia, and various behaviors, in communities that had more staff and more favorable non-pharmacological attitudes (p<.05). Dosages varied from 0-45 mg and co-prescribing was common. This study is the first to examine melatonin prescribing in AL; use may be appropriate if, for example, it is a replacement for hypnotics. The variation suggests practices may be modifiable; further research is needed.
Older Adults Walking the Camino de Santiago Pilgrimage: Motivations, Transformations, and Spiritual Perspectives
Authors: Nelson-Becker Holly , Pickard Joe , Aitch Gina , Buettner Alyssa
Published: December 2020

This mixed-method study describes reasons that older people chose to complete the Camino de Santiago pilgrimage route in Spain and their assessment of how they were changed by the experience. The study is framed in Maslow’s (1988) self-actualization and Tornstam’s (2005) concept of gerotranscendence. We analyzed a subset of 121 participants age 65 and over who completed an online survey. Motivation included five themes: gratitude and transitions, cultural or historical curiosity. relationships, challenge and adventure, and spirituality. Transformations since their return involved greater strength, self-understanding, peace, desire to live lightly and to integrate their experience. Older individuals who walked the Camino have done so for a variety of reasons. Spiritual reasons may be more difficult to disclose. Half responded in the open-ended question, but a later spirituality question added many more respondents. Older people envision many forms of benefit to walking the pilgrimage and find growth in the experience.
Culture Change and Quality Star Ratings in High Medicaid Nursing Homes: Does Time of Adoption Make a Difference?
Authors: Chisholm Latarsha , Ghiasi Akbar , Lord Justin , Weech-Maldonado Robert
Published: December 2020

Racial/ethnic disparities have been well documented in long-term care literature. Culture change is a movement to transition nursing homes to more home-like environments to improve the quality of care for all residents. The purpose of this study was to examine how the involvement of culture change initiatives among high Medicaid facilities was associated with nursing home quality. The study relied on both survey and secondary nursing home data for the years 2017-2018. The sample included high Medicaid facilities. The final model consisted of an ordinal logistic regression. High-Medicaid nursing homes with six or more years in culture change initiatives had higher odds of having a higher star rating, while facilities with one year or less had significantly lower odds of having a higher star rating. Culture change initiatives may require some time to effectively implement, but these initiatives are potential mechanisms to improve quality in high Medicaid nursing homes.
Three Trends Shaping the Politics of Aging in America
Authors: Super Nora
Published: December 2020

The demographic bulge created by the baby boom generation has shaped American politics since they came of age in the 1960s. Over the next decade, aging issues will become more relevant as the oldest boomers reach 84 and the youngest boomers will be eligible for Medicare. This paper highlights three converging trends that will shape United States politics; including increased spending on “entitlement” programs like Social Security and Medicare, growing mismatch in caregiving need and supply, and the heightened concentration of older adults in certain geographic areas. The next decade will see not only extraordinary demographic change but also unprecedented advances in technology and medicine, and cultural and societal shifts that were once unimaginable.
Challenges for Elder Abuse Prevention Law
Authors: Tsukada Noriko , Katsumata Asako
Published: December 2020

This paper compares components of four abuse prevention laws in Japan, including elder abuse, child abuse and domestic abuse, and abuse for people with disabilities and delineates major strengths and weaknesses of the Elder Abuse Prevention Law in comparison to the other three. Based on this analysis, this paper recommends improvements　in the elder abuse prevention law given the success of the related abuse laws. Despite the requirement of re-evaluation every 3 years, no amendments have been made to the elder abuse prevention law, while amendments have been made to the child abuse and domestic abuse prevention laws, based on outcome data and implementation experience. Identified needed revisions include provisions of protection orders and temporary shelters to protect elder victims from abusers at the time abuse is reported.