bluuebunny/crossref_metadata_2025 huggingface dataset:
Reducing Aspiration Pneumonia Risk for Older People: Effect of Evidence-Based Oral Care
Authors: Goldberg Lynette , Crocombe Leonard , Bettiol Silvana , King Anna , Khadka Sangeeta
Published: December 2021

Poor oral health increases the risk of aspiration pneumonia for older people. This is due primarily to six pathogens found in the mouth: five bacteria and one fungus. With a cohort of older people who were dependent on others for their oral care, we analyzed the load and type of bacteria and fungi from swabs of cheek, gum, and tongue mucosa. There were no significant differences between the three sites for load of bacteria (H (2) = .89; p = .64); there were significant differences between the sites for type of bacteria (F (2,78) = 11.97; p <.001) with the tongue showing the greatest diversity. There were no significant differences between the three sites for load (H (2) = 2.94; p = .23) or type (F (2,77) = .46; p = .63) of fungi. We then investigated the effect of regular compared to evidence-based oral care over a six-week period, and whether evidence-based oral care could significantly reduce the absolute count of the six oral pathogens specifically related to aspiration pneumonia. Participants self-selected into Regular Care (n = 10) and Evidence-based Care (n = 17) Groups. Evidence-based oral care resulted in significant decreases (p = .02 to p < .001) in the load of four potentially pathogenic bacterial species, including E. coli, gut-based bacteria, and in an increased load of Lactobacillus reuteri, a host-protective normal flora in the mouth, compared to baseline. There were no significant differences between groups for the abundance and type of fungi.
Effectiveness of an Intergenerational Service-Learning Program to Change Attitudes on Aging
Authors: Bartlett Sara , Bergman Sky , Solomon Phyllis , Gellis Zvi
Published: December 2021

This study evaluated the efficacy of a 10-hour intergenerational service-learning program administered to undergraduates to determine if it would increase knowledge about aging, improve attitudes about older adults, and reduce ageism more than a course with less service-learning activity. Making maximum impact on students in these areas in a short amount of time is particularly relevant in short, quarter-based university programs. A quasi-experimental design using a convenience sample compared pre-test and post-test scores between an experimental intervention (N=68) and a comparison (N=71) group on The Facts on Aging Quiz Multiple Choice version, Aging Semantic Differential, and Fabroni Scale on Ageism. Qualitative data via open-ended survey questions was also collected. The experimental intervention, the Lives Well Lived project, was based on a documentary film by the same name, which incorporates themes of successful aging. During the project students and older adults interviewed one another about living a life well lived, participated in a photo shoot, and created a Memoir for the older adult. The comparison group included two social visits to a congregate meal program. Results from multiple regression analysis showed that students in the intervention group had less ageist stereotypes and less negative bias about aging at post-test and qualitative data indicated they were more inclined to participate in intergenerational relationships in the future. Programs like this one that are longer and more relational may be useful for consideration in undergraduate gerontology courses in reducing ageism and promoting intergenerational relationships which benefit those of all ages.
Analysis of Cell and Molecular Phenotypes of a Highly Replicated Longevity-Associated FOXO3 Variant in Older Adults
Authors: Davy Philip , Chen Randi , Allsopp Richard , Willcox Bradley
Published: December 2021

Aging demographics in the US, and other industrialized nations, are resulting in rapidly increasing health care costs from age-related diseases. New therapeutic interventions to extend healthspan in older adults requires understanding connections between basic aging biology and human longevity factors. Using clinical samples from the Kuakini Honolulu Heart Program (HHP) and their Offspring, we are examining potential links between molecular and cellular mechanisms of aging and the longevity associated FOXO3 genotype (carriage of SNP rs2802292 “G” allele). Telomere dynamics in leucocytes (LTL) have shown strong correlation with multiple lifestyle and health factors. We previously demonstrated a significant protective relation between FOXO3 longevity genotype and LTL in a cross-sectional study. Now we are assessing a longitudinal relation, at three time points over 20+ years, in older men. We are also exploring stem cell frequency and differentiation capacity in neurological and peripheral blood samples to assess FOXO3 genotype and human cell dynamics.
The Dartmouth Falls Prevention Training Program: Primary Care and Community-Based Organization Collaboration
Authors: Pidgeon Dawna
Published: December 2021

Falls are a leading cause of fatal and non-fatal injuries in older adults. Older adult participation in community-based falls prevention programs can significantly reduce falls risk, however, identifying and referring individuals to appropriate programs can be challenging. Through Administration for Community Living (ACL) funding, we have developed a comprehensive Dartmouth Falls Prevention Training Program for healthcare and community based organizations that includes (1) Falls screening in primary care; (2) “Balance Days”, a community-based education and balance screening event encompassing falls risk stratification and coaching into programs; (3) Instructor Training for Tai Ji Quan: Moving for Better Balance®, a highly effective falls prevention program; and (4) Implementation Training, a research informed workshop shown to enhance community-based program sustainability through participant retention. We will share strategies for sustainable collaborations between primary care and CBOs to reach at-risk individuals and improve lives and decrease costs associated with falls.
Leveraging Promising Policies to Support Long-Term Care Residents' Quality of Life Post-Pandemic
Authors: Taylor Deanne , Keefe Janice , Cook Heather
Published: December 2021

Long-term care (LTC) is highly regulated and often the policy language is complex and in tension with residents’ quality of life goals. Prior to COVID-19, LTC policy levers prioritized safety over other quality domains such as privacy, dignity, spirituality, and comfort. During the pandemic, this focus on safety regulations, while important, intensified in ways that often negatively impacted residents’ overall quality of life. In this symposium, we share findings from a five- year research project where we conducted a unique and expansive review of regulatory policy across four Canadian jurisdictions. We highlight how 11 different quality of life domains are supported and which texts offering promising policy language to enhance a well-rounded quality of life for residents. These are timely insights to offer as policy-makers look to the future and consider the lessons learned from the pandemic. We contend that creating more LTC policy is not a timely pathway forward to LTC reform. Instead, we suggest that existing policy can be leveraged when applied within a resident-centred quality of life lens. We will guide attendees through examples of existing promising policies highlighting how they might leveraged in planning for a better LTC system. The discussion will be rooted in our unique resident-centred approach to policy analysis using specific domains of quality of life and then applied to four different perspectives: residents, families, staff and volunteers. Our discussant a Ministry of Health decision-maker will address the implications of our research for post-pandemic planning to improve resident quality of life
Multiscale Brain Aging in the Context of Neurodegeneration and Alzheimer's Disease
Authors: Thrush Kyra , Markov Yaroslav
Published: December 2021

The brain, with a diverse array of specialized cells, regional substructures, and a relatively isolated microenvironment, represents a uniquely challenging organ system for aging research. The brain can experience physical trauma, interact with the periphery, and is responsible for cognitive and behavioral modifications that can feed back into the molecular processes of aging both within and external to the brain. Advances to our understanding and ability to intervene in the complexity that personifies brain aging and associated neurodegeneration will require integrated, multiscale approaches operating in tandem. Therefore, we have organized this symposium to highlight promising new approaches to study brain aging through the lens of multiple biological levels of organization. We will provide insight not only into normal brain aging, but will also suggest key spurious processes that may drive neurodegeneration and functional decline.
The Arc of Astrocyte Aging: Insights From scRNAseq
Authors: Meer Margarita , Minteer Christopher , Levine Morgan
Published: December 2021

There is an urgent need to increase our understanding of brain aging and its role in neurodegeneration. While, evidence suggest that many hallmarks of aging, including epigenetic alterations and cellular senescence may be implicated in dementia, studying these and other progressive molecular changes in the brain remains extremely challenging. We asked whether something as simple as artificially aging cells in culture could recapitulate the changes that occur during organismal aging. To test this, we passaged human primary astrocytes and performed single-cell RNA sequencing (scRNAseq) of cells at passages 2-10. We observe that the sequential passaging—that terminates with a cluster of senescent cells—can be captured by manifolds and used to quantify a pseudo-time measure of progressive transcriptional changes. We identify genes underlying this transition and apply this signature of in vitro astrocyte passaging to scRNAseq from human and mouse brain aging studies, demonstrating associations with aging and neuropathology.
Cultural Appropriateness of an Intervention to Promote Functional Recovery From Hospitalization: Caregiver Views
Authors: BeLue Rhonda , Boltz Marie
Published: December 2021

The Fam-FFC model includes caregiver education and care pathway to promote physical function, wellbeing, and cognition. The Ecological Model (EM) provided a framework to assess the cultural appropriateness of the Fam-FFC intervention, through interviews with family caregivers, patients, and nurse champions, and focus groups with staff. Findings are described within the eight dimensions of the EM: 1 ) language: perceptions of the dyads’ comfort level with intervention information; (2) persons: representation of dyads’ ethnic /racial group within the nurse champions’ ethnicity/race; (3) metaphors: use of cultural terms equivalent to those used by participants; (4) content: integration of participants’ values, customs, and traditions in the intervention; (5) concepts: congruence of caregiving concepts with cultural norms; (6) goals: congruence of the intervention goals with participants’ cultural norms and goals; 7) methods: the culturally appropriateness of the delivery of the intervention; and (8) context: alignment of the intervention with the participant’s socio-community context.
Self-Care Theory and Translation to Intervention
Authors: Hirschman Karen , Riegel Barbara
Published: December 2021

Self-care is defined as a process of maintaining health through health promoting practices and managing illness when it occurs. Self-care is integral in the management of chronic conditions, but even those without illness engage in some level of self-care daily. In our on-going study we promote self-care as a means to control the stress associated with caregiving. We acknowledge the burden of caregiving for a loved one experiencing a serious chronic illness. That responsibility is typically associated with significant stress for the caregiver. We use stress theory to address the caregivers’ appraisal of events and coping responses. Three experienced health coaches were hired to provide 10 sessions of coaching over a 6-month period to each of the caregivers randomized to the intervention group. The emphasis of the iCare4Me coaching sessions is to address primary and secondary appraisal and coping as a means to improve self-care and thereby decrease stress.
A Qualitative Study of Characteristics of an Effective Health Coach: Personal, Professional, and Program Based
Authors: Clason Caitlin , Barg Frances , Riegel Barbara
Published: December 2021

Health coaching continues to grow in popularity as an effective intervention to empower and engage patients and their caregivers. However, little is known about what characteristics contribute to the success of health coaches in implementing evidence-based interventions. This study examines the characteristics that contribute to effective health coaches. Semi-structured interviews were conducted with health coaches and an interdisciplinary research team of an ongoing study examining a virtual health coaching intervention. Interviewees identified three discrete themes of characteristics that contribute to the success of health coaches: personal (e.g. compassion), professional (e.g. transferability of soft skills) and program based (e.g. training regimen). We conclude that it is not just innate personality attributes that make a health coach effective in their role, but training and program design intended to support health coaches are also important in implementing interventions.
At-Homeness Influences the Cognition of Multimorbid Older Adults: Longitudinal Path Analysis Through Loneliness
Authors: Gan Daniel R Y , Best John , Wister Andrew
Published: December 2021

Approximately two-thirds of older adults’ experience multimorbidity in North America. Challenges of symptoms management and reduced mobility often coincide with late-life depression which is associated with a 2 to 5-fold increased dementia risk. Loneliness and depression are connected in the prodromal phases. We examine the effects of physical environment (e.g., housing and neighborhood factors) and social environment (e.g., social support) on loneliness, depression, and cognition using path analysis, controlling for baseline. Data(n=15,087) was drawn from the Canadian Longitudinal Study on Aging. Measures of housing, neighborhood and life satisfaction were used to construct an index of “at-homeness” based on theory. We found good model fit (TLI=.989; CFI=.999; RMSEA=.026; SRMR=.006). At-homeness(B=-.20, p<.001) rivaled the effect of social environment(B=-.19, p<.001) on loneliness. Together, physical environment and loneliness had as much effect on cognition as depression. If causality is supported, modifying older adults’ satisfaction with their home environment may reduce loneliness and cognitive decline.
A New and Worrisome Predictor of Attitudes Toward Suicide: Self-Rated Health
Authors: Cooney Julene
Published: December 2021

Do people have the right to end their own lives? The General Social Survey has monitored the attitudes of Americans towards suicide since 1977 using four questions: Do you think a person has the right to end his or her own life if this person has an incurable disease, has gone bankrupt, has dishonored his or her family, or is tired of living and ready to die? These four responses can be combined into a reliable index representing an individual’s attitude toward suicide. As average population education levels have increased and religiosity has fallen, attitudes favoring the right to suicide have increased across the population. This research project introduces a previously understudied predictor of attitudes toward suicide: self-rated health. Using logistic and ordinal logistic regression, and controlling for age, education level, religiosity, marital status, survey year, race, and sex, I find that, over time, self-rated health has become a significant predictor of attitudes toward suicide. Since 2002, respondents who perceived themselves to be in poor health are significantly more likely to favor the right to end one’s life, especially if the individual has an incurable disease. After stratifying by age and race, I find that the relationship between self-rated health and attitudes toward suicide is strongest among individuals in the mid-life and is equally significant as a predictor for White and Black Americans after 2010. These findings provide further evidence that mental health screening is an increasingly vital component of physician/patient interactions and highlight the importance of continuity of care.
Work Does Not End When You Leave: Concerns and Coping Strategies Among Nursing Home Social Workers During COVID-19
Authors: Fields Noelle , Miller Vivian , Anderson Keith , Kusmaul Nancy
Published: December 2021

Nursing home social workers (NH SW) at the frontline during COVID-19 are faced with many challenges in meeting the psychosocial needs of residents while balancing their own well-being needs. In order to explore the experiences of NH SW during COVID-19, the study utilized a cross-sectional survey distributed to social media sites (e.g., Reddit, Facebook) and professional networks. The survey asked participants (N = 63) open-ended questions which were analyzed using the rigorous and accelerated data reduction (RADaR) method. Themes suggested that fear for self, lack of administrative support, and overall stress were notable concerns among NH SW. Findings also suggested that support from family/friends and self-care were most personally helpful to NH SW. Lastly, themes related to coping strategies included talking with co-workers, mindfulness, and boundary setting. Findings suggest the need for increased supports for NH SW. Implications related to stress and coping during COVID-19 are offered.
The VA’s Long-Term Care Strike Team Supporting Florida’s Nursing Homes Workforce
Authors: Golden Adam
Published: December 2021

In coordination with the Florida Department of Health, the VA Sunshine Healthcare Network (VISN 8) established Long-Term Care Strike Teams to provide services to the LTC facilities most affected by the COVID-19 pandemic across the state of Florida. Between April 2020 through September 2020, the Strike Teams provided direct patient care to community residents, infection control/ prevention education, and patient/staff COVID-19 swabbing. We encountered facilities with large numbers of staff infected with COVID-19 and agency staff that were refusing to come to “COVID-infected” facilities. Remaining staff, including the administrators, were under much psychological distress. However, our experience supporting the long-term care facilities also had a major impact on our own perceptions of nursing home care. The bravery, dedication, and caring that we witnessed reinforced that the health care workers in long-term care facilities are true heroes.
Cardiovascular Risk Factors and Carotid Intima Media Thickness: Mediation and Interaction by Grip Strength
Authors: Mendo Christian , Keezer Mark , Sylvestre Marie-Pierre
Published: December 2021

Frailty is often described as being an increased vulnerability to the effects of stressors. There is little research investing how frailty may act as either a mediator or participate in interactions in the associations between risk factors and chronic disease. We will present novel analyses of the Canadian Longitudinal Study on Aging, focusing on the 30,000 study participants who underwent serial physical evaluations at one of 11 data collection sites between 2011 and 2018. Using the 4- way decomposition method elaborated by Vanderweele, we investigate the role of grip strength, as a component of physical frailty, in the effect of cardiovascular risk factors on the atherosclerotic burden of individuals (measured using carotid intima media thickness). Our findings clarify the mechanisms underlying of grip strength in the associations between cardiovascular risk factors and carotid intima media thickness.
The Frailty Syndrome: An Emergent Property of Parallel Dysregulation in Multiple Physiological Systems?
Authors: Cohen Alan , Ghachem Ahmed , Fried Linda , Legault Véronique , Bandeen-Roche Karen , Presse Nancy , Gaudreau Pierrette
Published: December 2021

Despite its widespread presence in older adults, frailty etiology is still unclear, being associated with dysregulation in diverse physiological systems. Here, we show evidence that frailty emerges from broad loss of homeostasis integrated through complex systems dynamics. Using the NuAge and WHAS cohorts, we calculated Mahalanobis distance-based physiological dysregulation in six systems and tested the breadth, diffuseness, and nonlinearity of associations between frailty and system-specific dysregulation. We found clear support for breadth of associations, but only partial support for diffuseness and nonlinearity: 1) physiological dysregulation is positively associated with frailty in many or all systems, depending on analyses; 2) the number of dysregulated systems or the total amount of dysregulation are more predictive than individual systems, but results only partially replicated across cohorts; 3) dysregulation trends are exponential, but not always significant. These results suggest, but do not fully prove, that frailty is an emergent property of complex systems dynamics.
Taking Age-Friendly Campus Efforts to New PEAKS
Authors: Elfenbein Pamela
Published: December 2021

The University of North Georgia’s Personal Enrichment, Action, Knowledge Series (PEAKS) was developed as a monthly series of engaging and seasonally appropriate presentations and activities designed to expressly meet the needs of the region’s large and quickly growing older adult population during the Covid-19 pandemic and resultant isolation. The PEAKS programs are available virtually to allow for broad participation throughout the 30 county UNG service region. While we developed PEAKS to specifically reach-out to older adults in our region, we have found that our audience is actually multi-generational, actively engaging with our speakers and one another. AFU underpinnings for PEAKS include Principle #8 - To enhance access for older adults to the university's range of health and wellness programs and its arts and cultural activities; and #9 - To engage actively with the university's own retired community.
An Age- Friendly Campus Partnership for Hospitalized Older Adults in the COVID Era and Beyond
Authors: Kheirbek Raya , Mojdeh Heavner , Fass Marjorie , Cafeo Christina , Netzer Giora , Gulati Mangla , Brandt Nicole , Resnick Barbara
Published: December 2021

As hospitals isolate COVID-19 patients to prevent the spread of this highly contagious disease, patients and family are separated during times of critical illness. For many older adults inflicted with coronavirus it is not the fear of dying that matters the most, it is the fear of dying alone. Utilizing the 4Ms approach, University of Maryland, Baltimore (UMB) and University of Maryland Medical Center (UMMC) responded with several initiatives including intergenerational programs designed to shape and inform the development of future healthcare clinicians in addressing what matters the most to patients and leveraging technology to connect them with families, provide mobility opportunities, monitor medications, and reduce errors.
The Elder Justice Act and the Pandemic
Authors: Blancato Robert
Published: December 2021

This session will provide updates on how the pandemic led to horrific situations in long-term care facilities and how the pandemic influenced major federal efforts to address elder abuse, neglect, and exploitation.
Pandemic Lessons From a Long-Term Care Ombudsman
Authors: Painter Mairead
Published: December 2021

This session will provide updates on how the pandemic led to horrific situations in long-term care facilities and how the pandemic influenced major federal efforts to address elder abuse, neglect, and exploitation.
Do Objective or Subjective Neighborhood Indicators Protect Against Adversity on Mental Health and Well-Being?
Authors: Staben Omar , Infurna Frank , Grimm Kevin , Luthar Suniya
Published: December 2021

The neighborhood context through which individuals interact is shown to be associated with mental and physical health across adulthood. Much less is known regarding potential underlying reasons why, such as protecting against the deleterious effects of stress. This study explores whether objective and subjective neighborhood factors are associated with maintenance of mental health and well-being in the context of monthly adversity. We use longitudinal data from a sample of midlife (N =362) who completed monthly questionnaires for two years. Results show that experiencing a monthly adversity was associated with poorer mental health and well-being. Living in a neighborhood with more disorder was associated with stronger declines in mental health and well-being when a monthly adversity was reported. Our discussion focuses on why the neighborhood context is relevant for middle-aged adults and the various ways through which neighborhood context has the potential to shape the course of development in adulthood.
Costs of Raising Grandchildren on Grandmother-Adult Child Relations in Black and White Families
Authors: Hou Yifei , Suitor J Jill , Gilligan Megan , Ogle Destiny , Stepniak Catherine , Jiang Yufu
Published: December 2021

The cost of raising grandchildren on grandmothers’ mental and physical health has been well-documented; however, little is known about whether raising grandchildren also has a cost on grandmothers’ relationships with the adult children whose children the grandmothers have raised. Drawing from theories of exchange and affect, stress process model, and racial differences in intergenerational solidarity, we tested how raising grandchildren affects grandmother-adult child relations. Further, we explored the extent to which these patterns differed by race. To address this question, we used mixed-methods data collected from 553 older mothers regarding their relationships with their 2,016 adult children; approximately 10% of the mothers had raised one or more of their grandchildren “as their own.” Data were provided by the Within-Family Differences Study-I. Multilevel analyses showed that raising grandchildren was associated with greater closeness in grandmother-adult child relationship in Black families; however, in White families, raising grandchildren was associated with greater conflict in the grandmother-adult child relationship. Further, the differences by race in the effects of raising grandchildren on closeness and conflict were statistically significant. Qualitative analyses revealed that race differences in the association between raising grandchildren and relationship quality could be explained by mothers’ reports of greater family solidarity in Black than White families. Our findings highlight the ways in which race and family solidarity interact to produce differences in the impact of raising grandchildren on Black and White mothers’ assessment of the quality of their relationships with their adult children, consistent with broader patterns of racial differences in intergenerational cohesion.
From Margin to Center: Intersectionality and the Politics of Environmental Gerontology
Authors: Oswald Austin , Yeh Jarmin , Yeh Jarmin
Published: December 2021

As the population becomes increasingly older and culturally diverse, so too does the need for critical scholarship that examines the complex lives of differently positioned older adults in relation to their social and physical ecologies. This innovative symposium reflects the importance of putting intersectional frameworks (Collins & Bilge, 2016) in conversation with environmental gerontology to critically examine structures of power in assessing who matters and who benefits from place-based initiatives that intend to support healthy aging (Phillipson, 2004). Perry et al.’s paper addresses the politics of responsibility, asking who is responsible for keeping older people safe in light of Covid-19 though a citywide senior housing coalition in Detroit. The second paper, authored by Johnson, speaks to the politics of access and structural inequalities that create disparities in end-of-life care for unhoused older adults. The third and fourth papers, by Stinchcombe and colleagues and Oswald, critically examine dominant paradigms of age-friendliness in Canada and the United States though a politics of representation that highlights who is (in)visible in these initiatives. The final paper by Reyes, on the civic participation of Latinx and African American older adults, illustrates how structural change cannot happen without engaging these populations in the political process. Together, these papers exemplify the politics of environmental gerontology and demonstrate that without acknowledgment of multi-layered identities and the structures contributing to their inequities, environmental gerontology is inadequate, as it may overlook important social and environmental factors that connect older people to the places where they live and die.
Educational Mobility and Age-Related Decrements in Kidney Function Across Adulthood Among Black and White Adults
Authors: Surachman Agus , Santos Alexis , Daw Jonathan , Alexander Lacy , Coe Christopher , Almeida David
Published: December 2021

This paper examines the association between educational mobility and age-related decrements in kidney function. Data from the main survey and the Biomarker Project of the Midlife in the United States (MIDUS) Wave 2 and Refresher samples were combined, resulting in 1,861 adults (54.5% female; age 25-84, Mage=53.37) who self-identified as non-Hispanic Black (n=326) and non-Hispanic white (n=1,535). The estimated glomerular filtration rate (eGFR) was based on serum creatinine, calculated using the CKD-EPI formula. Intergenerational educational mobility was based on the comparison between parental education (no high school/HS degree versus HS degree or higher) and participant’s education level (HS degree or lower versus some college versus bachelor’s degree or higher). Results from regression analysis indicated that Black participants in the moderate upward mobility group (parental education = no HS degree, participant’s education = some college) showed significantly steeper age-related decrements in eGFR across adulthood compared to Black adults with higher stable high status (parental education = HS degree or higher, participant’s education = bachelor’s degree or higher), B=-0.70, SE=0.26, p=.008, or white adults with higher stable high status, B= 0.58, SE=0.29, p=.044. A steeper age-related decrement in eGFR is known as a reliable risk factor for chronic kidney disease and cardiovascular disease. These findings support the notion of skin-deep resilience among Black adults who experience upward socioeconomic mobility. We explored multiple psychosocial factors that may explain these findings, including lifetime and daily discrimination, social status and financial strains, and perceived stress and depressive symptoms.
Responding to Intergenerational Food Security and Nutrition Education Needs With Remote Programming
Authors: Naar Jill Juris , Scrivano Rachel , Jarrott Shannon
Published: December 2021

In-person intergenerational programming focused on nutrition education and healthy food access among older adults and preschool children in care settings was abandoned last year when COVID forced center closures. Food for a Long Life (FFLL), a 5-year community-based participatory research (CBPR) project, re-oriented programming in response to heightened community food insecurity and social isolation during COVID. With county Extension agents, FFLL modified and initiated new partnerships to expand food pantry services for several hundred families and deliver nutrition programming to youth (n=28) and older adult (n=130) participants in two states. In this presentation we share how the CBPR method supported adaptive programming and evaluation while continuing to advance project goals, including to promote the sustainability of an intergenerational food pantry and nutrition programming delivery after funding ends in summer 2021.
Results of Optimize: A Cluster Randomized Trial of Patient, Family, and Provider Education in Primary Care
Authors: Green Ariel , Bayliss Elizabeth , Shetterly Susan , Drace Melanie , Norton Jonathan , Reeve Emily , Sheehan Orla , Boyd Cynthia
Published: December 2021

Individuals with cognitive impairment frequently have multiple chronic conditions (MCC), increasing their risk for polypharmacy and associated adverse outcomes. Optimizing medications through deprescribing (reducing or stopping the use of inappropriate medications or medications unlikely to be beneficial) may improve outcomes for this population. Optimize was a pragmatic, 12-month cluster-randomized trial of deprescribing in primary care within a not-for-profit integrated delivery system. Participants were age 65+ with dementia or mild cognitive impairment (MCI), 2+ chronic conditions, and 5+ chronic medications. The intervention consisted of a deprescribing educational brochure for patients/caregivers, and Tip Sheets for primary care clinicians. Outcomes were the number of chronic medications and presence of potentially inappropriate medications (PIM). In total, 1,433 patients received, and 1,579 control clinic patients would have been eligible to receive, the intervention (N=3,012). After 6 months, mean estimates of chronic medications were 6.23 in the intervention group and 6.33 in the control group adjusting for baseline counts, age, and gender (p=0.13). Excluding those without complete 90 days follow-up increased the adjusted effect size to 0.14 (p=0.08). In sub-analyses of individuals with 7+ medications at baseline (N= 1,434), the adjusted effect size was 0.19 (p=0.07) at 6 months and 0.21 (p=0.045) when excluding those without complete 90 days’ follow-up. Change in proportions of PIM did not differ between intervention and control groups. An educational intervention for patients, caregivers and clinicians may prompt reductions in chronic medications. The relatively small effect size highlights the complexity of medication management for individuals with dementia or MCI and MCC.
Health Concerns for LGBTQ+ Caregivers of People With Alzheimer’s Disease and Related Dementias
Authors: Kittle Krystal , Anderson Joel , Pharr Jennifer , Moonie Sheniz , Flatt Jason
Published: December 2021

We examined four states with data on LGBTQ+ identity and the ADRD caregiving modules from the 2019 Behavioral Risk Factor Surveillance System. Multivariable regression models examined the associations between LGBTQ+ identity and health outcomes. Among the ADRD caregivers, 55,920 (4.7%) identified as LGBTQ+. Compared with non-LGBTQ+ caregivers, LGBTQ+ caregivers were younger and more likely to live in rural counties. Half of LGBTQ+ caregivers spent 20+ hours per week providing care, and nearly 72% reported helping with personal care. LGBTQ+ caregivers reported more days when their mental health was not good than non-LGBTQ+ caregivers (B = 8.01;95% CI= 2.32-13.75). Female caregivers overall were twice as likely than males to experience depression (OR = 2.11;95% CI=1.29-3.45). These findings provide insight into characteristics of LGBTQ+ caregivers and their health concerns. Interventions that promote mental health and reach diverse LGBTQ+ caregivers in rural communities are crucial in supporting LGBTQ+ caregivers of people with ADRD.
The Impact of Visitation Guidelines During COVID-19 on Well-Being and Daily Life in Nursing Homes
Authors: Gerritsen Debby , Backhaus Ramona , de Boer Bram , Urlings Judith , Koopmans Raymond , Hamers Jan , Verbeek Hilde
Published: December 2021

Nursing homes across the world have taken very restrictive measures, including a ban for visitors, to prevent and control COVID-19 infections. This study reports on findings of a study investigating guidelines on allowing visitors in nursing homes and the impact on residents’ well-being, family caregivers and staff. In total, 76 nursing homes in the Netherlands were followed using a survey study, including three waves of data collection in (May 2020, September 2020, March 2021. Results indicated a negative impact of a visitation ban for residents’ overall well-being. There was a variety in guidelines of allowing visitors in nursing homes, and showed that safe visiting was possible during the COVID-19 pandemic. Staff perceived a fragile balance between infection prevention and the impact of restriction on residents. In conclusion, a general ban for visitors is not necessary and may do more harm than good for residents living in nursing homes.
Reablement Services Across the World: Effectiveness and Impacting Factors
Authors: Vluggen Stan , Buma Lise , Resnick Barbara
Published: December 2021

Due to the ageing of the world population, solutions are necessary to reduce the increasing demand for care. Besides the need for more care, older people often wish to remain as independent as possible and retain as much control as possible. A possible solution are services based on the concept of reablement, which includes working in a more rehabilitative and person-centered manner and has been researched in various forms internationally. Reablement services are promising and use the patient's strengths and, through interdisciplinary cooperation, aims to achieve the goals important for, and set by, the individual to remain/become as independent as possible. During this symposium, five presenters from the US, New-Zealand, Norway and the Netherlands talk about the impact and implementation of reablement services. The first presentation is about the results of a systematic review of the effects of reablement on daily functioning and identifying common features of effective interventions. The second presentation is about a systematic scoping review mapping how physical activity strategies are integrated and explored in reablement research and identifying knowledge gaps. The third presentation is about the significant impact of COVID-19 and its associated restrictions on residents in assisted living communities. The fourth presentation is on combining lessons learned and practical implications from research on reablement services into the SELF-intervention. The fifth presentation describes the implications of funding on practice and outcomes of reablement. This symposium represents the current practice and future directions regarding implementation and research of reablement services across the world.
The Effectiveness and Common Features of Reablement Services on Clients’ Daily Functioning: A Systematic Review
Authors: Buma Lise , Vluggen Stan , Zwakhalen Sandra , Kempen Gertrudis , Metzelthin Silke
Published: December 2021

This systematic review, guided by the ReAble-definition, (1) provides an overview of reablement interventions and their effect on Activities of Daily Living (ADL), and (2) identifies common features of effective interventions. A systematic search was conducted from 2002 to 2020, identifying nineteen studies from eight countries with a total of 6,534 participants. Ten studies (with moderate to high quality) revealed improvements in ADL functioning. Three common intervention features were identified within effective interventions: use of multidisciplinary teams; a protocoled or standardized assessment; and using multiple components such as ADL-training, education and exercise programs. This review emphasizes that future studies should provide a more consistent and detailed reporting on the intervention and its components. Furthermore, a uniform approach regarding components, follow-up times and outcome measures can contribute to the comparison of reablement interventions and better determine their effectiveness, independent of the healthcare system or country in which it is used.
Tailoring Stroke Counseling for Risk Reduction Intervention to African American Men
Authors: Aycock Dawn , Harden J Taylor , Salazar Laura , Magwood Gayenell , Clark Patricia
Published: December 2021

Early life course achievement and maintenance of ideal cardiovascular health is associated with reduced risk of developing stroke later in life. The Stroke Counseling for Risk Reduction (SCORRE) intervention is an age-and-culturally relevant intervention originally designed to correct inaccurate stroke risk perceptions and improve lifestyle behaviors to reduce stroke risk in AAs age 20-35. In a study testing SCORRE, fewer men participated, but most were not at a stage of readiness for behavior change; many did not think they were at risk despite averaging three modifiable risk factors, and while improvements in outcomes were observed in women they were not in men. These differences led to tailoring SCORRE to young AA men. The methods for tailoring SCORRE and resulting strategies for attracting, engaging, and empowering them towards stroke risk reduction, including hypotheses concerning food supply, housing, economic and social relationships, education, and mental health care will be raised for discussion.
Accelerometry-Based Physical Activity and Affective Responses to Daily Stressors: An Analysis of the AAPECS Study
Authors: Puterman Eli , Hives Benjamin , Tomiyama A Janet , Low Carissa , Ruissen Geralyn , Beauchamp Mark , Wright Aidan
Published: December 2021

Evidence suggests that physical activity on a daily basis dampens the extent to which one experiences elevations in negative affect in response to daily stressors. Yet, these studies primarily relied solely on end-of-day recall of stressors and negative affect, and self-reported physical activity. More intensive assessments throughout the day and accelerometry-based physical activity measurements are required to answer whether any type of body movement (e.g. light, moderate, vigorous) reconfigures the end-of-day recall of the intensity of the affective experience of a stressor or, rather, mitigates the actual experience of a stressor in real-time. This presentation will summarize results addressing this question using data from the University of Pittsburgh’s Assessment of Personality, Ecological Context, and Stress (AAPECS) study. AAPECS includes172 participants who wore accelerometers to assess movement-based activities and completed ecological momentary assessment 6 times daily for 14 days, with additional ‘bursts’ of affective assessments following reported stressors at any time.
Traumatic Events and Health: An Ecological and Life Course Perspective
Authors: Dong XinQi
Published: December 2021

During the past decades, researchers have shown an increasing interest in the study of traumatic events among aging populations. The majority of studies on trauma focus on mental health, which overlooks the possibility that trauma may also have an adverse effect on other health outcomes, such as cognitive function. A number of studies focus on a single traumatic event. However, this approach may underestimate its health impact as many people experience multiple forms of traumatic events. Indeed, the impact of traumatic events on health depends on the event itself (e.g., single or multiple forms, time) as well as ecological factors. This symposium aims to address the above limitations. The first longitudinal study An Ecological Model of Risk Factors in Elder Mistreatment (EM) Victims tested different dimensions of the ecological model to prevent recurrence of EM. The second study Polyvictimization and Cognitive Function in an Ethnic Minority Aging Population explored whether exposure to multiple forms of EM affects cognitive function. The third study Traumatic Events and Cognitive Function: Does Time Matter? examined whether traumatic events happened in childhood, adulthood, or old age will influence late-life cognitive function. The fourth study Face-saving and Help-seeking among Older Adults with EM identified cultural determinants of help-seeking behaviors in EM victims. This symposium will advance knowledge in the health consequences of polyvictimization and exposure to traumatic events in different life stages. It will also inform interventions to stop the recurrence of EM in immigrant families and enhance the help-seeking behaviors of ethnic minority older adults.
Policy Implications of the Active Aging Framework in Poland
Authors: Perek-Białas Jolanta , Varlamova Maria
Published: December 2021

Poland's relatively young population in the past, is aging rapidly, which provokes a growing interest in the realisation of the older population's potential within the framework of the concept of active ageing. From 2012, when the first Governmental Program on Social Participation (ASOS 2012-2013) was introduced, the active aging framework remains one of the dominant strategies in developing and implementing social policies for the older generation. In the current paper, the focus is made on the employment and social participation of older citizens policies, showing the considerable gap in the prioritisation and hence in the outcomes, highlighted both by Active Ageing Index (AAI) indicators and more in-depth analysis. We will discuss the perceived risks and pitfalls of the current long-term ageing policy approach in Poland and provide recommendations for improvement.
Expansion of a Web-Based Platform to Support Caregivers in California Using CareNav
Authors: Young Heather , Bell Janice , Kelly Kathleen , Kilaberia Tina , Mongoven Jennifer
Published: December 2021

About one in five Americans is engaged in providing care to a family member. Caregivers (unpaid family members or friends) support older adults and persons with disability with a variety of conditions, including challenges in physical, cognitive, and mental health. In California, 4.5 million family caregivers are assisting individuals over the age of 18. The CA Department of Health Care Services funds 11 Caregiver Resource Centers (CRC) to support caregivers and, in 2019, provided support to expand information technology services through adoption of a statewide online assessment platform and client portal, CareNav™, to serve as a client record and referral tool. CareNav™ facilitates collection of consistent state-wide data that can inform program improvement and policy. This study evaluated the implementation process from the perspective of 35 CRC team members in guided focus group discussions. CRC staff identified several potential benefits to adopting CareNav™, including ease of client access and convenience, the ability to aggregate data to inform planning and policy, and a streamlined process for resource sharing. Challenges included customizing site-specific data needs, as well as concerns about equitable access to internet services. Ongoing evaluation will focus on validation and visualization of data, and translation of data into actionable information to improve quality and reach.
Caregiver Burden Is Associated With Dementia Patient Cognitive Performance in NHATS
Authors: Wennberg Alexandra , Anderson Loretta
Published: December 2021

Informal caregivers of dementia patients engage in multicomponent care that is often stressful. In heart failure patients, caregiver burden has been associated with occurrence of cardiovascular events. However, little is known about how caregiver burden affects patient cognition in dementia care dyads. Using data from the National Health and Aging Trends Study and National Study of Caregiving, we examined the association between caregiver burden, assessed on 38 aspects of caring, and patient cognition, assessed with the immediate and delay word recall, Clock Drawing, and self-rated memory. In fully adjusted models at round 7 (2017) higher caregiver burden was cross-sectionally associated with lower immediate (B=-0.02, 95% CI -0.03, -0.01) and delayed (B=-0.03, 95% CI -0.04, -0.02) word recall. Longitudinally, across rounds 7-9 (2017-2019) higher burden was associated with lower patient Clock Draw score (B=-0.01, 95% CI -0.03, -0.001). These findings have implications for economic assistance and interventions in dementia care dyad.