bluuebunny/crossref_metadata_2025 huggingface dataset:
BIOSOCIAL PATHWAYS AFFECTING HEALTH AND AGING IN THE HEALTH AND RETIREMENT STUDY
Authors: Klopack Eric , Meier Helen
Published: December 2023

Representative population studies, like the Health and Retirement Study (HRS), are gathering large amounts of biomarker and multi-omic data. This presents a unique opportunity to investigate how population-level aging effects is driven by social inequality. This research has the capacity to uncover targets for intervention that could result in extending longevity and healthy life span and reducing inequalities in aging. There has been substantial research and progress in identifying biological processes underlying age-related decline, morbidity, and mortality (the so-called biological hallmarks of aging); however, despite this progress, demographic, social, and psychological factors (the so-called social hallmarks of aging) are substantially associated with cognitive aging and ADRD above-and-beyond genetic and biological factors There is, therefore, a need for research that carefully integrates the social and biological hallmarks of the human aging processes. This symposium highlights research that investigates interactions between biological and social processes that lead to inequalities in health and aging among older adults utilizing recently released data from the HRS Venous Blood Study (a nationally representative sample of US adults over age 55). Included are papers investigating the role of timing of childhood adversity in affecting adult DNA methylation patterns, how childhood parental loss is associated with accelerated epigenetic aging, how socioeconomic status patterns expression of genes related to inflammation and cellular senescence, and how sets of age-related biomarkers can explain sociodemographic inequalities in mortality. These studies contribute to an emerging literature integrating social and biological sciences to better understand inequalities in the aging process.
SPATIAL PROFILING CELLULAR SENESCENCE IN THE HUMAN BRAIN ACROSS EIGHT DECADES OF LIFE
Authors: Orr Miranda
Published: December 2023

Neurons with tau-containing neurofibrillary tangles (NFTs) closely correlate with Alzheimer’s disease (AD) progression and severity, but do not undergo immediate cell death. Our prior work determined that NFT-bearing neurons undergo a change in cell fate consistent with cellular senescence. CDKN2D/p19 was identified as a key biomarker for identifying senescent neurons in postmortem human AD brain tissue. Studying the interaction between senescent (e.g., p19+/NFT+) neurons and their environments is a necessary next step to understanding how these cells may be impacting their local and synaptically-connected neighboring cells. The goal of this project was to evaluate the expression and subcellular localization of multiple analytes in normal and senescent cells in postmortem mouse and human brains using non-destructive, multi-plex, spatially-resolved profiling methods. Postmortem mouse and human brains were analyzed using NanoString, Inc GeoMx digital spatial profiling (DSP) and CosMx spatial molecular imaging (SMI). Region of interest (ROI) selection included the presence or absence of neuronally expressed AT8 (phosphorylated tau, NFTs) and/or p19 (senescence). NFTs with or without p19 expression were compared to healthy neurons from the same cases. The expression of 86 proteins associated with neuropathology, inflammation, autophagy and cell typing was determined for each ROI and immediate environment using GeoMx. CosMx SMI was used to develop a subcellular expression map of >1000 genes and spatially-resolved cell type map of mouse and human entorhinal cortex and hippocampus. The complete dataset consisted of over 160,000 single cells and ~170 million transcripts, and a spatially-resolved cell type map of mouse brain tissue. Significant differences across biological aging pathways between disease and healthy conditions in both species were identified. Additionally, the results provide insights into which cells are susceptible to senolytic clearing interventions currently underway (NCT04685590).
CONTRACT NURSE STAFFING AND NURSING HOMES: ANTECEDENTS AND CONSEQUENCES
Authors: Pradhan Rohit , Weech-Maldonado Robert , Banaszak-Holl Jane
Published: December 2023

Nursing home (NH) quality has been a matter of long-standing policy interest at the federal and state level, as it concerns the health and well-being of one of our most vulnerable populations. Nurse staffing intensity and skill mix have a consequential impact on NH care quality. Unfortunately, NH staffing has been marked by multitudes of challenges including high levels of turnover and absenteeism. In recent years, the utilization of agency or contract nurse staffing has increased as facilities face persistent staffing shortages exacerbated by COVID-19 which has had a disproportionate and devastating impact on NHs. The literature suggests that agency staffing negatively influences the performance of healthcare organizations due to multiple reasons including unfamiliarity with organizational culture, decline in teamwork, and the attendant high costs attached to contract staffing. However, contract nurse utilization practices and its impact on NH care has not been studied adequately, and much of the limited literature relies on datasets with limited understanding of agency staffing. The overarching goal of this symposium is to explore the antecedents and consequences of the increased utilization of contract nurse staffing. As part of the symposium, we include studies examining NH nursing skill mix and intensity, the organizational and market level factors associated with higher levels of contract staffing, and the impact of nurse contract staffing on NH staff turnover, quality, and financial performance. We believe that this series of studies would have important managerial and policy implications. This is a Research in Quality of Care Interest Group Sponsored Symposium.
THE IMPACT OF CONTRACT NURSE UTILIZATION ON NURSING HOME FINANCIAL PERFORMANCE
Authors: Ghiasi Akbar , Davlyatov Gani , Pradhan Rohit , Lord Justin
Published: December 2023

Ensuring the financial viability of NHs is an important policy and managerial concern. The financial sustainability of nursing homes has been threatened in the recent past by high staff turnover, growing competition, low Medicaid reimbursement, and declining occupancy rates. The literature suggests that nurse staffing may have a significant impact on NH financial performance. We examined whether higher ratios of contract nurse use were associated with NHs operating margin. Employing a pooled cross-sectional observational study design, we extracted secondary data from the PBJ nurse staffing, Nursing Home Compare, Healthcare Cost Report Information System (HCRIS) Dataset, RUCA codes, and the ACS for the period 2017-2021. To test the relationship between the ratios of contract nurses and operating margin, we employed multivariate mixed-effects maximum likelihood regression. We ran three separate regressions for RN, LPN, and CNA. Our findings showed that a 10% increase in the contract nurse ratio among RNs, LPNs, and CNAs is associated with a 0.45%, 0.48%, and 0.52% decrease in operating margin, respectively. Our results demonstrate a consistent negative association between the ratio of contract nurses and nursing home operating margin. Our results are consistent with the extant literature with contract nurse staffing said to be significantly more expensive. Considering NHs operate in a financially precarious environment, the increased utilization of contract nurse staffing may pose a further threat to their financial viability, with negative implications for quality and access.
A COMMUNITY-ENGAGED RESEARCH JOURNEY: USING HOME REPAIRS TO PROMOTE HEALTH EQUITY AMONG OLDER ADULTS
Authors: Filec Sarah , Schechter Gail , Laz Mike , O’Conor Rachel
Published: December 2023

Homeownership is a primary mechanism to build wealth. The majority of older Chicagoans own their home, but stark racial inequities exist due to discriminatory lending and purchasing practices. Homeownership requires regular maintenance, but low-income older adults are often forced to defer maintenance for financial reasons, which can lead to hazardous living environments, falls, and the need to move. Intuitively, housing conditions play a pivotal role in enabling older adults to continue to live in their home safely, yet few studies have examined the independent benefit of home repairs towards preserving homeownership and improving older adults’ health. In 2019, stakeholders from community based organizations (CBO) and academic researchers convened a partnership identifying shared research goals and priorities focused on the impact of housing support services on older adult health. Over the past four years, we formalized a partnership and through iterative conversations with experts in aging and housing, and older adults with lived experience, our team identified a need to evaluate home repairs and their impact on 1) health outcomes, and 2) preserved homeownership and independent living for older adults. Our team iteratively co-developed a pilot study, with all stakeholders (older homeowners, CBOs, researchers) informing the methodology and research questions. In January 2023, we collectively launched our research pilot to evaluate the impact of a home repair program on health outcomes and homeownership preservation among predominantly Black low-income older adults in Chicago. Together we established a trusted partnership that will continue to address root causes of health inequities of older adults.
POPULATION ATTRIBUTABLE FRACTIONS FOR THE CONTRIBUTION OF HEARING LOSS ON DEMENTIA RISK ACROSS COHORT STUDIES
Authors: Smith Jason , Burg Emily , Sharrett A Richey , Reed Nicholas , Lin Frank , Coresh Josef , Deal Jennifer , Ishak Emily
Published: December 2023

Estimates range from 2-8% of dementia cases in the US are attributable to hearing loss. Here, we investigate measurement considerations in quantifying the population attributable fraction (PAF) of dementia from hearing loss to highlight how differences in methodology can underestimate the PAF. We use two cohort studies of older adults in the US: the National Health and Aging Trends Study (NHATS), a nationally-representative sample of older Medicare beneficiaries; and the Atherosclerosis Risk in Communities (ARIC) Study, a large, community-based cohort study with longitudinal follow-up. Each study collects reference-standard hearing measures on participants. We have two specific aims. First, we compare two valid, formula-based approaches to quantifying the PAF. The advantages of quantifying a PAF using a well-characterized, biracial, community-based sample with a longitudinal design are weighed against those of using a nationally-representative sample with a cross-sectional design (moderate or greater hearing loss: PAF in NHATS, 16.9% [95% CI: 4.1-28.7%]; PAF in ARIC, 13.2% [95% CI: 2.2-20.9%]), highlighting the need for longitudinal designs in studies of the PAF from hearing loss. Second, we describe the impact of subjective versus objective measures of hearing loss on the PAF. In ARIC, subjective hearing loss was not associated with incident dementia (hazard ratio <1.0). PAFs of dementia from objective hearing loss were 6- to 8-fold greater than PAFs previously quantified using self-reported hearing measures in population-based studies. Our findings have broad implications for the inclusion of hearing loss as a potentially modifiable risk factor in clinical and public health initiative for dementia prevention.
REDUCING HOSPITAL ADMISSIONS FOR PEOPLE LIVING WITH DEMENTIA—RESULTS FROM THE GERMAN DEMWG-STUDY
Authors: Wolf-Ostermann Karin , Schmidt Annika , Stiefler Susanne , Altona Janissa , Kratzer Andre , Donath Carolin , Graessel Elmar
Published: December 2023

People living with dementia (PlwD) have a high risk of being admitted to hospital, especially in advanced stages of dementia – with often severe negative consequences. The DemWG-study therefore aimed to reduce the number of hospital admissions for long-term care dependent PlwD by a complex intervention - including motor and cognitive training for PlwD and education of caregivers and general practitioners. By means of a cluster randomised longitudinal design, data on hospital admissions as well as quality of life, risk of falls, challenging behaviours and cognitive functioning were assessed in 97 shared-housing arrangement (SHA) in Germany with a total of 341 PlwD at baseline and after a 6 months intervention. Results of the of longitudinal data analysis showed a significant decline in hospital admissions for the intervention period and less challenging behaviours. Quantitative and additionally qualitative data were also collected 12 and 18 months after baseline. Caregivers perceived improved social interaction, which in turn has a positive effect on living together in the SHA. Based on the results and in light of the urgent need for easy to implement non-pharmacological and/or psychosocial therapy approaches recommendations for better care and support can be derived and the intervention can be implemented in everyday practice.
ASSESSING STAFF PERCEPTIONS OF WORKPLACE SAFETY IN NURSING HOMES: ITEM SET DEVELOPMENT AND TESTING
Authors: Zebrak Katarzyna , Yount Naomi , Sorra Joann , Gray Laura , Kirchner Jessica , Campione Joanne
Published: December 2023

Workplace safety is important for advancing resident safety and eliminating harm to both nursing home staff and residents. The goal of this study was to develop and test survey items to assess how the organizational culture in nursing homes supports workplace safety for staff. After conducting a literature review and background interviews with nursing home staff and workplace safety experts, we identified important areas of workplace safety culture (i.e., workplace hazards; moving/transferring/lifting residents; inappropriate resident behavior toward staff; interactions among staff; supervisor/management support for workplace safety; workplace safety reporting; and, work stress/burnout) and drafted survey items to assess each area. These draft items were administered with the AHRQ Surveys on Patient Safety Culture (SOPS) Nursing Home Survey to staff in 48 U.S. nursing homes. We conducted psychometric analysis on data from 2,468 respondents. Confirmatory factor analysis results and internal consistency and site-level reliability coefficients were acceptable for the 18 survey items grouped into 6 composite measures. All composite measures were significantly correlated (p< 0.05) with each other and with the overall rating on workplace safety, indicating adequate conceptual convergence among survey measures. On average, 33% of respondents reported symptoms of burnout. Higher burnout was significantly correlated with lower job satisfaction (rs=-0.42) and greater intent to leave the nursing home (rs=0.37). Nursing homes and researchers can use the Workplace Safety Supplemental Item Set to assess nursing home staff burnout and the dimensions of organizational culture that support staff safety, and to identify both strengths and areas for improvement.
KUAKINI HHP CENTER FOR TRANSLATIONAL RESEARCH ON AGING: LATEST FINDINGS FROM MODEL ORGANISMS TO HUMANS
Authors: Willcox Bradley , Allsopp Richard , Martin Peter
Published: December 2023

Kuakini Medical Center (Kuakini) was funded by NIH in late 2019 to create an interdisciplinary Hawai’i-based, Center of Biomedical Research Excellence (COBRE), for translational research on aging. This Center is building upon Kuakini’s five-decades of prior NIH-funded research. These resources include clinical data from the 58-year ongoing Kuakini Honolulu Heart Program (HHP), Honolulu-Asia Aging Study, HHP Offspring Study and a large biorepository with over 500,000 biological samples. The Center’s overarching aim is to increase infrastructure for collaborative aging research in Hawaii. The first step is to grow the Center’s faculty by hiring and mentoring research project leaders (RPLs) from diverse disciplines to become independent, R01-funded, investigators on aging. Our first RPL has graduated after obtaining R01-funded status. His project utilizes novel CRISPR methods to i) improve the safety and efficacy of delivering potentially therapeutic genes (such as FOXO3) to the mouse genome, and ii) test whether temporal enhancement of FOXO3 expression improves healthy aging in this mouse model - both key steps for potential translation to human clinical therapies. This work will be highlighted in the Program Overview session followed by current RPL findings. These findings include novel findings on a potential relation between FOXO3 genotype and stroke dynamics in elderly Japanese-American males; venous congestion in the brain and its potential impact on cognitive function; new findings on the Okinawan longevity phenomenon, among other interesting findings related to healthy aging. Supported by NIGMS 5P20GM125526 and NIA R01AG027060.
RACIAL DIFFERENCES IN ASSOCIATION OF OBJECTIVELY MEASURED PHYSICAL ACTIVITY WITH INDOOR AND OUTDOOR FALLS
Authors: Le Qun , Churchill Linda , Kane Kevin , Chen Lingming , Crouter Scott , Berry Sarah , Hannan Marian , Li Wenjun
Published: December 2023

Fall-related injury and hospitalization rates have been steadily increasing by 2% and 4% per year. Physical Activity Guidelines advise older adults to remain physically active to promote muscle strength, bone health, and balance. The Healthy Aging and Neighborhood Study enrolled 379 community-dwelling persons aged 65 years or older in Central Massachusetts (2018-2020). Participant physical activity (PA) levels were measured using waist-worn Actigraphy accelerometers for at least 8 hours per day for 5 or more days including 1 weekend day. Average daily PA intensities were categorized according to minutes of sedentary (SB), light (LPA), and moderate-to-vigorous-intensity PA (MVPA) using Copeland cutoffs. Falls, including the circumstances of the fall, were ascertained using monthly falls calendars and follow-up telephone interviews. Negative Binomial Regressions were used to estimate the associations of PA with rates of indoor and outdoor falls. Models were run overall and by race, with all models adjusting for age and gender. Mean age was 73.71(SD:6.41) years, 58.31%(n=221) were female, and 35.62%(n=135) were non-White. There was no significant difference in SB, LPA, and MVPA by race. White race was associated with higher rates of outdoor falls (RR(95% CI)=2.73 (1.51, 4.93)). Every 30 more minutes of MVPA was significantly associated with 25% lower rate of indoor falls (RR(95% CI)=0.74 (0.58, 0.97)) and 42% higher rate of outdoor falls (RR(95% CI)=1.42 (1.04, 1.95)) among non-White but not White (p for interaction=0.03, 0.07, respectively). Socioeconomic factors may explain the differences observed by race. Thus, future investigations should consider socioeconomic when examining indoor and outdoor falls.
VALUING AND SUPPORTING THE INVISIBLE WORKFORCE OF FAMILY CAREGIVERS
Authors: Reinhard Susan
Published: December 2023

The 2023 update to the Valuing the Invaluable series estimates the economic value of unpaid, family caregiving in America was $600 billion in 2021. This estimate continues a 25-year trend of increasing economic value for family caregiving, which fills an essential role in the fractured LTSS system. This work also details the diversity of family caregivers and their care experiences, the challenges that caregivers face juggling care with work and child care, and the impact of direct care worker shortages on family caregivers. This symposium showcases the national and state estimates of the economic value of caregiving, details who caregivers are today, what challenges they face, and what policies and practices can support and recognize them and the vital care they provide. Presenter 1 shares an overview of the methodology used in this report and the national and state estimates of the economic value of caregiving. Presenter 2 discusses the increasing generational, racial and ethnic, and sexual identity and orientation diversity of family caregivers today and the challenges specific to different communities of caregivers. Presenter 3 highlights promising policies and practices to support caregivers and details recommendations for building on those promising policies and practices. This is a Family Caregiving Interest Group Sponsored Symposium.
ALASKA NATIVE DEMENTIA CAREGIVERS AND THE INCREASING NEED FOR CULTURALLY SAFE RESOURCES
Authors: Lewis Jordan , Kim Steffi , Asquith-Heinz Zayla , Thompson Lena
Published: December 2023

With the rate of dementia increasing among Alaska Native people and the tribal health system ill-equipped to meet the challenges associated with dementia care, there is an urgent need to better understand cultural perspectives on dementia caregiving and what states and communities can do to support their caregivers. Despite the fact caring for others is a value and cultural practice for Indigenous communities, and caregivers tend to report fewer challenges and barriers related to care, they still experience barriers and challenges. Guided by Kleinman’s explanatory model of illness, a qualitative, the aim of this study was to gain insight on Alaska Native caregiver experiences in caring for someone living with dementia in communities across Alaska. 21 interviews with Alaska Native dementia caregivers in rural and urban communities were completed. Despite being innovative and resourceful in providing care, caregivers reported the high cost of care, inadequate training of health care providers, and the paucity of culturally safe caregiver training, education, and resources are especially concerning and need to be addressed in a timely fashion. Caregivers in this study recommended the development of basic educational materials to be aware of dementia, its stages, and the available supports, as well as caregiver support and respite services. The recommendations from this study focus on outreach and education for caregivers to improve their access to education, training, and support to reduce isolation, increase their dementia knowledge, expand their awareness of ancillary resources, and inform help-seeking decisions.
CAREGIVING INTERACTIONS OF FORMAL CAREGIVERS AND PERSONS WITH DEMENTIA: A SYSTEMATIC REVIEW OF MEASURES
Authors: Paudel Anju , Liu Wen , Jao Ying-Ling , Dasanayake Thakshila , Liao Yo-Jen , Akter Nahida
Published: December 2023

A psychometrically sound assessment of caregiving interactions is essential to collect valid information about the interactions, and to establish interventions to optimize the interactions in dementia care. This review aims to identify measures of caregiving interactions between formal caregivers and persons with dementia and evaluate their psychometric properties. We conducted a systematic review of studies published by February 2023 in four databases— PubMed, PsychINFO, CINHAL, and Web of Science. COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) checklist was chosen for quality appraisal of selected studies. Our search yielded 818 scholarly records and identified five eligible instruments (published in six scholarly records). Three measures assessed interactions between formal caregivers and persons with dementia from both caregiver and person with dementia’s perspectives while one evaluated from the caregiver perspective and the other from person with dementia’s perspective. Additionally, three measures assessed interactions based on observations while other two were based on interviews. Preliminary results showed the Communication Behavior in Dementia (CODEM) as a promising measure with some excellent psychometrics but it needed further testing with larger sample and assessment of responsiveness to change. The remaining four measures (IC-Communication-SR, Coding Scheme for Mealtime Interactions, Montreal Evaluation of Communication Questionnaire for use in Long-Term Care (MECQ-LTC), and Barnards Feeding Scale) had concerns related to low internal consistency, low reliability, and lack of adequate psychometric tests. Overall, this review identified gaps in current measures, suggesting a need to establish psychometrically sound tools to assess and optimize caregiving interactions in dementia care.
BRIDGING THE DIVIDE: REACHING THE POTENTIAL OF TECHNOLOGY TO ENHANCE OLDER ADULTS’ WELL-BEING AND QUALITY OF LIFE
Authors: Boot Walter
Published: December 2023

Existing and emerging technologies hold great promise with respect to improving the lives of older adults, in particular, by supporting and enhancing their independence, productivity, health, safety, social connectivity, and quality of life. Unfortunately, although differences in technology use and adoption between younger and older adults have declined over the past decades, barriers still exist that fully prevent the promise of technology from being realized to achieve these aims. This presentation will provide an overview of the current state of the intersection of aging and technology (nationally and internationally), with special attention to factors such as diversity, disability, and geographic region. Next, I will discuss approaches available to reduce the digital divide. These include changing the person (e.g., changing attitudes and proficiency) and changing the technology (human factors engineering). I will then discuss how a user-centered design process is crucial for the success of technology-based interventions. Without placing the user at the center of the design process, many novel technology solutions will likely fail to reach their potential. Finally, I will conclude with a discussion of if and when the age-related digital divide might close entirely by projecting changes in demographics, technology proficiency, technology proliferation, and technology change into the future.
HOW TECHNOLOGY IMPACTS LONELINESS: PERSPECTIVES OF AFRICAN AMERICAN OLDER ADULTS
Authors: Pace Sarah
Published: December 2023

The use of information and communication technologies (ICT) has been found to decrease loneliness among older adults by enabling communication with friends and family. Over 25% of older adults experience loneliness, and having a larger social network can reduce this risk (Chawla et al., 2021; Dahlberg et al., 2022). Despite the success of using ICTs and the growing ubiquity of ICTs among people of varying social demographic backgrounds there remains a digital divide, which refers to inequality in terms of access to ICT based on race, age, economic status, or other factors. While ICT use is becoming increasingly common among older adults, few studies have included African American older adults, who are less likely to have access to high-speed internet and computers than their White counterparts. However, African American adults are more likely to use text messages, video and voice calls, email, and social media to stay connected. The proposed research aims to explore the perspectives of African American older adults on how ICT impacts loneliness. Semi-structured interviews will be used to collect data from a purposive sample of about 10 people who meet specific selection criteria. Data will be analyzed using thematic analysis. The results may be useful for gerontological practitioners interested in promoting ICT use as a way to enhance the social well-being of African American older adults. The study could lead to the development of interventions that increase technology adoption and use, ultimately reducing loneliness among African American older adults.
A NOVEL NATIONAL FAMILY CAREGIVER ADVOCACY TRAINING PROGRAM: LESSONS LEARNED
Authors: Donovan Heidi
Published: December 2023

The 2022 National Strategy to Support Family Caregivers recommended 24 legislative or policy changes to improve the national caregiving landscape. With basic training, unpaid family caregivers (CG) can be powerful stakeholder advocates to drive policy change. In collaboration with national caregiver advocacy organizations, the University of Pittsburgh National Rehabilitation Research and Training Center on Family Support hosted a Family Caregiver Advocacy Program (FCAP) with the educational objectives of increasing CG motivation, self-efficacy for, and participation in policy advocacy. FCAP is a series of virtual workshops for family caregivers on caregiving-related policies, how laws are written and passed, how caregiver advocates can inform the policy-making process, how to contact and meet with legislators, and how to tell their story to advocate for change. Caregivers (n=68) enrolled in the inaugural FCAP workshops participated over a 3-month period to develop and implement group-selected advocacy products. FCAP participants ranged from 20-29 to 70+ years old, were primarily women (88%) caring for individuals who are aging (65%), have a physical disability (41%), have an intellectual / developmental disability (27%), and / or have a mental illness (27%). This presentation will report on the CG products and outcomes and plans for future iterations of FCAP based on lessons learned.
EXAMINING SOCIOCULTURAL RESILIENCE FACTORS IN WIDOWHOOD AND COGNITIVE FUNCTION AMONG OLDER CHINESE IMMIGRANTS
Authors: Lee Yura , Jiang Yanping
Published: December 2023

Loss of a spouse is one of the most stressful life events in later life and often entails significant physical and mental health outcomes for widowed individuals. Although there is growing evidence on widowhood and cognitive function, existing studies have shown mixed results. Little is known about resilience factors that may attenuate the adverse effect of widowhood on cognition among older Asian immigrants. This study explored potential moderators (i.e., social support, acculturation, leisure activities), which may contribute to resilience in the association between widowhood and cognitive function among older Chinese immigrants. The study sample included 2,515 adults aged 60 or older who completed two waves (2011–2013 and 2013–2015) of the Population Study of Chinese Elderly in Chicago. Cognitive function was measured by global cognitive function and episodic memory. Widowhood group was categorized into three groups based on the marital status at two waves: 1) married, 2) recently widowed and 3) previously widowed. Linear regression analyses were conducted with interaction terms. Our results show that social support moderated the relationship between widowhood and global cognitive function, and acculturation moderated the relationship between widowhood and episodic memory. Specifically, the findings indicate that adverse effect of widowhood on cognitive function is more pronounced at lower levels of social support and acculturation. This implies buffering roles of social support and acculturation in cognitive health among older Chinese immigrants who experience widowhood. Providing supportive programs and interventions to increase social support and acculturation is suggested to promote cognitive function in this population.
YOU JUST LEARN WHAT TO HOLD ON TO AND WHAT TO LET GO: NARRATIVES OF MINDFUL AGING IN SOUTH ASIAN AMERICAN OLDER ADULTS
Authors: Khan Mushira , Basic Ajla
Published: December 2023

Mindful Sustainable Aging (MSA) is a multidimensional concept incorporating elements from four prominent gerontological theories – activity theory, disengagement theory, successful aging theory, and gerotranscendence theory (Nilsson et al., 2015). Informed by mindfulness practices, MSA is a holistic approach to supporting healthy aging in the social, physical, mental, and spiritual dimensions of life (ibid.). Using MSA as a theoretical framework, this qualitative study explores mindful aging in community-dwelling South Asian American older adults – one of the fastest-growing yet relatively understudied racial/ethnic minority groups in the US. In-depth, semi-structured interviews were conducted with 32 South Asian Americans aged 50+ (18 male, 14 female; mean age=63.5 years). Thematic analysis of the interview data showed that aging was accompanied by significant modifications such as adjusting to everyday life after the death of a spouse, perceived loss of role and status in the family, reduced finances, and limited mobility due to emergent health concerns. Yet, participants expressed an overall sense of peace and gratitude, embracing aging as an “inevitable” and “natural” process of discovery and acquiring wisdom. Participants tried to remain connected to their social networks through messaging and video calling apps like WhatsApp, volunteered at local places of worship like temples and mosques, and helped their adult children with childcare and household chores. Limited availability of culturally-appropriate opportunities for active aging was a key barrier to participants’ sense of well-being. These findings suggest that culturally-sensitive, mindfulness-based interventions like gentle yoga or bilingual guided meditations may enhance subjective well-being in this population sub-group.
MULTIDIMENSIONAL AND INTERSECTIONAL APPROACHES TO ACCESSIBLE AND HEALTHY AGING IN DIVERSE POPULATIONS
Authors: Garcia Catherine
Published: December 2023

Aging is a complex process that affects different individuals in different ways. To ensure that healthy aging is accessible for all individuals, it is crucial to consider the unique needs of diverse populations through multidimensional and intersectional approaches. Multidimensional approaches recognize that aging is a complex process and that many different factors shape how individuals experience it. Intersectional approaches to aging consider individuals’ multiple identities and social locations, creating unique experiences and needs around aging. When these two approaches are combined, it is possible to create accessible and healthy aging for individuals from all backgrounds. The five presentations in this symposium center on two large and diverse racial and ethnic groups in the U.S. – Vietnamese and Puerto Rican older adults – groups underrepresented in studies of aging. Using data from the Vietnamese Aging and Care Survey (VACS), Miyawaki and colleagues examine the association between disability, chronic disease, and depression. The next set of presentations uses longitudinal data from the Puerto Rican Elderly Health Conditions Project (PREHCO). Quashie and colleagues explore whether neighborhood socioeconomic status moderates the relationship between living arrangements and cardiometabolic disease. Thompson and colleagues examine the relationship between hurricane stressors and cognition. Guinn and colleagues examine whether social support mediates the relationship between hurricane-related stressors and depression. Ballard and colleagues examine how hurricane-related stressors influence perceived stress. Overall, the results from these investigations show a need for authentic community and stakeholder engagement to develop, implement, and create sustainable interventions to promote healthy aging.
DIGITAL DANGERS: TECHNOLOGY-FACILITATED ABUSE AMONG ADULTS AGE 50+
Authors: Bayne Alycia , Mumford Elizabeth , Lancaster Caroline , Sheridan-Johnson Jackie
Published: December 2023

Older adults (age 50+ years) are adopting new technologies to increase their independence, prevent social isolation, and help them to age in place. However, digitalization introduces new risks for technology-facilitated abuse (TFA). TFA is any form of online abuse including threats, identity theft, financial fraud, among other forms of victimization. Limited research has explored TFA in general population samples among older adults in the U.S. With support from the U.S. Department of Justice, NORC at the University of Chicago conducted a survey of TFA experiences in a nationally representative sample of n=1,011 U.S. adults aged 50 years and older. Latent class analyses were applied to understand the pattern of older adults’ exposure to ten different forms of TFA, resulting in three classes distinguished by the number of different forms of TFA experienced. This session describes findings from the study, such as socio-economic characteristics associated with TFA profiles, the respondents’ relationship to the perpetrator, behaviors taken in response to TFA, and resulting harms. Among key findings are that six in 10 community-dwelling adults age 50+ have experienced at least one form of TFA in their lifetime. The most common forms of TFA experienced were financial abuses and identity theft. Different demographic groups of older adults experienced different victimization patterns. For example, those who identify as LGBQA were at a much higher risk of experiencing TFA. This session concludes with research and education opportunities for preventing TFA across multiple levels among older adults.
CORRELATES OF RETIREMENT EXPECTATIONS AMONG BABY BOOMERS IN US AND SOUTH KOREA: APPLICATIONS OF TREE-BASED METHODS
Authors: Dang Linh , Mezuk Briana
Published: December 2023

75 million US Baby Boomers are expected to retire by 2030. Retirement decisions are a result of a complex interplay of multiple psychosocial factors, including individual (demographics, health characteristics), family (marital status, spousal characteristics), work-related factors (job characteristics, workplace environment), and cultural contexts surrounding retirement. However, traditional regressions of retirement expectations limit the inclusion of a large set of factors and their interactions. This study employed decision trees and random forests to explore the salient psychosocial correlates of retirement expectations among Baby Boomers in two countries that differ in retirement norms and policies, US and South Korea. Sample included adults aged 52-65 from the 2016 wave of the Health and Retirement Study (n=1,192) and the Korean Longitudinal Study of Aging (n= 766). Expectation (probability) of working full-time for the next 5-10 years was modeled continuously (range: 0-100). Prediction models of expectations included 52 psychosocial factors relating to individual, family, and work characteristics. Mean expectations were higher in Koreans than US adults (71.4% vs. 36.7%). Age, self-reported probability of living to age 75, and work hours strongly predicted expectations in both US and Korean adults. While type of employment, Social Security or private pension benefits, and employment tenure were important predictors in US adults, flexible work arrangements were important in Koreans. Differences in features predicting retirement expectations between the US and Korean adults suggest opportunities for country-specific programs and policies aimed to promote workplace environment and pension benefits for successful retirement planning in the Baby Boom generation.
TRUST AND BETRAYAL TRAUMA IN OLDER ADULT FINANCIAL EXPLOITATION
Authors: Hall LaToya , Lichtenberg Peter , Gomez Jennifer
Published: December 2023

Despite a growing body of literature on financial exploitation (FE) and older adults, considerably less research has focused on sub-populations of older adults’ experiences with substantiated financial exploitation, particularly exploitation by trusted others. A 2023 study conducted through Wayne State University’s Successful Aging through Financial Empowerment (SAFE) program used a sample of 95 clients ages 55 and over to examine factors associated with participants’ experiences of substantiated FE perpetrated by trusted others. The SAFE program was created in early 2017 to provide no cost assistance to older adults addressing the financial fall out associated with being financially exploited. The study used betrayal trauma theory (BTT) as a conceptual framework in an attempt to understand how financial vulnerability and mental health are associated with FE committed by trusted others. The study used a cross-sectional design to investigate group differences among 32 (33.7%) older adults who were victims of financial exploitation by trusted others and 63 (66.3%) older adults who were victims of financial exploitation perpetrated by strangers. The group of older adults who were victims of FE by trusted others had lower functional ability scores, higher stress and financial exploitation vulnerability scores and lost more money on average than those victimized by strangers. These results suggest older adults who have been victimized by trusted others are more vulnerable and need more assistance with functional tasks than those victimized by strangers. The present study also supports the notion that BTT provides a valuable framework for understanding vulnerability to various types of FE.
INTIMATE RELATIONSHIPS, SOCIAL ISOLATION, AND COGNITION
Authors: Engelman Michal , Moorman Sara
Published: December 2023

This symposium considers the cognitive impacts of a spectrum of social relationships, including both intimate partnerships and, in contrast, social isolation. Drawing on rich data from the Wisconsin Longitudinal Study (WLS), the Health and Retirement Study (HRS), the National Social Life, Health, and Aging Project (NSHAP), and the Mexican Health and Aging Study (MHAS), the papers showcase empirical linkages between older adults’ cognitive health with a set of exposures including marital status and relationship characteristics, social activities, and a lack of social connections. We begin with papers that examine the impact of particular marital relationship attributes and social behaviors on cognition and health. One paper employs the WLS to explore the impact of concordance and discordance in marital couples’ reports of similarity with and closeness to their spouse on cognition, while the second draws on NSHAP to consider the cognitive consequences of various domains of couples’ sexuality. The third paper uses the HRS to examine couples’ co-trajectories of physical, mental, and cognitive health, focusing particularly on how a spouse’s cognitive decline influences the other partner’s subsequent health trajectory. The fourth paper shifts our attention to variation by marital status in the cognitive impacts of leisure activities via data from MHAS, while the fifth focuses specifically socially-isolated older adults in the HRS and highlights variation in the relationship between social isolation and dementia by race and ethnicity. The symposium will conclude with a discussion of future directions for research on the cognitive consequences of relationships, social connections, and social isolation.
MARITAL CLOSENESS, SPOUSAL SIMILARITY, AND COGNITION: THE GENDERED IMPACT OF DISCORDANT PERCEPTIONS
Authors: Qin Yue , Moorman Sara , Engelman Michal
Published: December 2023

Many older adults are in long-term marriages, and an emerging literature examines the impact of marital attributes on later-life cognitive function. While both spouses’ perceptions of the marital relationship may influence health outcomes in the couple, most research only captures one partner’s report. Using unique data on 2,791 heterosexual married couples from the Wisconsin Longitudinal Study, we analyze the dyad’s evaluations of their similarity and closeness in 2004 and the impact of concordance or discordance in these marital attributes on cognitive health in 2020, when participants were approximately 80 years old and cognitive variation is more manifest. Results from OLS regressions reveal notable gender differences. Compared with dyads in which both spouses reported being “very similar,” women in marriages with discordant views on the partners’ similarity had significantly lower cognition in 2020 (wife gave the poorer rating: b=-0.74, p<.05; husband gave the poorer rating: b=-0.84, p<.05). Men’s cognitive function was not influenced by assessments of similarity in the couple. Furthermore, compared with dyads in which both spouses reported being “very close,” men in marriages with discordant views on the partners’ closeness had significantly lower cognition in 2020 (woman gave the poorer rating: b= -0.88, p < .05). Women’s cognitive function was unrelated to dyadic reports of closeness. Our results suggest that within-couple discordance in assessment of marital closeness and spousal similarity – more than marital attributes themselves – influences later-life cognitive function for women and men in varied ways.
ROOTS TO GROW AND WINGS TO FLY: EDUCATING MEDICINE AND PHARMACY TRAINEES ON VIONE MEDICATION DEPRESCRIBING METHODOLOGY
Authors: Battar Saraswathy , Silverman Michael
Published: December 2023

An aging world population translates to more chronic illnesses, more medications with potential and relevant cumulative burdens such as non-compliance, adverse outcomes, prescription cascades, confusion, compromised patient safety and quality of life standards. VIONE stands for the 5 filters that categorize medications as Vital, Important, Optional, Not indicated, Every medication has an indication. This is an electronic health record methodology currently implemented in 122 VA facilities across the nation. Physicians and pharmacists review medications, prioritize medications that merit deprescribing interventions, deprescribe through shared decision making and monitor outcomes. In the VA system, within 7 years, we successfully deprescribed over 1.4 million inappropriate medications impacting over 600,000 veterans, used by over 14000 medical providers, with an annualized cost savings of ~ 132 million US dollars. We incorporate VIONE deprescribing education while training our pharmacy residents, medical students, residents and fellows rotating at our VA Medical Center through case based, bed side, didactic and team based multi media learning strategies . The engagement, feedback, demonstrated formal and informal responses remain very promising. Capturing the attention of trainees in their formative years deepens their roots as they spread their wings into practicing safe medication prescribing practices that are current, cutting edge, evidence based and empowering as we train the trainers. We envision medication deprescribing to be part of future academic core curriculum. Our Interdisciplinary team will present compelling data, experiences and outcomes stemming from education of trainees regarding safe medication optimization and deprescribing practices utilizing VIONE methodology that won national and international acclaim.
CHALLENGES OF VERY LATE LIFE: PHYSICAL AND MENTAL HEALTH, CAREGIVING, AND AGING PERCEPTIONS
Authors: Jopp Daniela , Boerner Kathrin
Published: December 2023

The very old are the fastest growing population in developed countries, yet research on this age group remains limited. There are, however, specific challenges of very old age that differ from those in earlier late life phases. Very old individuals and their families may thus have unique needs and may require adapted services. In this symposium, we address selected challenges associated with reaching very old age, including physical and mental health issues, as well as implications of both receiving and providing care. Ribeiro and colleagues report on centenarians’ health and morbidity profiles using the Portuguese census, by comparing individuals aged 100 years old in 2011 and 2021. Jopp and colleagues present findings from the first national Swiss centenarian study on centenarians’ health, cognition, and well-being. Gomes da Rocha and colleagues investigate depressive symptoms in Swiss centenarians during the COVID-19 pandemic, showing notably elevated scores. Kim and colleagues focus on aging perceptions and their correlates among dyads of very old parents and their old children from South Korea, highlighting the impact of the care experience for both dyad members. Gallagher and colleagues examine how old children of very old parents with dementia manage behavioral and psychological symptoms through specific strategies, offering insights on how to better support family care givers of very old dementia patients. In sum, this symposium offers novel insights on specific challenges encountered in very old age, by the individual and their families, and proposes potential pathways towards better understanding and handling of such challenges.