bluuebunny/crossref_metadata_2025 huggingface dataset:
EVALUATION OF AN OFF-THE-SHELF, WEARABLE ACTIGRAPH SYSTEM FOR USE BY OLDER COUPLES
Authors: Jacelon Cynthia , Adeleye Khadijat , LaBlanc Raeann , Mamo Sara , Spencer Rebecca
Published: December 2023

There are many off-the-shelf wearable devices that provide the user with information regarding their physical activity and sleep patterns. Little is known about how easy it is for older individuals to use these devices. We tested a wrist-worn actigraph on couples both of whom were at least 70 years old. The aim was to evaluate the usability of the device, and to share data within the couples. Mixed methods were used to collect data. Over the three-week trial, 14 couples, nine of which had one member with mild cognitive impairment, used the system. Each person wore a Garmin Vivofit 4 continuously and used the Garmin application installed on an iPad mini to compare and review results over time. At the end of weeks one and three, participants completed the positively scored System Usability Scale (SUS), and each week met with the researcher to discuss the data and system usability. All couples were able to work together to use the system after being trained. Scores on the SUS indicated the system was moderately easy to use. Qualitative findings were that most participants (88%) liked being able to wear the device continuously, without breaks for charging. They compared information about their activity and sleep patterns within the dyad. There were several age-specific usability challenges, but use of off-the-shelf actigraphs by older individuals holds promise if age-related physical and cognitive changes are considered during selection of the device.
EXAMINING THE ASSOCIATION AMONG ADLS, DEMOGRAPHICS, WITH FOOD SECURITY ADULTS AT SENIOR CENTERS IN FULTON COUNTY, GA
Authors: Akintola Kehinde , Foley Sophia , Willis Angelique , Ramisetty-Mikler Suhasini , Cook Miranda , Mayfield Kellie
Published: December 2023

Food security amongst community-dwelling older adults attending senior centers is not often examined. It is an integral determinant of health because of the impact on multiple health conditions, which are further impacted by functional impairments and co-morbidities that can come with increasing age. Additionally, meal and nutrition education providers do not typically collect this information, which can be used to better provide services to their clients. This study examined the relationship between food security and demographic variables of older adults attending senior centers in Georgia served by nutrition provider Open Hand Atlanta (OHA). One hundred sixty-five senior center attendees were recruited from nine senior centers throughout Fulton County. The age of the participants ranged between 52 to 97, with most identifying as female (86.7%) and African American (79%). Food security (outcome of interest) was measured by the USDA 6-item module. Bivariate associations were tested between food security and ADLs and iADLs (instrumental ADLs) measured by a 15-item list, health conditions, shopping habits, transportation, caregiving, and demographics. Results showed that food security differed based on race/ethnicity X2 (n=165) = 8.94 (df=2), p = .011 and type of insurance X2 (n=100) = 5.95, (df=1) p = 0.015). In addition, those who are under public/Govt. insurance experience a higher proportion of food insecurity compared to those under private insurance (p=.015). Results have implications for nutrition providers when offering additional services to senior centers and the older adults they serve.
EXPERIENCES OF SOCIAL ISOLATION BY MANDARIN AND PUNJABI-SPEAKING OLDER IMMIGRANTS LIVING IN CALGARY
Authors: Ekoh Prince , Zhu Change , Walsh Christine , Guruge Sepali
Published: December 2023

Loneliness and social isolation have continued to be risk factors for the health and overall quality of life of older adults globally. The impact of loneliness on healthy ageing may even be more profound for older immigrants in Western countries like Canada, where there is a different language and culture from that of their home countries. As part of the Inclusive Communities for Older Immigrants (ICOI), which seeks to create knowledge about social isolation and improve social connectedness among older immigrants across Canada, we examined the experiences of social isolation amongst older Mandarin and Punjabi-speaking immigrants aged 60 years and over living in Calgary. Quantitative data was collected from 64 (33 Mandarin-speaking and 31 Punjabi-speaking) older adults in Calgary, Alberta. The data were cleaned and analysed using descriptive analysis with the aid of Statistical Packages for Social Sciences (SPSS), and findings showed that older immigrants conceptualised social isolation as limited participation in various community activities. Our results also showed that older immigrants perceived physical and mental health status, social conditions and environmental conditions as significant factors predisposing older immigrants to social isolation. The study, therefore, recommends designing interventions that will increase older immigrants’ participation in community activities considering their age, language, disabilities, health, and social conditions.
EXPLORING THE RELATIONSHIP AMONG PLACE ATTACHMENT, SELF-PERCEPTION OF AGING, AND SOCIAL PARTICIPATION
Authors: Chen Wei-An , Liu Li-Fan
Published: December 2023

In the context of aging in place, the purpose of the study was to explore the relationship between place attachment, self-perception of aging and social participation of middle-aged and older adults living in the community. The study sample consisted of 226 people aged 50 and over that lived in an urban community in Tainan city, Taiwan. The instrument used were questionnaires that included socio-demographics, health status, and scales for the three main variables. The data was analyzed using correlation, linear regression and mediation testing. The result showed a significant positive correlation between place attachment and both positive and negative self-perception of aging. Furthermore, it was found that negative self-perception of aging and place attachment had significant effects on social participation. Specifically, individuals with lower levels of negative self-perception of aging and higher levels of place attachment showed higher levels of social participation. Finally, the mediation analysis indicated that place attachment played a partial mediating role in the relationship between negative self-perception of aging and social participation. This means that under the positive effect of place attachment, social participation of middle-aged and older adults with negative self-perception of aging can still be increased. In conclusion, based on the interaction between aging and the environment, in addition to the importance of reducing negative views on aging, this study sheds light on the power of emotional bonds with living place in promoting active and healthy aging in familiar neighborhoods.
FACTORS INFLUENCING OLDER KOREAN AMERICAN IMMIGRANTS’ FRAILTY: A QUALITATIVE STUDY
Authors: Sagong Hae , Chon Myoung-Gi , Tsai Pao-Feng
Published: December 2023

The older immigrant population, characterized by unique attributes such as diverse cultural backgrounds, health beliefs, health behaviors, language barriers, and low health literacy, requires a specific focus on identifying factors that influence frailty. This study aims to explore the influencing factors of frailty among older Korean American immigrants (OKAIs) residing in suburban areas with limited Korean healthcare infrastructure. Semi-structured interviews were conducted with 9 OKAIs residing in Lee County, Alabama, focusing on four factors associated with frailty: health literacy, physical activity, diet, and mental health. Qualitative content analysis was employed to analyze the data. Validated assessment tools for frailty, health literacy, physical activity, nutrition, depression, and cognitive impairment were also used to gather participant characteristics and complement the qualitative findings. Participants exhibited significant differences in health literacy scores between the Korean and English versions. Content analysis yielded seven categories and twenty-two sub-categories were derived from the eighty identified codes. In addition to typical age-related changes observed among older adults in general, their social activities, health behaviors, and healthcare visits were constrained by different environments/healthcare systems compared to Korea, as well as limited English proficiency and healthcare resources. Participants expressed a need for Korean healthcare providers or interpreters during their healthcare visits and emphasized their preference for Korean food and sought ways to maintain vitality. To prevent and manage frailty among OKAIs, interventions need to consider their unique characteristics, facilitators, and barriers. This approach may also benefit other ethnic minority populations facing similar challenges, thus enhancing healthcare for these communities.
FEAR OF CANCER RECURRENCE IN OLDER WOMEN IN REMISSION FROM GYNAECOLOGICAL CANCER IN REGIONAL AUSTRALIA
Authors: Kulatunga Senara , Rich Stacey , Steer Christopher , Rasekaba Tshepo , Webb Nicole , Blackberry Irene Darmadi
Published: December 2023

Fear of cancer recurrence (FCR) can be a constant feature of cancer survivorship and can negatively impact quality of life. Whilst the symptom burden from FCR is higher in younger patients, the impact of FCR in older adults is poorly understood. This project explores FCR, survivorship and the coping strategies associated with FCR in older women in remission after treatment of gynaecological cancer, a cancer type with high recurrence rates. Qualitative interviews were conducted with ten older women (age range 68-87 years) in remission from gynaecological cancer (Ovarian = 5, Uterine = 5). Interviews were designed to explore the experience of FCR in older women who had been treated at a regional cancer centre in Australia. Thematic analysis was undertaken to uncover themes related to the experience of FCR and coping strategies employed. Emergent themes included fear of burdening others, the emotional impact of the death of close others, and positive or negative experience of prior treatment. Emergent themes in coping with FCR in survivorship included helping others, comparison to others, keeping occupied, and support from others. Patients discussed preferring not to dwell on thoughts of recurrence. These findings are novel in FCR literature as they point to an experience of FCR in older women that may not fit the profile of the general population. Whilst further work is needed, these findings support the need for a tailored approach to supporting older women through survivorship to ensure optimal quality of life.
FEMALE BREAST CANCER SURVIVAL IN BLACKS VERSUS WHITES ACCORDING TO TUMOR STAGE, AGE, AND MARITAL STATUS AT DIAGNOSIS
Authors: Merrill Ray , Gibbons Ian
Published: December 2023

Female breast cancer survival is significantly influenced by tumor stage, age, and marital status at diagnosis. While Blacks have historically had lower breast cancer survival than Whites, it is not clear whether this lower survival differs across the levels of tumor stage, age, or marital status at diagnosis. This paper will assess this using five-year relative survival (5-YRS) estimates from the Surveillance, Epidemiology, and End Results (SEER) Program. Cases reflect 2000-2015 and follow-up extends through 2020. 5-YRS was 90.9% in Whites and 81.1% in Blacks, consistently lower by the levels of tumor stage, age, and marital status at diagnosis. In a regression model adjusting for these variables, the difference in 5-YRS was 8.0% for Whites versus Blacks, -15% for regional stage and -67% for distant stage (versus local stage), lower in older ages at diagnosis, and 5.2% for married (or cohabitating) versus otherwise. The lower 5-YRS in Blacks significantly varied by tumor stage at diagnosis (4.2% for local stage, 9.9% for regional stage, and 11.6% for distant stage; p=0.0098) but did not significantly vary by age or marital status at diagnosis. The variation across tumor stage at diagnosis in the lower 5-YRS for Blacks depended on age (p< 0.0001), with greater variability in the younger age groups and less variability in the older age groups. Thus, poorer 5-YRS for Blacks versus Whites persists across tumor stage, age, and marital status at diagnosis and becomes increasingly more pronounced in later stages at diagnosis, especially in younger versus older age at diagnosis.
FINANCIAL AND HEALTH INSURANCE STATUSES OF ALZHEIMER’S DISEASE AND RELATED DEMENTIA CAREGIVERS
Authors: Walker Jenny , Patel Roshni , McGuire Lisa
Published: December 2023

The number of individuals with Alzheimer’s disease and related dementias (ADRD) is rising as the U.S. population ages. Important sources of care for these individuals are the approximately 11 million caregivers who donate upwards of 18 billion hours of unpaid time while incurring many of the daily expenses and out-of-pocket healthcare costs associated with their role (Alzheimer’s Association, 2023). Therefore, the financial statuses of these individuals are important to understand as we continue to develop and fortify ADRD programs and health services. Participants from 40 U.S. states and territories who completed the 2021 Behavioral Risk Factor Surveillance System caregiving module were divided into three categories: non-caregivers (n = 184,709), non-ADRD caregivers (n = 36,459), and ADRD caregivers (n = 10,583). Results from a series of Rao-Scott chi-squared tests indicate that household income levels were similar across these three categories, but a significantly higher percentage of caregivers had other people—likely the care recipient— living in their household (87.3% non-ADRD, 86.8% ADRD, 81.1% non-caregivers). Moreover, while significantly fewer caregivers reported that they lacked health coverage (7.3% non-ADRD, 6.4% ADRD) than non-caregivers (8.4%), a larger percentage reported missing a healthcare appointment in the previous year because they could not afford it (12.6% non-ADRD, 12.8% ADRD, 8.8% non-caregivers). These results further highlight the need for focused federal, state, and local interventions for community-dwelling caregiver populations to support the financial toll of caregiving.
FINANCIAL CAPABILITY AMONG OLDER ADULT IMMIGRANTS, A SYSTEMATIC REVIEW
Authors: Lopez Bruna , Campos Barbara Mendez , Sabbath Erika
Published: December 2023

The Financial Capability approach assesses individuals’ financial knowledge and behaviors within the context of opportunities in the environment. Scholars and practitioners have documented how immigration status can influence individuals’ access to and eligibility for financial products and services, due to federal, state, and community rules and norms. Those who lack immigration status (i.e., undocumented immigrants) often face additional financial hurdles. A separate line of research has shown how financial capability can influence retirement savings, yet this did not focus on immigration status. As such, this systematic review seeks to understand how variations in legal immigration status impact the financial capability and long-term financial wellbeing of older adult immigrants in the United States. The current review utilized standardized procedures and protocols to identify articles related to financial capability, immigration status, and retirement savings, resulting in an initial list of 3,599 articles. Three studies published before May 2023 were included in the final narrative synthesis due to their inclusion of immigrants over 55. Results demonstrate that financial capability studies of older adult immigrants that met eligibility criteria have centralized Asian individuals, particularly Chinese, Taiwanese, and Korean populations. Furthermore, studies indicate that increasing financial capability among older immigrants can strengthen their financial security, yet these studies focus less on the impact of immigration status. Programs, services, or products operating on the financial capability paradigm warrant continued research as older immigrants have unique attributes (e.g., language, culture) and require careful design, implementation, and evaluation of efforts seeking to target long-term financial wellbeing.
FURTHER EVALUATION OF A MODIFIED VERSION OF THE HOSPICE PHILOSOPHY SCALE: A DIFFERENTIAL ITEM FUNCTIONING ANALYSIS
Authors: Becker Todd , Clem Sarah , Sacco Paul , Cagle John , Davitt Joan , Kusmaul Nancy , Cain Cindy
Published: December 2023

The hospice philosophy of care (HPOC) is a set of values applicable to all interdisciplinary group members that drives organizational and individual approaches to hospice care. As the only established measure of HPOC attitudes, we aimed to extend previous exploratory psychometric evaluation of the eight-item Hospice Philosophy Scale (HPS-8). An interdisciplinary convenience sample of 481 hospice clinicians participated in this cross-sectional study. Participants were recruited through hospice and palliative care membership associations representing the core members of the Medicare Hospice Benefit-designated hospice interdisciplinary group (physicians, nurses, social workers, chaplains). After examining uniformity through confirmatory factor analysis, we tested HPS-8 items for differential item functioning (DIF) by professional discipline using multiple indicators, multiple causes models. We compared models via nested chi-square difference tests. Our final model assessed uniform DIF for the HPS-8 factor, controlling for DIF-indicated items. We also assessed internal consistency reliability. After correlating errors for two similarly worded items, global fit indices met prevailing thresholds, χ²(19)=55.18, p<.001 (RMSEA=.06, SRMR=.03, CFI=.98, TLI=.97). The uniform DIF model indicated two items with DIF. Chaplains endorsed the need for mental and spiritual preparation for death more than physicians (β=0.21, p<.001). Nurses endorsed involving patients and families in deciding treatments and services more than physicians (β=0.21, p=.006). Despite statistically significant DIF on these items, statistically significant differences among professions were not observed at the factor level (p>.50 for all). Composite reliability estimates satisfied internal consistency thresholds (CR=.76). Results support the HPS-8’s use as a valid and reliable measure for assessing HPOC in hospice clinicians.
GENETIC PLEIOTROPY OF KIDNEY FUNCTION AND SOLUBLE RECEPTOR FOR AGE: THE LONG LIFE FAMILY STUDY
Authors: Feitosa Mary , Jin Shiow , Acharya Sandeep , Wojczynski Mary , Christensen Kaare , Zmuda Joseph , Brent Michael , Province Michael
Published: December 2023

Chronic kidney disease (CKD) patients have increased inflammation and oxidative stress that may escalate the production of advanced glycation end-products (AGEs), a biomarker implicated in aging. Circulate soluble receptor for AGE (sRAGE) is associated with CKD and inversely associated with the estimated glomerular filtration rate (eGFR). In the Long Life Family Study, eGFR measured by creatinine (eGFRcr) and cystatin-C (eGFRcys) correlated with sRAGE (r~ -0.27, p< 1x10-30). We investigated genetic pleiotropy conducting GWAS for eGFRcr, eGFRcys, and sRAGE and correlated meta-analysis (CMA) on GWAS p-values from whole-genome sequence variants in 4,182 subjects (age range: 24–110). Of the 59 loci identified (p< 5x10-8), 42 were novel eGFR discoveries. We performed TWAS and CMA-TWAS for eGFRcr, eGFRcys, and sRAGE on blood RNA-seq in 1,209 subjects and identified 17 genes with pleiotropic expressions for eGFRs and sRAGE (Bonferroni-p< 2.73x10-6). Several CMA-GWAS gene variants (e.g., SH3GLB1/SELENOF, CENPP) were eQTLs in glomeruli and tubule kidney (Human Kidney eQTL Atlas, HK-Atlas) and other tissues (GTEx-v8). The bioinformatics analyses identified (i)genes harboring eQTLs in glomeruli and tubule kidney (HK-Atlas), (ii)enhancer-promoter gene variants associated with kidney function-related phenotypes at genome-wide significance (GeneHancer/GeneCards/GWAS-catalog), and (iii)enhancer regions predicting gene expressions in kidney related-function (EPRI, enhancer-promoter-RNA maps). Some functional genes were found among bioinformatics (e.g., MTX1, TOPORS, SNTB1, LSP1, SNTB1, ATG2A, TP53INP2) and others were unique (e.g., TEC, CCN1, and ERGIC1, GeneHancer/GeneCards/GWAS-catalog). Genomic, transcriptomic, and bioinformatics results demonstrated evidence that some novel variants and genes have functional regulatory features in the kidney and are likely involved in biological and clinical aging.
HEALTH PROFESSIONAL STUDENT-LED SOCIAL PHONE CALLS TO ADDRESS LONELINESS IN AGING-IN-PLACE ADULTS AFTER STROKE
Authors: Burnett Jason , Savitz Sean , Broussard Jordan , Beauchamp Jennifer
Published: December 2023

Social isolation and loneliness (SIL) increases the risk of stroke and recurrence by 32% and 40%, respectively. The functional and cognitive deficits that often accompany stroke can impair social engagement behaviors and increase SIL. Intergenerational programs have proven effective for addressing SIL through social engagement behavior change in older adults, but the feasibility of these programs is unspecified for aging-in-place adults after stroke. We paired 14 community-living adults after stroke with 14 health professional students (HPS) for 6-weekly unstructured social phone calls. Baseline and follow-up data measuring SIL and other psychosocial metrics were conducted. HPSs journaled following each call. The 13 (93%) participants completing all calls were an average of 57 years old and white non-Hispanic (77%). The calls lasted approximately 49 minutes. Average baseline scores for loneliness and social isolation were 48 and 22, respectively. The average score for loneliness decreased 4 points at week six. The average score for social isolation was unchanged. Average baseline scores for symptoms of depression and anxiety were 20 and 8, respectively, and scores decreased by 1 point at week six. Participants disclosed physical and emotional challenges, previous valued employment, and enjoyment from the social engagement. HPSs learned about the struggles of aging-in-place after stroke and valuing compassionate care and social engagement. An intergenerational social phone call program provided a feasible, acceptable, and encouraging approach for addressing loneliness in community-living adults after stroke and has encouraging effects on mental health. A randomized controlled trial is needed to provide definitive data on intervention effects.
HEALTHCARE WORKERS’ PERSPECTIVES ON AI-ENABLED ROBOTS USE IN LONG-TERM CARE: A SCOPING REVIEW
Authors: Hung Lillian , Wong Karen Lok Yi , Wong Joey , Park JuYoung , Alfares Hadil , Zhao Yong , Mousavi Hossein , Zhao Hui
Published: December 2023

Artificial intelligence (AI) enabled robots are increasingly implemented in long-term care homes (LTC). However, the views of LTC staff on these robots remain largely unexplored. Our scoping review delves into the staff’s perceptions, outlining the advantages and challenges of using AI robots in LTC settings. Using the Joanna Briggs Institute’s methodology, we screened 86 articles from 2013 to 2023, with 35 fitting our criteria. Our analysis was informed by McCormack’s Person-centred Care Practice (PCP) Framework and the Consolidated Framework for Implementation Research (CFIR). We identified five key barriers: 1) the complexity of the robot, 2) potential job losses and increased workload, 3) concerns about safety and efficacy, 4) risk of depersonalized care, and 5) a lack of supportive regulations and resources in LTC facilities. To address these challenges, we recommend strategies: a) staff training, b) clarifying robot benefits to staff, c) demonstrating how robots can fulfill resident needs, d) implementing ethical guidelines, and e) aligning robot use with LTC policies while ensuring resource availability. In conclusion, partnership is required among healthcare workers, organizational leaders, robot developers, and researchers; they should not work in silos. More research is needed to explore how to facilitate effective partnerships.
HEMOPEXIN’S RELATIONSHIP WITH MUSCLE QUALITY AND COGNITIVE FUNCTION IN OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Zeng Derong , Qi Xiang , Wu Bei , Kawasaki Teruaki , Akiguchi Ichiro , Kinoshita Ayae
Published: December 2023

The imminent increase in Alzheimer’s disease (AD) and dementia increases the need for effective prevention strategies. Increasig attention has been paid to exercise as a prevention strateg to promote cognitive health. Recently, the link between hemopexin which is secreted by atrophied skeletal muscle and cognitive function maintenance has been studied, but evidence remains inconclusive.This study examined the relationship between hemopexin, muscle mass, muscle quality (Phase Angle, PhA), and cognitive function (measured by Mini-Mental State Examination) among 377 cognitively impaired older adults (mean age = 83.5 years).TANITA (MC-780A-N) was used to measure body composition. The concentration of hemopexin in human plasma samples was measured using the HPX (Human) ELISA Kit (KA0481). In Pearson correlation analysis, hemopexin showed no significant correlation with muscle mass, quality, or cognitive function. Multivariate regression analysis revealed that lower PhA is significantly associated with poorer cognitive function (t-value=2.012, p< 0.05), but hemopexin and muscle mass were not significant. An interaction analysis indicated that the relationship between hemopexin and muscle quality was modified by sex (t-value=2.052, p< 0.05). In the multivariate analysis for females, hemopexin correlated negatively with muscle quality (t-value=-2.128, p< 0.05). This study shows that hemopexin, though not affecting cognitive function or muscle mass directly, may impact muscle quality, especially considering the link between AD in older women and atrophied muscle with hemopexin secretion. Hence, interventions focused on muscle quality might improve cognitive function in older individuals with cognitive impairment, possibly preventing dementia onset. Further studies are warranted to solidify these connections.
HOW SPOUSAL BEREAVEMENT SHAPES LIFE SATISFACTION: STABILITY AND CHANGE ACROSS HISTORICAL TIME
Authors: Ghose Urmimala , Krämer Michael , Richter David , Wagner Gert , Infurna Frank , Ram Nilam , Gerstorf Denis
Published: December 2023

Lifespan psychological and life course sociological research have long shown that spousal bereavement constitutes one of the most stressful life events in older adulthood that is often associated with marked declines in well-being. It is an open question though whether and how the well-being implications of spousal loss have changed over the past decades. To do so, we used multi-year within-person longitudinal change data from 2,042 participants (Mage at event =65.73 years, 71% women) of the German Socio-Economic Panel obtained annually since 1984. We combine latent basis growth models with methods that analyze the Area under the Curve so as to consider the time window from five years prior to five years after spousal loss. Results revealed that having lost one’s spouse in the 2000s and 2010s is associated with overall less well-being declines than having lost one’s spouse in the 1980s and 1990s. Building on earlier approaches that have distinguished anticipation, reaction, and adaptation phases of bereavement revealed that such improvements are primarily driven by fewer declines in the anticipation phase and faster recovery in the adaptation phases (both by about 0.1 SD per 10 years of historical time), whereas we found partial evidence for steeper declines in the immediate reaction phase. We discuss and in part examine possible explanatory factors at the individual, spousal, social, and societal level for the observed historical improvements in life satisfaction trajectories surrounding spousal loss in Germany over the last three decades.
THE IMPACT OF COVID-19 CONCERNS ON OLDER ADULTS’ DEPRESSION: THE ROLES OF RACE/ETHNIC STATUS AND EDUCATION
Authors: Qu Shan , Burr Jeffrey
Published: December 2023

Framed within the Conservation of Resources Theory and the Cumulative (Dis)advantage Theory, this study examined the association between COVID-19 concerns (worries) and risk of depression among older adults. The study also investigated whether race/ethnic status and education moderated this relationship. We used a nationally representative sample of Americans over age 50 from the 2020 Health and Retirement Study. Depression was defined as having greater than or equal to three depressive symptoms, as derived from the 8-item Center for Epidemiologic Studies-Depression scale. COVID-19 concerns were measured with respect to respondents’ own health, the health of family members, respondents’ financial situation, the ability to get help from family, friends, or others during the pandemic, and concerns about the future; the study also included a summative index of these concerns. The associations between COVID-19 concerns and older adults’ depression were estimated with unadjusted and adjusted logistic regression models. Compared to respondents with lower scores on the COVID-19 concern measures (the index and the five domains), those with higher scores were more likely to be depressed. The moderation models showed the relationship between respondents’ concerns about what will happen in the future and depression was not as strong among non-Hispanic Black older adults compared to non-Hispanic White older adults. There was no statistically significant moderation effect for education. The results imply that healthcare providers should focus on vulnerable older adults to reduce disparities in access to resources during public health emergencies like the COVID-19 pandemic.
TRANSCRIPTOMIC ANALYSIS OF PROGERIA MODEL, KLOTHO KO MOUSE AND THE THERAPEUTIC EFFECT OF MITOCHONIC ACID 5
Authors: Tongu Yoshiyasu , Kasahara Tomoko , Abe Takaaki
Published: December 2023

Klotho is recognized as a protein that enhances longevity, and its deficiency leads to symptoms resembling progeria. The Klotho KO mouse displays several aging-related phenotypes similar to those observed in humans and typically dies by 8-10 weeks old. Klotho is expressed primarily in the kidney and the brain, which leads to severe progeria. We’ve recently developed a novel mitochondria-homing drug called Mitochonic Acid (MA)-5, which can penetrate the blood-brain barrier and is currently in Phase 1 clinical trials. A decline in mitochondrial function is a well-documented characteristic of aging and is considered a major factor in the aging process. To explore the potential benefits of MA-5 on aging-related symptoms, we administered the drug orally to Klotho KO mice from 4 weeks old and studied them until 7 weeks old. We observed that levels of uremic creatinine and BUN were elevated in the Klotho KO mice, but MA-5 treatment brought about significant improvements. Pathological examinations and snRNA-seq data suggest that kidney fibrosis caused by Klotho KO might be behind the renal dysfunction, and this is mitigated by MA-5. Furthermore, the result of snRNA-seq in brains shows the abnormalities occurring in the brains of Klotho KO mice which leads to progeria and the therapeutic effect of MA-5 on them. Given the role of mitochondrial dysfunction in aging symptoms, our drug presents as a promising candidate to treat age-related renal failure, and a range of other aging manifestations.
EXPLORING INTERSECTIONALITY IN SPIRITUAL EXPERIENCES DURING DISEASE OF OLDER ADULTS AND CAREGIVERS
Authors: Won Sarah , Regier Natalie , Kruahong Suratsawadee , Kim Changhwan
Published: December 2023

Spirituality is known to be an important contributor to older adults’ and caregivers’ psychological and physical well-being. Despite this significance, their spiritual aspects are often overlooked within the context of treating and managing disease. Moreover, limited evidence exists regarding what specific intersectional identities of older adults and caregivers have the potential to cause disparities in their spiritual well-being. Therefore, the purpose of this study was to identify the extent to which intersectionality has been considered within the literature concerning factors associated with the spiritual aspects (defined as spiritual needs, spiritual support, and spiritual well-being) of older adults and their caregivers. Consequently, a five-stage integrative review was conducted using the protocol proposed by Whittemore and Knafl. This process yielded a total of 543 articles identified in PubMed, Embase, Cochrane, CINAHL, PsycINFO, and Web of Science in March 2023. Following the application of inclusion/exclusion criteria, 18 articles were selected for data extraction. Finally, four themes related to intersectional considerations were found: 1) The potential role of intersecting multiple identities in differences in spiritual experiences; 2) Older adults and caregivers, the pre-existing identities, that intensify the likelihood of intersectionality leading to disparities in spiritual experiences; 3) The importance of spiritual perspective in addressing challenges derived from the intersections of multiple identities; 4) Recommendations for professionals to consider potential intersectional factors in research and clinical contexts to improve inclusiveness. Findings highlight the necessity of adopting an intersectional lens within both research and clinical domains to prevent overlooking any resulting variations in spiritual experiences.
IMPLEMENTATION & SUSTAINABILITY OF AGETECH TO SUPPORT AGING IN PLACE: PRACTICAL RECOMMENDATIONS FOR POLICYMAKERS
Authors: McNeil Heather , Genge Courtney , Freeman Shannon , Debergue Patricia
Published: December 2023

AgeTech, a subset of the health technology industry, uses technology to support healthy aging, and support care partners and health professionals to improve quality of life for aging adults. By enhancing and adapting alternative care approaches through emerging technologies, it is possible to enable and extend the ability for older adults to safely age in place within their own homes, improve care experiences, and/or decrease long-term care costs/needs. With the rapid development and proliferation of AgeTech into the consumer market, it is paramount for policymakers in the health system to ensure that AgeTech solutions can be leveraged to support older adults to age well in place. This poster highlights five key messages for policymakers. First, AgeTech should solve a real problem. Technology must be a solution that complements care of older adults, not complicates it. Second, it is essential to embrace a life course perspective on aging, recognizing the heterogeneity of older adults who experience diverse and evolving needs. AgeTech should adapt as needs and capacities evolve. Third, health related AgeTech should empower, enhance, or support existing health care services, while recognizing the value of human interactions. In-person interactions can provide meaningful connection and important health data which should be enhanced not replaced. Fourth, the establishment and ongoing fostering of authentic partnerships to inform, co-create and co-design AgeTech solutions is key to developing successful products. Finally, policymakers and funders have an important role to play in enabling accelerated design, development and testing to meet current and future needs.
IMPLEMENTATION SCIENCE IN THE DEVELOPMENT OF RECRUITMENT PROCEDURES AND MATERIALS: A CASE STUDY
Authors: Ulmer Cameron , Silbersack Johanna , Stratton Lauren , Fazio Sam , Zimmerman Sheryl
Published: December 2023

Recruiting long-term care organizations, administrators, and direct-care staff to participate in research has become increasingly challenging after the pandemic due to staffing shortages, limited resources, and numerous competing priorities. In light of these challenges, it is especially important to develop recruitment procedures and materials that are fine-tuned to the participant group based on best practices. This presentation will describe the use of implementation science principles and an expert focus group in the design of recruitment procedures and materials for a NIA-funded clinical trial “Evaluating a National Person-Centered Training Program to Strengthen the Dementia Care Workforce.” The project is especially well-suited to employ and critique best practices given that recruitment is at both the organizational-level (assisted living communities) and the person-level (staff within those communities). Recruitment materials were designed in accordance with the Considering Determinants of Diffusion, Dissemination, and Implementation of Innovations in Health Service Delivery and Organization conceptual model, which emphasizes highlighting the advantages of the training, how the training fits into existing systems, the process of training, the endorsement of organizational leaders, and the transfer of the knowledge conveyed by the training into practice. Best practices from the literature were discussed with a focus group of assisted living experts to evaluate the draft procedures and materials. This presentation will share the resulting procedures and materials and explain their evolution to their final form; the process and results are widely applicable to other clinical trials and other studies. Funded by a grant from the National Institute on Aging (R01 AG079124).
INDICATORS OF WELLBEING AND SELF- AND INFORMANT-REPORTED COGNITIVE DECLINE IN OLDER ADULTS
Authors: Britton Karysa , Hill Patrick , Bogdan Ryan , Oltmanns Thomas , Willroth Emily
Published: December 2023

Wellbeing has been associated with objective cognitive decline and is a promising target for dementia prevention. Less is known about associations between wellbeing and subjective cognitive decline (SCD), an early indicator for progression to Alzheimer’s Disease and related dementias (ADRD). Given the importance of early detection and intervention in ADRD, the current study assessed whether positive and negative indicators of wellbeing were associated with SCD via self- and informant-reports using zero-inflated Poisson regressions. A total of 1,014 participants (MAge=71.8, SD=3.1) were included in analyses. The sample was representative of both males (55%) and females (45%) and was racially diverse (65% White, 32% Black/African American, 2% other races). SCD was assessed with the AD8 Dementia Screening Interview (self- and informant-report versions), sense of purpose with the Life Engagement Test, life satisfaction with the Satisfaction with Life Scale, depressive symptoms with the Beck Depression Inventory-II, and loneliness with the UCLA Loneliness scale. Higher positive indicators of wellbeing were associated with lower SCD via self- and informant-reports. Higher levels of depression were associated with greater SCD via self-report. Higher levels of life satisfaction attenuated the association between depressive symptoms and SCD via self-report. These associations were statistically significant (p < .05) and held after applying False Discovery Rate correction. Effect sizes ranged from small to medium (ORPositive Wellbeing Indicators = 0.84-0.89, ORDepression = 1.34). These findings extend past wellbeing and objective cognitive decline research by demonstrating that positive and negative indicators of wellbeing are also associated with SCD assessed via self- and informant-reports.
INFLUENCE OF PHYSICAL THERAPY REHABILITATION ON FUNCTIONAL RECOVERY OF OLDER PEOPLE AFTER COVID-19
Authors: Ochiai Gabriela , Silva Erika Gouveia E , De Melo Daniella , Ramos Diêgo Araújo , Freitas Fabio Cavalcanti , Sousa Vivian Cintra , Schmitt Ana Carolina , Pompeu Jose
Published: December 2023

Retrospective cohort conducted through an online survey sent to older people (≥60 years) of both sexes, with confirmed diagnosis of Covid-19 registered in the Municipal Health Department of Sao Paulo, Brazil. Individuals with cognitive limitations and those who refused to participate were excluded. Functional capacity was assessed using Katz and Lawton Indices for pre-Covid, immediate post-Covid, and current time points, and characteristics of post-Covid physiotherapeutic rehabilitation were collected. Statistical analysis was performed using JASP-0.17.3 software, and group comparisons were made using repeated measures ANOVA, considering alpha=0.05. From March to August 2023, 86 individuals participated, with median age of 66.5 [62.3-71.0] and 57.0% (n=49) male. Among them, 39.5% (n=34) received recommendations for physiotherapeutic rehabilitation and 88.2% (n=30) of them were rehabilitated, while 11.8% (n=4) did not receive treatment. Older people with recommendation for physiotherapy post-Covid-19 demonstrated worse functional status (p< 0.001). Older people who received treatment were functionally equivalent to those who did not attend physiotherapy rehabilitation (p=1.000 for Katz Index and p=0.812 for Lawton Index). The primary indication for post-Covid-19 physiotherapy was muscular fatigue (70.0%, n=21), and domiciliary care was the predominant modality received (46.7%, n=14). Older people who were recommended for physiotherapy showed worse functional status after Covid-19, but there was no difference in long-term functional capacity. This suggests the potential importance of physiotherapeutic rehabilitation for functional recovery after Covid-19.
INTERACTION OF RESILIENCE AND DISTRESS IN THE ELDERLY-CAREGIVER DYADS: AN ACTOR-PARTNER INTERDEPENDENCE MODEL
Authors: Wang Anni , xiong zhiyao
Published: December 2023

Aims

The aim of this study was to explore the interaction between resilience and psychological distress in disabled elderly-caregiver dyads. Design: A cross-sectional descriptive study.

Methods

A total of 246 homebound disabled elderly individuals and their family caregivers from five provinces of China were investigated by convenience sampling using the Chinese version of the Resilience Scale and the Distress Thermometer and Problem List. Data analysis was conducted using the actor-partner interdependence model (APIM) method and based on structural equation modelling.

Results

The effect of resilience on psychological distress shows a mixed pattern. With regard to the actor effect, the resilience of disabled elderly individuals and caregivers was negatively related to their own psychological distress. Regarding the partner effect, the resilience of disabled elderly individuals was negatively associated with caregiver psychological distress, and the resilience of the caregiver was negatively associated with the psychological distress of the disabled elderly individual.

Conclusion

There is a dyadic interaction between disabled elderly individuals and their caregivers, suggesting that resilience can relieve not only one’s own psychological stress but also that of others to some extent. Health professionals can design dyadic interventions that focus on resilience and its dyadic interaction and effectively leverage the resilience advantages of the dyad based on the individuals’ level of psychological distress to improve the mental health of elderly people with disabilities and their caregivers.
INVESTIGATING THE EFFECTS OF PM2.5 ON DEMENTIA RISK: A CASE-CONTROL SWEDISH TWIN REGISTRY STUDY
Authors: Parkinson Luisa , Karlsson Ida , Ericsson Malin , Tomlinson Sam , Lindgren Finn , Russ Tom , Finkel Deborah , consortium LifeGEIST
Published: December 2023

There is growing evidence that air pollution, and particularly PM2.5, is associated with dementia risk around the time of diagnosis. However few studies are able to investigate longer term effects of air pollution due to a lack of historical air pollution data. In this study we use PM2.5 data for Sweden available at 5-yearly intervals to investigate the short and longer term effects of PM2.5 on dementia risk. A case-control data set from the Swedish Twin Registry with dementia ascertained from hospital admissions between 1990 and 2015 and municipality of residence available at time of admission was analysed using hierarchical spatial models with R-INLA. The analyses show a relative risk of dementia per 5µg/m3 PM2.5 of 1.43 (95% confidence interval: 1.13-1.80), 1.36 (1.14-1.64), 1.31 (1.11-1.54) and 1.04 (1.00-1.09) for 0-5, 6-10, 11-15 and 16-20 years prior to diagnosis respectively. The cumulative effect over 0-20 years prior to diagnosis of an annual 5µg/m3 increase in PM2.5 on the relative risk of dementia is 1.19 (1.06-1.34). The clear association between PM2.5 and dementia risk for up to 20 years prior to diagnosis suggests that there are long term effects of air pollution on dementia risk. For these analyses only one residential location was available, so the uncertainty about an individual’s residential location increases with time prior to diagnosis. To fully understand the effects of air pollution on dementia risk a life-course approach in a data set with lifetime residential history and access to historical air pollution data will be necessary.
INVESTIGATING THE IMPACTS OF METFORMIN ON AGING AND LIFESPAN IN DIVERSITY OUTBRED MICE
Authors: Yuan Rong , Zhu Yun , Frungieri Monica , Masternak Michal , Bartke Andrzej
Published: December 2023

Metformin, a type 2 diabetes treatment, has profound effects on regulating development, metabolism, and aging acting via the mTOR/autophagy pathway. Nevertheless, its potential to extend lifespan and counteract aging remains an open question. Previous research highlighted the intricate interplay between genetic background, gender, and treatment commencement age in shaping outcomes. To examine the long-term effect of metformin on aging and lifespan, this project utilizes the diversity outbred (DO) mice, initially derived from the interbreeding of eight inbred strains, effectively emulating the intricate genetic complexity found in humans. Initiated at 2 months old, DO mice were subjected to metformin-infused food [0.1%, w/w] (n=15 and 14, females and males respectively) or a metformin-free counterpart (n=10 for both sexes). Starting from 12 months of age, a statistically significant increase in male body weight was observed within the metformin-treated group, while no significant effect was found in females. Indirect calorimetry assays revealed a significantly elevated respiratory ratio in both sexes of metformin-treated mice. Surprisingly, at the age of 12 months, metformin treatment significantly impaired glucose tolerance in females, whereas in males, pyruvate and insulin tolerance exhibited significant reductions. After the first submission deadline, by 16 months of age, two females died in each of the treatment and control groups. Notably, the metformin-treated male cohort lost four individuals, but no mortality in the control male cohort (P=0.07, log-rank test). These preliminary findings underscore a potential deleterious impact of metformin on metabolic traits and lifespan when initiated from a young age, particularly in male mice.