bluuebunny/crossref_metadata_2025 huggingface dataset:
INTENTION TO USE WEARABLE ROBOTS FOR INDEPENDENT LIVING : THE ROLE OF CULTURE AND PERSUASIVE HEALTH COMMUNICATION
Authors: Cheng Clio Yuen Man , Lou Vivian Weiqun
Published: December 2023

Soft wearable robots are emerging assistive technologies that can prolong independent living among older adults experiencing progressive muscle loss, such as sarcopenia. In order to fulfil the wish of aging-in-place and relieve caregiver burden, it is essential to increase wearable robots acceptance through persuasive health communication strategies. This study draws on the integration of the senior technology acceptance model, health communication, and cultural value orientation to predict the intention to use wearable robots among older adults. A 2 (message framing: gain- versus loss-framed) x 2 (temporal framing: distal- versus proximal-framed) randomized experiment was conducted with 154 older adults aged 50 to 74 years, using a self-administered cross-sectional from December 2022 to March 2023 in Hong Kong. A hierarchical multiple regression analysis was conducted with six blocks of variables. Demographic variables including age, gender, and sarcopenia potential were not significantly associated with intention to use. Horizontal individualism is significantly associated with intention to use (p=.011). Also, horizontal collectivism is significantly associated with intention to use (p=.018). Vertical collectivism interacts with persuasive health communication to predict intention to use among older adults (p=.041). The final model (F(12,141) = 3.699, p<.001, R2=.24) which included cultural value orientations showed significant improvement from the first model which only included age and gender. Overall, the final model accounted for 23.9% of the variance. This study is the first to predict the intention to use wearable robots among older adults and provide valuable insights on future policy development to promote aging-in-place, with the aid of wearable robots.
USING TIMEBANK TO IMPROVE VOLUNTEERING AMONG OLDER PEOPLE: A QUASI-EXPERIMENTAL STUDY
Authors: Lu Shiyu , Chui Cheryl , Lum Terry
Published: December 2023

Timebanking, a system in which people earn time credits through volunteering and exchange earned credits for goods and services, can potentially promote late-life volunteering. However, evidence to support this innovation remains limited. This paper reports the findings of a quasi-experimental study on a timebanking program implemented in six districts in Hong Kong between January 2021 and August 2022. Three districts were assigned as the experimental districts, while others were assigned as the control districts. We recruited 116 older people in the three experimental districts to join the timebank group and 114 older people in three control districts to join the comparison group. Both groups were offered opportunities to volunteer in community elderly centres within their districts (e.g., home visits or phone calls to older people with disabilities). The timebank group could exchange their earned time credit for rewards (e.g., dining coupons and cookies offered by social enterprises), while no reward was offered for the comparison group. Their volunteering hours were recorded using a tailored mobile phone application, and their volunteering intentions were assessed at baseline, during the timebank intervention (7th month), and post-timebank intervention (13th month). After controlling for covariates (e.g., age, years of volunteering experience) using linear mixed models, the timebank group had significantly more volunteering hours (adjusted mean difference [AMD]=1.37, 95% CI: 0.20-2.54, p=0.021) and higher volunteering intention (AMD=0.51, 95% CI 0.29-0.82, p=0.001) than the comparison group. This is the first quasi-experimental study to provide evidence that timebank is a promising and effective approach to promoting late-life volunteering.
PERSONALITY AND WORD RECALL AS INTERACTIVE PREDICTORS OF PERCEIVED MEMORY ABILITY
Authors: Hill Patrick , Pfund Gabrielle , Cruitt Patrick , Spears Isaiah , Norton Sara , Bogdan Ryan , Oltmanns Thomas
Published: December 2023

Cognitive gerontology research requires consideration of both actual performance and perceptions of performance. While subjective memory perceptions are positively associated with memory performance, these correlations typically are modest in magnitude. Therefore, researchers have noted the need to consider potential moderators of this association, to better understand whether certain people show weaker or stronger linkages between performance and perceptions. The current study leveraged personality (NEO Big Five), memory performance (i.e., word recall), and perceptions of memory ability (i.e., metamemory in adulthood scale and subjective memory complaints) data from the St. Louis Personality and Aging Network (SPAN) study (n = 774, mean age: 71.52 years). Personality traits were more associated with subjective than objective memory, and the most consistent associations were for extraversion (r = -.20 for complaints, r = .26 for metamemory) and conscientiousness (r = -.26 for complaints and r = .33 for metamemory). Moreover, extraversion moderated associations between word recall and both memory capacity and complaints. Results suggested that associations between word recall and the two subjective indicators were weaker for those adults higher in extraversion, relative to adults who scored lower on extraversion. One possible interpretation is that extraverted older adults may construct their cognitive self-perceptions using information from their social interactions more than objective cues. These findings highlight the need to determine how personality traits influence which sources of information older adults employ when thinking about their cognitive ability, which in turn may explain their choices for activity engagement.
DAILY STRESS AND SAME-DAY SUBJECTIVE MEMORY: AGE DIFFERENCES AND PHYSICAL ACTIVITY AS A BUFFER
Authors: Stuart Nicole , Wen Jin , Klaiber Patrick , DeLongis Anita , Puterman Eli , Sin Nancy
Published: December 2023

Growing research indicates that daily stress is associated with poor same-day memory performance, but it is unclear whether this relationship varies by age and whether moderate-to-vigorous physical activity (MPVA) might offset the within-person link between stress and memory in daily life. Ecological momentary assessment data were collected from adults aged 25-88 across British Columbia, Canada. For 14 days, participants (N = 249) wore a tri-axial physical activity monitor, reported stressor occurrence and perceived stressfulness of the events in mobile surveys 4 times per day, and rated their memory at the end of each day. Multilevel modeling was run to evaluate daily perceived stressfulness as a predictor of subjective memory, with same-day MVPA engagement (activity counts >570 counts/60s) and age (years) entered as moderators. At the within-person level, on days when stressors were perceived as more stressful than usual, subjective memory was rated as relatively worse (b = -0.037, CI[-0.061, -0.017], p < .001). MVPA did not buffer against the within-person associations of daily stress with subjective memory, nor did age (p > .05). Future work could examine the mechanisms that might explain the link between stress and memory, for example cortisol, as well as the associations of different intensity and forms of physical activity on stress across age groups.
RECRUITING SAMPLES OF OLDER ADULTS FROM VULNERABLE GROUPS
Authors: Barry Lisa
Published: December 2023

Since 2000, the number of incarcerated persons age ≥50 in the U.S. grew 280% and those in this age group with substance use disorders (SUDs) grew from 1.7 to 5.7 million. Yet, these groups, which comprise some of the most medically vulnerable persons in society, are difficult to recruit to research studies. We successfully recruited and retained 171 incarcerated persons age ≥50 in a cohort study. We will discuss how recruitment required strong partnership with the state corrections system, how we had to be cognizant of measures that were meaningful in the context of the unique environment (prison activities of daily living), and how measures were modified (when life gets hard I just want to escape). As we continue to recruit persons ≥50 seeking SUD treatment, we will discuss the usefulness of snowball recruiting and balancing decisions regarding modification of inclusion criteria while maintaining integrity of the original research question.
TECHNIQUES FOR OVERCOMING CHALLENGES TO RESEARCH WITH INDIVIDUALS NEARING THE END OF LIFE
Authors: Dillon Ellis , Martinez Meghan , Li Martina , Hernandez Alyssa , Liang Su-Ying , Patel Manali
Published: December 2023

People living with advanced disease and nearing the end of their lives are often omitted in research on healthcare and the lifespan. This omission occurs for practical, ethical, and cultural reasons. Drawing on examples from studies on individuals receiving home hospice care, and individuals with advanced cancer and their caregivers, we will review (1) practical, ethical, and cultural challenges to doing this research, (2) techniques to increase access, recruitment, and participation through developing partnerships, flexibility and resource allocation, and (3) research team training and support. Practical challenges include the unpredictability of illness and symptoms leading to cancellations and increased attrition, and increased time and resources needed to recruit, consent, and travel to community residences. Ethical and cultural challenges include concerns about “vulnerability,” and stigma around directly discussing dying. Techniques to facilitate successful inclusion of these populations include developing partnerships with community organizations, clinical teams, and patient or family advocates, justifying and allocating sufficient resources and flexibility in study design and word choices to reflect the spectrum of understanding and experiences, and additional training and support for research staff. Other techniques to include this population include use of secondary data, reconsidering research exclusion criteria, and surveying/interviewing family members and other caregivers. Hard to reach populations are often overlooked, yet they are vital to ensuring full representation of lived experience. Science benefits from developing strategies to include these populations in research.
“GOD ALONE EXISTS IN SOLITUDE”: INTERVIEWING OLD MIGRANTS ABOUT LONELINESS
Authors: Bilecen Basak
Published: December 2023

Current research emphasizes the need for a more critical reflective approach to studying older migrants, with particular attention paid to methodological and ethical challenges during fieldwork. One of the key methodological challenges researchers face is selecting appropriate questions, as the questions asked can influence the insights gained into the phenomenon under study. This is because researchers gain an understanding of the phenomenon based on the questions they ask. Previous research on the well-being of older migrants has primarily focused on their family relationships, health status, social participation into activities, and vulnerabilities. However, an important question to understand the well-being of older migrants is whether and to what extent they experience loneliness. This study involved conducting 20 semi-structured interviews with first-generation Turkish migrants over the age of 65 living in northern Netherlands. The findings suggest that the phrasing of questions plays a significant role in both how participants interpret the questions and their responses. During the interviews, while loneliness was generally considered a negative issue, some participants approached it from a religious perspective, leading to reflection on more fundamental existential questions, which in turn led to denial.
RACISM IN RESEARCH ON OLDER MIGRANTS AND ETHNO-RACIAL MINORITIES: INSIGHTS FROM TWO SCOPING REVIEWS
Authors: Torres Sandra
Published: December 2023

The study of ethno-racialized minorities used to be primarily the domain of American social gerontologists. Meta-analyses of this scholarship have shown that this research has so far been characterized by two sets of practices: it engages in racialization but vaguely acknowledges racism, and it seems inequality-obsessed but justice-oblivious. Some gerontologists have therefore argued that the scholarly imagination that informs inquiries on older ethno-racialized minorities needs to be expanded, and that one way to do this could entail taking cues from European migration scholars’ inquiries on aging and old age. These scholars place the social position that is migrancy (rather than ethnicity and/or race) at the center of their scholarly imagination. This presentation presents the results of a scoping review of peer-reviewed literature published between 1990-2022 that focuses specifically on how the literature on older migrants engages with racism (since literature on older ethno-racialized minorities was in focus in another scoping review; 1998-2017). The review shows that although scholarship on older migrants recognizes that these axes of oppression could have an impact in their life-courses, empirical inquiries on the ways in which older people experience such oppression are still quite rare. The presentation will juxtapose the results of both scoping reviews in order to argue that our failure to inquire into older migrants’, and older ethno-racialized minorities’ experiences of racism impedes us from furthering our understanding of how the social positions that are ethnicity, race and migrancy impact (on their own and together) people’s experiences of aging and old age.
DESIGN, DELIVERY, AND EVALUATION OF DYADIC INTERVENTIONS WITH OLDER ADULTS
Authors: Lyons Karen , Johnson Kalisha Bonds
Published: December 2023

With increasing evidence of the interpersonal context of health and illness, there is growing interest in interventions that target the needs of the family care dyad. Yet, there are often specific challenges to the design, delivery and evaluation of dyadic interventions that are not often disseminated. This session includes four papers that will discuss the benefits (but also challenges and lessons learned) of four different dyadic interventions targeted at older adults and their care partners in both cognitive impairment and chronic illness contexts. First, Dr. Rashelle Hoffman and colleagues will present results from focus groups with rural MCI care dyads that inform the adaptation of an existing efficacious telerehabilitation physical activity intervention (TPAB). Second, Dr. Glenna Brewster and colleagues will discuss recruitment and delivery challenges, and the benefits of a pilot behavioral sleep intervention for adults with cognitive impairment and their care partners. Third, Dr. Lyndsey Miller and colleagues will report the feasibility, acceptability and preliminary efficacy of a program to support preparation for future care needs and improved well-being in care dyads living with dementia. Finally, Dr. Karen Lyons and colleagues will present findings from a pilot communication-based intervention for couples living with heart failure. The presentation will discuss the individual versus dyadic benefits of the program and challenges related to recruitment and retention. Speakers and Discussant, Dr. Kalisha Bonds Johnson, will share challenges and best-practices in designing, delivering, and evaluating interventions to optimize the health and well-being of the older adult care dyad.
BEHAVIOR CHANGE TECHNIQUES IN PERSONS WITH MCI AND MD AND THEIR CARE PARTNERS: A REPORT OF AN ORAL HEALTH INTERVENTION
Authors: Bryant Ashley , Cho Youngmin , caiola courtney , Bailey Donald , Plassman Brenda , Wu Bei , Anderson Ruth
Published: December 2023

Older adults with cognitive impairment are likely to experience a decline in oral health and hygiene, which can have profound negative impacts such as cavities, gum disease and tooth loss. Poor oral health is also linked to adverse health outcomes including diabetes, cardiovascular disease, and aspiration pneumonia. Despite these factors, inadequate oral hygiene practices provided by formal and informal care partners may contribute to poor oral hygiene. In this study, we aimed to improve oral hygiene outcomes (plaque index and gingival index) for individuals with mild cognitive impairment (MCI) or mild dementia (MD) by fostering behavior changes among care partners trained to assist them. We identified and compared active behavior change techniques (BCT) used in a care partner-assisted oral health intervention for individuals with MCI and MD using a qualitative, secondary analysis of coaching sessions with care partners (n=17 dyads: 10 dyads for MCI, 7 dyads for MD). Frequently used BCTs in both MCI and MD groups were prompts and cues, instruction on how to perform the behavior, review behavioral goal, and problem solving. Common BCTs were found across both MCI and MD groups that provide clarity on the active components for behavior change. Social support-unspecified emerged for MCI group and credible source emerged for MD group. In this intervention, BCTs were focused on oral health, however BCTs can assist in addressing multiple types of behavior change. Findings from this study provide insight into the mechanisms of changes in individuals’ behaviors using these interventions.
THE ROLE OF MILD COGNITIVE IMPAIRMENT AND MARITAL STATUS ON LONELINESS AND INTRUSIVE THOUGHTS IN DAILY LIFE
Authors: Van Bogart Karina , Engeland Christopher , Witzel Dakota , Graham-Engeland Jennifer
Published: December 2023

Loneliness is associated with maladaptive cognitions (e.g., rumination and intrusive thoughts) among young adults, but less is known about this association among older adults. Experiencing loneliness and intrusive thoughts throughout daily life may disrupt emotion regulation and increase risk for cognitive decline during later life. Moreover, social and cognitive factors, including marital status and mild cognitive impairment (MCI), may be protective or exacerbating factors that moderate these associations. For example, having close relationships (e.g., being married) is associated with better mental health and overall well-being for older adults and intrusive thoughts have been associated with poorer cognitive performance. We used multilevel modeling to examine the association between momentary loneliness and intrusive thoughts among older adults and whether MCI and marital status moderated this association. Participants were 316 diverse older adults without dementia (40% Black; 13% Hispanic, mean age = 77.45 years, 67% women) living in the Bronx, NY who completed ecological momentary assessments 5 times daily for 14 consecutive days. There was a significant three-way interaction (β = -0.175, p < 0.05) such that the association between momentary loneliness and intrusive thoughts was strongest for those with MCI who were not married and weakest for those with MCI who were married. Covariates included race/ethnicity, years of education, age, and gender. These findings suggest that for those who have MCI, being married may be a protective factor against moments of loneliness and intrusive thoughts. For those who are not married, tailoring interventions to accommodate MCI status may be worthwhile.
NOVEL APPROACHES AND OUTCOMES TO INVESTIGATE RECOVERY AND MOBILITY IN HIP FRACTURE PATIENTS
Authors: Jansen Carl-Philipp
Published: December 2023

Hip fracture is the most frequent non-intentional injury of older persons leading to hospital admission in North America and Europe. Failure to fully recover and regain pre-fracture function and mobility is considered the single most important disability symptom experienced by hip fracture patients; severe detrimental effects on older adults’ physical, mental, and psychosocial health are reported. Being able to move back and live independently at home is seen as one of the most important aspects of recovery. However, at present, mere survival and care home admission are still the predominant reported outcomes in the recovery and rehabilitation phase. Only limited attention has been given to outcomes such as days at home or mobility performance in everyday life. At the same time, aspects of mobility recovery grounded in patients’ experience have not been addressed appropriately so far. Against this background, this symposium brings together research endeavours from Europe and North America, presenting novel approaches to investigate and disentangle trajectories of hip fracture recovery in older adults. In the first two talks, healthy days at home are investigated as central outcome after hip fracture with two different foci: the contribution of cognitive impairment to sex-based differences in recovery, and pre- vs. post-fracture development. The last two talks investigate mobility in hip fracture patients, again with two foci: results of real-world sensor-based mobility performance are presented and compared against patient-reported outcomes, and a conceptual framework of walking was developed based on a systematic review on patients’ walking experience.
IMPACT OF SEX AND ADRD ON DAYS SPENT AT HOME AFTER HIP FRACTURE AMONG OLDER MEDICARE BENEFICIARIES
Authors: Orwig Denise , Mutchie Heather , Gruber-Baldini Ann , Johnson Abree , Magaziner Jay , Falvey Jason
Published: December 2023

Men recovering from hip fracture tend to have poorer health and outcomes compared to women. Alzheimer’s disease or related dementias (ADRD), which is differentially recognized between the sexes, is one potential factor contributing to these differences. Data were drawn from 2010-2017 Medicare fee-for-service beneficiaries aged 65 years and older who survived hospitalization for hip fracture. Our primary outcome was days alive and at home (DAAH) which subtracts from 365 the number of days in a hospital and/or rehabilitation facility, nursing home, emergency department or hospital observation, and days not alive (index fracture admission day to date of death, if applicable). Multivariable Poisson regressions were adjusted for demographics, injury severity, chronic disease burden, and hospital-level fixed effects, to model the association between DAAH and ADRD in the 12 months post hip fracture, with an interaction term for sex and ADRD status. Among survivors, males with ADRD spent a mean of 160.7 DAAH compared to 228.4 for males without ADRD, 177.8 for females with ADRD and 248.0 for females without ADRD. In adjusted analyses, males without ADRD spent 8.2% fewer DAAH compared to females (rate ratio (RR)=0.92, 95% CI 0.92-0.92). This sex difference increased significantly when comparing those living with ADRD, with males spending an additional 3.3% fewer DAAH (interaction RR=0.96, 95% CI 0.96-0.97). Males spend fewer DAAH after hip fracture than females and males with ADRD have the fewest DAAH. This suggests that cognitive impairment may be a small but significant contributor to sex-based differences observed during hip fracture recovery.
PROFILES OF TWO COHORTS OF NEAR-CENTENARIANS AND CENTENARIANS: FINDINGS FROM HONG KONG CENTENARIAN STUDY 1 AND 2
Authors: Lau Bobo Hi-po
Published: December 2023

Hong Kong launched its first centenarian study in 2011 when there were just over 3,600 centenarians, and subsequently, the second phase in 2021/22 when the population of centenarians tripled. Both studies investigated the multidimensional well-being of local older adults of Chinese ethnicity aged 95 or above (near centenarians and centenarians, NCCs). A comparison of the two cohorts of community dwelling NCCs who lived with their family (2011: N=77; 2021/22: N=151) indicates a substantial drop in sensory functions (2011 vs 2021/22: intact vision: 94.8% vs 40.4%; intact hearing: 93.5% vs 53.6%), social activities (weekly or more: 48.1% vs 40.4%), outdoor activities (weekly or more: 75.3% vs 45.3%), and independence in activities of daily living (ADL) (no. of dependent task: 0.79 vs 2.79). Although the prevalence of comorbidities was comparable (Charlson age-adjusted comorbidity index: Mean = 2.7 vs 3.5), the frailty and pre-frailty was considerably more common in the 2021/22 cohort (55.3%; 39.0%) than the 2011 cohort (50.6%; 23.4%). We also found disparate predictors for health evaluations. Among the 2011 cohort, being male and having better psychological well-being were related to more favorable assessments of health compared to their peers. Among the 2021/22 cohort, favorable peer-compared health assessments were related to fewer ADL dependent tasks, better psychological well-being, higher age and being female. Despite the impact by COVID on the 2021/22 cohort, our findings alert policy makers and practitioners worldwide to the growing number of community-dwelling adults of advanced age with considerable personal care and health needs.
COMMUNITY COLLABORATOR AND OLDER ADULT EXPERIENCES WITH INTERVENTIONS DELIVERED BY OLDER ADULTS
Authors: Crawford Nicole , Gum Amber , Schonfeld Lawrence
Published: December 2023

This symposium will include researchers, collaborators from healthcare and social service organizations, and older adults serving as volunteer coaches or peer educators; speakers will describe their experiences conducting two randomized controlled trials involving behavioral interventions for older adults delivered by older adults. The first trial is a NIMH-funded three-site RCT for community-dwelling older adults with symptoms of depression, in which participants receive behavioral activation delivered by a masters-level clinician or a streamlined version (“Do More, Feel Better”) delivered by an older adult volunteer. This trial involves close collaboration with senior centers and an Area Agency on Aging (AAA). The second trial is a PCORI-funded RCT to reduce health disparities for Black/African-American and Hispanic/Latino older adults after medical hospitalization, in which participants receive the evidence-based Care Transitions Intervention (CTI), CTI plus a peer educator intervention, or usual care. This trial involves close collaboration with three regional hospital systems and an AAA. First, research investigators will describe the background, rationale, and methodology of each trial. Second, two representatives from the collaborating organizations (one from each trial) will present about their experiences collaborating on these trials – benefits of collaborating, challenges and strategies for overcoming challenges, and recommendations for other researchers engaged in similar community-based research. Third, two representatives from the older adult volunteers and peer educators (one from each trial) will present about their experiences collaborating on these trials – benefits of collaborating, challenges and strategies for overcoming challenges, and recommendations for other researchers engaged in similar community-based research.
AGING SERVICE AND HOSPITAL ADMINISTRATORS’ EXPERIENCE COLLABORATING ON INTERVENTION RESEARCH
Authors: McKay Mary Jo , Wilson Jason
Published: December 2023

The next two speakers will present on the methods, benefits, and challenges of collaboration on the two RCTs described previously. One speaker is Nutrition and Wellness Manager for an aging service lead agency that oversees the county’s senior centers and nutrition sites. She and her team meet monthly with the study team for the depression trial and coordinate regularly to facilitate recruitment, intervention, outreach, and dissemination activities. One speaker is Division Chief for an academic medical center’s Division of Emergency Medicine, where he oversees collaboration on the hospital trial. Each speaker will discuss benefits of collaboration, including expanding services offered by their organization to older adults, enhancing relationships with other community organizations, and contributing to an evidence base that could impact nationwide service delivery. Each speaker will also discuss challenges that have arisen during the two trials and strategies being used to address challenges. One challenge has been recruitment. For the depression trial, the collaborators meet monthly to review recruitment progress and identify new strategies, such as a countywide phone line, connecting with other aging service organizations, and attending in-person events. For the hospital trial, research coordinators have been embedded into each hospital with primary responsibilities for using EHR and working with hospital staff to identify and enroll participants. As a result, both trials are meeting recruitment targets thus far. Other issues that have benefited from close collaboration involve COVID-19 adaptations, technical support to older adults participating in the interventions virtually, and engaging older adult volunteers and peer educators.
FUNCTIONAL WELLNESS AMONG OLDER ADULTS WITH HIV/AIDS: BARRIERS AND FACILITATORS TO HEALTH AND LONGEVITY
Authors: Robinson Erin , Perkins Molly , Brennan-Ing Mark
Published: December 2023

In the United States, older adults make up over half of all people living with HIV/AIDS (PLWH). Today, this population is living longer and healthier lives due to advancements in HIV treatment. However, older adults living with HIV (OALWH) present a unique set of challenges as they face aging-related health considerations that intersect with their HIV status. This symposium brings together leading researchers in the field of HIV and aging, to highlight the complexity of this topic and present innovative research that examines the overall health and well-being of OALWH. Our first presentation is a qualitative inquiry into barriers to successful aging that are shared between older women and men living with HIV/AIDS, as well as differences. Our second presentation used a latent health profile model to identify subgroups of PLWH who had been discharged from a short-term skilled nursing facility (SNF). The goal of this research was to identify risk for institutional admission following their SNF stay. Our third presentation examined age-varying cognitive impairment among a sample of PLWH, people who use methamphetamines, and meth-negative/seronegative individuals to determine whether social relationships meditate the complex associations between meth use and cognitive impairment for PLWH and without HIV. And finally, our fourth presentation examined perspectives on weight change and body image among PLWH and the extent to which age and gender have an impact on those attitudes. Findings from this symposium demonstrates the complexity of what it means to be an OALWH and the various considerations for their well-being. This is a HIV, AIDS and Older Adults Interest Group Sponsored Symposium.
BARRIERS TO SUCCESSFUL AGING AMONG OLDER WOMEN AND MEN LIVING WITH HIV
Authors: Rubtsova Anna , Taylor Tonya , Wingood Gina , Ofotokun Ighovwerha , Gustafson Deborah , Vance David , Jeste Dilip , Moore David
Published: December 2023

This study identified and compared barriers to successful aging (SA) among older women and men living with HIV. Participants were recruited through 1) the Women’s Interagency HIV Study (WIHS), Atlanta and Brooklyn sites; and 2) the HIV Neurobehavioral Research Program at the University of California, San Diego. Our sample included 31 participants living with HIV: 17 women and 14 men, ages 52 to 73 years, 58% African American. We conducted semi-structured interviews, exploring SA with HIV. The interviews (~90 minutes long) were audio recorded, fully transcribed, and imported into MAXQDA software for analysis. Thematic and comparative analyses were conducted within a social-constructivist framework. We uncovered several themes related to SA barriers that were shared by women and men: challenging chronic conditions, stigmas, substance use, and lack of resources. We also found differences. While men stressed dreading old age and loneliness, women emphasized stress and ‘giving up’ as barriers to SA.
LATENT HEALTH PROFILES ASSOCIATED WITH INSTITUTIONAL ADMISSION AFTER SNF STAY AMONG MEDICARE PLWH
Authors: Olivieri-Mui Brianne , Shi Sandra , McCarthy Ellen , Oh Gahee , Kim Dae Hyun
Published: December 2023

Background

Health profiles may help identify PLWH at risk for institutional admission after a short-term skilled nursing facility (SNF) stay.

Methods

We estimated rates of institutional admission in one-year follow-up after discharge from a SNF stay (<100 days) among Medicare FFS beneficiaries with HIV (2014-2019). Latent profile analysis identified subgroups based on prevalent conditions one year prior to discharge including 8 indices: mental health (MH range 0-6), substance use (SU 0-4), cardiovascular conditions (CV 0-9), sensory (SE 0-4), musculoskeletal (MU 0-10), pulmonary (PU 0-2), learning disabilities (LD 0-9), and other chronic conditions (OCC 0-11). Cox models estimated the association between latent profiles and time to institution admission (hospital, nursing home), adjusting for demographics, dual eligibility, HIV treatment; censoring included death and study end.

Results

The 618 PLWH studied were male (73%), with mean age 60 (standard deviation [sd] 11). Two latent health profiles were: CV+OCC+MH (n=77), median values CV=3, OCC=2, MH=1; healthy (n=541), median 0 for all. Compared to the healthy group, the CV+OCC+MH group had similar days spent in an institute (60 days [96] vs 66 days [96]), and similar hazards for institutional admission in adjusted models (HR:1.09, 95% CI [0.81-1.46]) in one-year after SNF discharge. HIV treatment for ≥80% of the time prior to discharge had lower hazards (HR:0.76 [0.59-0.98]) and dual eligibility had higher hazards (HR:1.32 [1.09, 1.61]) of returning to an institutional setting.

Conclusions

Latent profiles had similar risk for institutional admission in one-year after discharge from a SNF stay, despite having significantly different contributing factors.
THE IMPACT OF AGING ON ATTITUDES TOWARD WEIGHT CHANGE AND BODY IMAGE AMONG ADULTS LIVING WITH HIV
Authors: Kaufman Jennifer , Wu Yiyi , Manalel Jasmine , Fusaris Ethan , Correa Arlene , Ernst Jerome , Brennan-Ing Mark
Published: December 2023

Some newer HIV antiretroviral therapy regimens have been associated with weight gain in populations at risk for obesity. This study examined perspectives on weight change and body image among people living with HIV and the extent to which age and gender have an impact on those attitudes. We conducted interviews with 61 individuals in a Medicaid managed care plan. The age range was 23 to 65 years; 49% were aged 50 or older. The sample was 56% non-Hispanic Black and 31% Hispanic. About half were cisgender men, 36% were cisgender women, and 13% were transgender/nonbinary individuals. Many participants had weight gain they associated with HIV medications. While experiences varied widely, we found that older and younger participants offered some different perspectives. Younger people, including transgender individuals, more often welcomed weight gain, associating it with better health. Participants aged 50 and older sometimes saw weight gain as a natural part of aging, and spoke of acceptance, whereas younger participants tended to focus on their appearance. Among those with unwanted weight gain, older participants expressed concerns about its negative effect on mobility and comorbid health conditions. Some older women in particular struggled with improving their diets. Healthcare providers should consider these different perspectives and the various challenges individuals face associated with age when advising patients with HIV about weight management. For providers working with older patients with HIV, specific considerations of how increased weight affects mobility and risk for comorbid conditions are warranted.
GENDER AND AGE DIFFERENCES IN ACCEPTANCE OF ADVANCED DRIVER ASSISTANCE SYSTEMS: INSIGHTS FROM OLDER AUSTRALIANS
Authors: Hansen Abigail , Kiely Kim , Attuquayefio Tuki , Hosking Diane , Regan Michael , Eramudugolla Ranmalee , Ross Lesley , Anstey Kaarin
Published: December 2023

Advanced Driver-Assistance Systems (ADAS) are in-vehicle technologies that promise to improve driver safety and may help support older drivers to drive safer for longer, however there is little research examining acceptance and use of ADAS among older adults. This study investigated age and gender differences in attitudes to ADAS and use of ADAS. We conducted an online survey of 1330 drivers aged 65 years or older (M=72, SD=6.9, 23% women) in partnership with National Seniors Australia. ADAS use was self-reported, classifying respondents in to users (96%) and non-users (4%). ADAS acceptance was measured by the Partial Automation Acceptance Scale. Linear regression estimated gender and age differences in acceptance. Logistic regression estimated differences in ADAS use by gender, age and acceptance. Older age was associated with higher levels of trust in ADAS (β = 0.032, p = 0.04) and lower perceived ease of use (β = -0.02, p = 0.02). Women were less likely to report ADAS use (β = -0.99, p = 0.008) but had higher levels of trust (β = 0.86, p = 0.001) than men. After adjusting for age and gender, positive attitudes towards ADAS (β = 0.12, p = 0.003) and lower perceived risk (β = 0.22, p = 0.046) were associated with higher levels of ADAS use. Consideration of the gender and age differences may inform future vehicle design, and older drivers may benefit from education on the risks and benefits of ADAS to aid in the acceptance and consequent use of ADAS.
LIVING WITH A ROBOT AT HOME: THE COMPLEXITY OF LIVING WITH ASSISTIVE ROBOTS LABRADOR AND DOUBLE IN EVERYDAY LIFE
Authors: Hung Lillian , Case Donna , Ren Haopu , Velazquez Nathan , Petrovskaya Olga
Published: December 2023

The potential for assistive robots to support older adults’ independence and social connections requires careful consideration of their implications in everyday use. This study investigates the use of two assistive robots, Labrador and Double, in older adults, guided by Actor-Network Theory (ANT). Labrador (a delivery robot) assists with medication management, meals, laundry, house cleaning to support independence, while Double (a teleprence robot) enables virtual social visits. ANT offers a way to understand how the robots interact with different actors, such as older adults, family members, staff, and the environment in which they operate. We applied a qualitative approach to explore how users construct meanings, use, and make sense of the robots in their everyday contexts. Semi-structured interviews and ethnographic fieldwork were conducted with participants to generate data. Reflexive thematic analysis was performed, and three themes emerged: (1) the human-robot relationship, (2) the robot’s agency, and (3) ethical implications. The findings suggest that having the robots in everyday life is a process of constant negotiation with the people, practice, and the robot. The study highlights the challenges and opportunities associated with the implementation of robots to improve quality of life in senior care. While there is a fear that assistive robots will dehumanize caring practices, our study shows that they have the potential to foster innovative user-technology relationships, which requires further research.
PRELIMINARY EFFICACY OF CARFREEME™-DEMENTIA: A DRIVING RETIREMENT PROGRAM FOR FAMILIES IN THE US
Authors: Peterson Colleen , Ingvalson Stephanie N , Birkeland Robyn , Louwagie Katie , Koffski Maya , Gaugler Joseph
Published: December 2023

Driving retirement can be a disruptive decision for people with Alzheimer’s disease and related dementias (AD/ADRD) and their families. Retiring drivers with AD/ADRD may lose their sense of independence and connection to community. Family members can experience relationship stress convincing persons with dementia to stop driving and feel strained taking on transportation responsibilities. CarFreeMe™-Dementia (CFM™-D) is an individualized psychosocial driving retirement program for families who are planning for, implementing, or adjusting to driving retirement. A small feasibility study of the program in the U.S. indicated that participants found it acceptable and useful for navigating driving retirement. Phase 2 of this study, enrolling 17 care partners, 16 retiring drivers, and 17 dyads, evaluated the preliminary efficacy of CFM™-D to provide emotional support and increase driving retirement readiness. Data from baseline, 3-, and 6-month surveys and an exit semi-structured interview were collected. Interviews confirmed that CFM™-D provided emotional support and practical preparation for driving retirement. Chi-square analyses comparing baseline to 6-month follow-up data showed fewer caregivers reached thresholds for concern on scales of strain (p = .019) and isolation (p = .001). Retiring drivers reported reductions in loneliness at 6-months (p = .017) and improved Assessment of Readiness for Mobility Transition scores at 3- and 6-month follow-ups (p = .003, p = .014, respectively). Findings have informed intervention delivery improvements for a future randomized trial evaluating whether CFM™-D is an efficacious tool for addressing the psychosocial complexities of driving retirement amongst people with AD/ADRD and their family.
CALORIC RESTRICTION AND AGING: FROM CALORIES TO FASTING Times
Authors: de Cabo Rafael
Published: December 2023

The caloric content and manipulations of nutrient composition have defined our research focus over decades, leading to the formulation of ideal diets and supplements for every phase of life. In the last few years, the control of meal size, frequency, and timing have become a powerful strategy to ameliorate and postpone disease onset and delay aging. Emerging evidence highlights the importance of prolonged fasting periods for the health and survival benefits of calorie restriction (CR) and time-restricted feeding (TRF) across multiple species. Furthermore, there is new evidence of the potential combinatorial use of these dietary interventions with established therapeutical approaches to enhance outcomes, particularly in anticancer treatments.
A P21-CRE MOUSE MODEL TO MONITOR AND MANIPULATE P21-HIGHLY-EXPRESSING SENESCENT CELLS IN VIVO
Authors: Xu Ming
Published: December 2023

The role of senescent cells has been implicated in various tissue dysfunctions associated with aging, obesity and other pathological conditions. We generated a p21-Cre mouse model, containing a p21 promoter-driving inducible Cre, enabling us to examine p21Cip1-highly expressing (p21high) cells, a previously unexplored cell population exhibiting several characteristics typical of senescent cells. By crossing p21-Cre mice with different floxed mice, we managed to monitor, sort, image, eliminate or modulate p21high cells in vivo. We showed that p21high cells can be induced by various conditions, and percentages of p21high cells varied from 1.5% to 10% across different tissues in 23-month-old mice. Intermittent clearance of p21high cells improved physical function in 23-month-old mice. p21-Cre mouse model might be a valuable and powerful tool for studying p21high cells to further understand the biology of senescent cells in aging.
OUTCOMES OF A PILOT PRAGMATIC TRIAL IMPLEMENTING PALLIATIVE CARE IN NURSING HOME CARE
Authors: Carpenter Joan , Hanson Laura , Hodgson Nancy , Jackson Amy , Gurlu Merve , Zhu Shijun , Ersek Mary
Published: December 2023

Palliative care that aligns treatments with preferences for people living with serious illness in nursing homes (NHs) can improve quality of life. Given limited access to specialty palliative care in NHs, enhanced primary palliative care is needed. We conducted a pilot pragmatic clinical trial to establish feasibility, acceptability, and preliminary effectiveness of an NH primary palliative care intervention. Nurse practitioners, employed by each intervention site, attended a 5-hour virtual course, one-day intensive workshop, and monthly 1-hour facilitation sessions to enhance palliative care practices. We recruited residents living with serious illness and palliative care needs from 12 NHs in the MidAtlantic US. Using a nonequivalent group design, participants were clustered by site and assigned to intervention or control group in a 2:1 (respectively) ratio. Our primary outcome was the Palliative Outcome Scale Version 2 (POSv2, range 0-40). Of 318 residents screened, 119 met inclusion criteria, and 45 consented for participation (n=35 intervention; n=10 control). Participants (mean age=86) were mostly White (98%), female (76%), and able to make their own decisions (58%). Clinician intervention fidelity and participant acceptability were high. At 21 days, quality of life did not differ between control (POSv2=8.79) and intervention groups (POSv2=10.03; p=0.72). We conclude that an NH primary palliative care intervention is feasible and acceptable; effectiveness to improve quality of life may depend upon the successful implementation of a highly tailored intervention and longer-term follow-up.
PERSONS LIVING WITH DEMENTIA AND MULTIPLE CHRONIC CONDITIONS IDENTIFYING HEALTH PRIORITIES WITH CARE PARTNERS
Authors: Vu Thi , Mroz Emily , Hernandez-Bigos Kizzy , Chow Denise , Samper-Ternent Rafael , Johnson Kalisha Bonds , Tinetti Mary , Monin Joan
Published: December 2023

Many older persons living with dementia (PLWD) also live with multiple chronic conditions (MCCs). Care partners of PLWD will increasingly need to make care decisions for PLWD, but the health care priorities of PLWD with MCCs may vary. The Patient Priorities Care Health Priorities Identification Process is an evidenced-based tool to support older adults with MCCs to identify and communicate their health priorities. In this pilot study, we adapted this tool to engage care partners of PLWD as active listeners while the PLWD discussed their healthcare goals and priorities. We recruited dyads consisting of a care partner and a care recipient in the early stages of dementia. We assessed feasibility and acceptability of going through the process together through open-ended questions. Two coders used thematic analysis to examine their responses. Five dyads (N=10) participated in the pilot study. The PLWD ranged in age from 70-83 years and had a range of three to eight chronic conditions. Care partners ranged from 39-78 years of age. The PLWD had no issues completing the process with their care partners present and enjoyed having their care partner present. Care partners valued engaging as active listeners and had a better understanding of the PLWD’s health care priorities. Engagement in this process also helped them recognize that the PLWD is proactive in their own health goals. Involving care partners in a healthcare priorities identification process is a valuable, feasible, and acceptable way to prepare care partners to be care proxies.
SINGLE-TIE CORE NETWORKS AMONG OLDER EUROPEANS: A POSITION OF PRECARITY AND LONELINESS?
Authors: Sun Haosen , Lee Jina , Schafer Markus
Published: December 2023

The problems of late-life social isolation and loneliness prompt significant concern. Individuals who have core personal networks limited to a single connection may be especially susceptible to loneliness, particularly when that connection is no longer available. The present research considers: 1) how prevalent such single-tie networks are and who is most likely to embed in them; 2) whether older adults in single-tie networks are more lonely than people with more expanded network forms; and 3) whether such networks put people at highest of loneliness in the event of network member loss. Using ego-centric network data from Waves 4 (2011) and Wave 6 (2015) of the Survey of Health, Ageing, and Retirement in Europe (SHARE), we conduct lagged dependent variable logistic regressions. Results show that a total of 28.2% of older Europeans rely on a single person as an important personal tie. Among those maintaining a single-tie network, spouses are the most common choice (62.4%), followed by a child (15.2%), a relative (8.5%), and a non-relative (13.8%). Factors significantly associated with holding different types of single-tie networks include age, gender, education, financial pressure, rural residence, participation in social activities, and grandparental roles. Child-only networks are significantly associated with greater levels of loneliness compared to multi-tie networks. Meanwhile, the loss of a partner as the only connection is associated with significantly increased loneliness, even after considering possible network additions. Future research should investigate how to better protect older adults in precarious network settings, especially during network losses.