bluuebunny/crossref_metadata_2025 huggingface dataset:
INVESTIGATING FORMAL SERVICE UTILIZATION IN CAREGIVERS OF PERSONS LIVING WITH DEMENTIA
Authors: Falzarano Francesca , Bloom Rachel , McCarthy Megan , Osso Francesco
Published: December 2023

In the United States, no acceptable alternatives exist to the heavy reliance on family caregivers in maintaining the long-term services and supports system. Despite their vital role, caregivers of persons living with dementia (PLWD) are often overlooked in healthcare encounters and their needs remain unaddressed, which can lead to deleterious impacts on the caregiver’s health, well-being, and capacity to provide adequate care. Although formal services and resources to assist caregivers of PLWD exist, there is a concerning disconnect between referral and service use uptake – largely due to a siloed, bureaucratic health system in addition to caregivers’ lack of knowledge, awareness, applicability, and access. However, the individual and psychosocial factors that influence attitudes toward and utilization of services remain unclear. Thus, the purpose of this study was to examine correlates of formal service use using data from an NIA-funded mixed-methods study of 46 caregivers of PWLD (Mage=55.9, SD=16.3). Across all domains queried (e.g., home health aides, adult day programs) at least 50% of the sample reported lack of use. Caregivers cited concerns regarding lack of trust, safety of the care-recipient, lack of flexibility, and cost as service barriers. Spousal, compared to adult-child, caregivers had more negative perceptions regarding formal services. Further, greater functional dependency, higher pre-loss grief, and lower levels of self-efficacy and preparedness were associated with more negative attitudes toward service use. These results underscore the importance in ascertaining the holistic needs of caregivers to inform more tailored efforts to connect caregivers’ unique needs to relevant services.
THE POTENTIAL AND PITFALLS OF TELEHEALTH TO SUPPORT AN AGING POPULATION
Authors: Boot Walter
Published: December 2023

As the population ages, telehealth services are becoming increasingly prevalent and important to help support older adults’ aging in place and manage their health at a distance. However, older adults often face barriers such as technology proficiency, physical and cognitive capacity, and lack of technical support to access and use telehealth. Designers and researchers need to design and evaluate telehealth interventions tailored to older adults’ needs to ensure these technology-based solutions meet their potential. This session will present a variety of technology-based research exploring the development, evaluation, and implementation of telehealth programs and interventions to better support older adults aging in place. L. Moo will present quantitative and qualitative data on challenges veterans experienced with clinical pharmacists’ video visits. L. Adepoju will present factors associated with in-person-only, telemedicine-only, and hybrid healthcare visits among older adults. P. Freddolino will present an evaluation of a telehealth 101 mini-course offered to older adults. F. Abujarad will discuss the development and evaluation of a digital health intervention (VOICES) to increase elder mistreatment identification. Finally, M. Gately will describe a study of person factors and environmental factors on older adults’ capacity to participate in video telehealth sessions. Older adult barriers and areas of improvement in telehealth design will be discussed throughout this session.
FEASIBILITY OF A DIGITAL ELDER MISTREATMENT INTERVENTION FOR COGNITIVELY IMPAIRED OLDER ADULTS
Authors: Abujarad Fuad , Edwards Chelsea , Neugroschl Judith , Hwang Ula , Marottoli Richard
Published: December 2023

Older adults with cognitive impairments (CI) are at a higher risk for experiencing elder mistreatment (EM) and are less likely to report. Research is limited for self-administrated digital screening in this population, and generally focus on provider-based solutions to increasing EM identification. We developed a digital health intervention, VOICES, to increase EM identification. VOICES combines educational resources, screening, and brief psychoeducational interviewing to encourage older adults to self-report. We recruited participants with CI at a geriatric outpatient center (N=30) and the emergency department (ED) (N=101) to examine feasibility. Most participants could use VOICES independently (Montreal Cognitive Assessment (MoCA) scores ranging from 14-25). 87% of ED participants felt VOICES was appropriate for use in the ED, and 97% felt that the digital coach instructions were easy to understand. Our results suggest that the VOICES is feasible for EM screening in older adults with CI, specifically with MoCA scores ranging from 14-25.
WHAT MATTERS TO CHINESE AND KOREAN DEMENTIA CAREGIVERS: INFORMING THE CULTURAL ADAPTATION OF THE NYUCI-ES PROGRAM
Authors: Wang Jing , Wu Bei , Johnson Min Kyoung , Leong I tek , Pei Yaolin , Epstein Cynthia , Cho Soyeon , Mittelman Mary
Published: December 2023

Family caregivers of persons with dementia (PWD) undertake an extensive amount of care and many are challenged by heavy caregiving burden and their own health problems. The New York University Caregiver Intervention (NYUCI) program has demonstrated effectiveness in multiple studies among largely Caucasian samples in improving the wellbeing of caregivers of PWD by decreasing their levels of depression and stress and improving self-reported health. As two large Asian immigrant population in the U.S., Korean and Chinese American caregivers of PWD have unique challenges impacted by their cultural background. However, there are limited studies on what can be done to support them in a culturally sensitive way. The current study aims to inform the cultural adaptation of the program for Chinese and Korean caregivers with multiple chronic conditions by exploring their perspectives to understand their unique challenges, unmet needs, and the best ways to support them in caregiving and engage them in selfcare. We interviewed 14 Chinese and 11 Korean caregivers living in the New York Metropolitan Area. We compared themes mentioned by both groups and found that cultural beliefs profoundly impact their perceptions of dementia and caregiving, their way of utilizing social and family support, and understanding of self-care and counselling services. Caregivers are facing and addressing new challenges during and after the Pandemic, providing insights into how we can use technology and telehealth to assist them in caregiving and coordinating support from others. Our findings provided implications to culturally adapt the NYUCI program to culturally diverse populations.
THE VALUE OF INTERNSHIPS IN CREATING AN AGE-SAVVY WORKFORCE
Authors: Donorfio Laura
Published: December 2023

As the 65+ population continues to grow, so too does the need for an age-savvy workforce. There is not a field or profession that will not intersect in some way with older adults (Karasik, Donorfio, & Greenberg, 2023). Current work shortages and forecasts, however, raise considerable concern for a sustainable and adequately prepared workforce. With regard to preparation, gerontological field placements, internships, and practicums are becoming increasingly instrumental to workforce development. Both the Gerontology Competencies for Undergraduate and Graduate Education (2020) and AGHE’s Gerontology and Geriatric Curricular Standards and Guidelines (2021) strongly recommend internship, practicum, and/or field work experiences for students at all levels. Fostering a successful intergenerational experience, however, can be challenging. In this presentation, key components, core elements, necessary steps, best practices and logistical considerations will be discussed. For example, who are the key players and what are their roles in such experiences? What needs to happen at the programmatic and curricular levels? In addition to exploring the various facets of gerontological field placements, attention will be given to utilizing AGHE’s Standards and Guidelines and Gerontology Competencies to help identify several “interactional competencies” that relate to internships, practicums, and field experiences. This session also serves as an introduction to the range of perspectives (student, faculty, community agency) that follow.
SOCIAL NETWORKS: BUILDING RESOURCES FOR DIVERSE AGING FAMILIES
Authors: Ajrouch Kristine , Antonucci Toni
Published: December 2023

Social networks provide tangible resources for older adults and their families. Yet, their formation and characteristics may vary across diverse aging contexts. Friedman and colleagues examine multiple dimensions of caregivers’ networks using a nationally representative sample (N=2,176). Latent profile analysis identified three classes of caregiving networks: (1) Large, sparse networks with relatively few kin and only some people who assist with caregiving tasks for care recipients; (2) Moderately-sized, somewhat dense, kin-based networks; (3) Small, very dense family networks where caregiving is shared across network members, all of which uniquely influence caregiver well-being. Hu and colleagues evaluate measurement invariance of objective and subjective social isolation between US-born and foreign-born older adults using a regionally representative sample (N=611). Findings show indicators of social network structure and perceived relationship quality may be useful for examining social isolation among older immigrants. Ajrouch and colleagues show distinct dimensions of networks differentially influence older adult’s cognitive function. Larger networks and higher proportion of family are positively related while higher contact frequency is negatively related to cognitive function. Using data from the Detroit-based Social Relations Study, Webster and Chin show the extent of similarity in health-related behaviors between older adults and their closest social network members. Analysis of 247 dyads illustrate associations between multiple social network factors (homophily, structure, and relationship quality) and similarity in these behaviors. Together, these papers advance theoretical and methodological approaches to the ways in which social networks serve as a resource across diverse aging contexts.
BIOPSYCHOSOCIAL DETERMINANTS OF COGNITIVE FUNCTION AMONG BLACK OLDER ADULTS
Authors: Thierry Amy
Published: December 2023

Black older adults in the United States have twice the risk of being diagnosed with Alzheimer’s disease and related dementias than their white counterparts. However, there remains a gap in knowledge of which factors may contribute to this disparity as well as mechanisms that either increase or decrease risk for poor cognitive outcomes, specifically in older Black adults. This presentation will highlight recent interdisciplinary population health research on the biopsychosocial determinants of cognitive function among Black adults 65 years and older in the Health and Retirement Study. Using within-group regression analyses, studies examine associations between multiple measures across neighborhood, psychosocial, and biomarker domains with cognitive function, measured by Telephone Interview for Cognitive Status scores (range: 0-35) which captures memory and overall mental status. We find that high neighborhood disorder and low social cohesion were associated with worse cognitive function, especially for more highly educated Black older adults and those living in urban communities. Greater frequency of experiences of everyday discrimination among Black older adults was also related to lower cognitive function. Volunteering and having a high sense of purpose in life were associated with better cognitive function for older Black men and women, while being physical active was associated with increased cognitive function for older Black women. C-reactive protein, a measure of systemic inflammation, was positively associated with cognitive function. Overall, this body of work demonstrates the need to further critically assess both risk and resilience processes underlying cognitive function among older Black adults towards reducing current cognitive health inequities.
CYCLICAL MIGRATION IN ALASKA NATIVE ELDERS AND ITS IMPACT ON ELDERS’ IDENTITY AND LATER LIFE WELL-BEING
Authors: Lewis Jordan , Kim Steffi , Asquith-Heinz Zayla , Thompson Lena
Published: December 2023

This paper outlines a unique culturally driven cyclical migration of Alaska Native Elders. This Indigenous cyclical migration is distinct from other previously described mobility observations in that Elders spend extended time in more than one community. We describe the cyclical migration of Alaska Native (AN) Elders and its influence on the Elders’ identity, health, and well-being. Employing a life course perspective and social theory of migration, inductive content analysis was employed to identify themes related to Elders’ cyclical migration between rural and urban communities and the impact on their identity, health, and well-being. Interviews with 125 AN Elders were conducted across five regions of Alaska: Bristol Bay, Interior, Norton Sound, Aleutian Pribilof Islands, and Southcentral. AN Elders traveled between rural and urban communities to access resources and connections critical to their identities, health, and well-being. Urban Elders maintained a connection to rural villages because they perceive them as healthier places to age based on access to traditional practices, land, and the community. Rural Elders spent extended time in urban settings to access health care services, be closer to family, and to benefit from the lower costs of living. This study builds upon existing migration theories by introducing a cyclical pattern uniquely driven by AN identity, culture, and traditional practices. Findings illustrate how AN communities can support Elders who experience cyclical migration patterns to ensure they age successfully in both locations. Future recommended research should explore cyclical migration patterns among other Indigenous populations with histories of migration.
INDIGENOUS CULTURAL GENERATIVE ACTS TO REDUCE GENERATIVE MISMATCH AND IMPROVE HEALTH OF ALL GENERATIONS
Authors: Lewis Jordan
Published: December 2023

The gerontological literature predominantly focuses on aging-related losses and less on the gifts we acquire as we age. Alaska Native Elders have experienced a lifetime of adversity, which persists today, but they have also remained resilient. One characteristics of successful aging among Alaska Native Elders is their commitment and passion for sharing their teachings with the youth. Generativity is concerned with using personal resources to improve the quality of life for future generations. While not commonly used in gerontological social work research, it is a cultural practice among Indigenous Elders. This decade long study has been exploring the concept of successful aging from an Alaska Native perspective, or what it means to age in a good way in Alaska Native communities. Qualitative, in-depth, interviews have been conducted with 154 Elders representing 20 participating communities across the State of Alaska to explore the concept of successful aging and the role of generativity in the aging process. For this presentation, 108 interviews with Alaska Native Elders explored successful aging. This presentation will highlight the critical role generativity plays in Alaska Native Elders’ ability age in a good way, how generativity can be adapted to bridge the generative mismatch happening between generations and support each generation to healthy and meaningful lives. This presentation will also explore innovative and culturally responsive ways to teach the youth about aging in a good way and how families and communities can support their Elders to be meaningful engaged in the rapidly changing families in the Arctic.
LOCAL ADAPTATIONS OF HIH: VARIATIONS IN STRUCTURE AND IMPLEMENTATION OF HIH MODEL ACROSS SIX VA PROGRAMS
Authors: Samant Akanksha , Park Sungjae , Franzosa Emily , Sullivan Jennifer , Dadgostar Porooshat , Darcy Derek , Hung William
Published: December 2023

A number of Department of Veterans Affairs (VA) medical centers have adopted the Hospital-In-Home (HIH) model of care to provide at home services to Veterans requiring acute-level hospital care. We aimed to identify similarities and variations in structure and implementation of the HIH model across VHA sites. Of 11 programs, six (55%) used a standardized presentation template to present their specific program characteristics, outcomes and goals at monthly national program meetings. Presentations were transcribed and abstracted into themes by two reviewers. Programs varied in their staffing, services provided, referral sources and clinical outcome metrics. While one site provided in person visits, 3 reported program adaptations such as virtual follow-up visits for COVID patients. Review of clinical outcome metrics also revealed substantial site to site variations including 30-day readmission rates, cost avoidance, bed days or emergency department visits. All sites offered complementary (from hospital) and substitutive (from other than hospital) HIH stays. Substitutive stays varied across referral sources admitting patients from emergency departments, outpatient clinics, home based primary care and inpatient settings. Additionally, variations in catchment area (driving distance), and staffing in the parent stations highlighted differing contexts of HIH programs. We hypothesize that variations among sites may exist due to factors such as the setting and unique needs of the population and facility. An in-depth understanding of the contextual factors that influence implementation can be achieved through interviews with key staff from each site. Future work will examine if such variations are related to program outcomes.
CORTICAL CONTROL OF MOBILITY: MOVING TOWARD CLINICAL OUTCOMES AND INTERVENTIONS
Authors: Rosso Andrea , Tian Qu , Kritchevsky Stephen
Published: December 2023

A three-year series of pre-conference workshops at GSA a decade ago brought together leading scientists in the multidisciplinary field of brain, aging, and mobility. Since then, the field has advanced the understanding of motor control as a predominantly subcortical phenomenon to the attentional and cortical control of mobility and has extended the view of cognitive and motor functions as distinct to there being shared causes of cognitive and mobility declines. Emerging studies are further elucidating mechanisms of motor control (Holtzer, Baillargeon), demonstrating relations with important clinical outcomes, including dementia (Tian) and community mobility (Rosso), and exploring novel interventions on clinical and neurophysiological outcomes (Kahya), as demonstrated by the series of talks in this symposium. Roee Holtzer assesses prefrontal cortex efficiency over repeated trials of attention-demanding dual-task walking in older adults with and without multiple sclerosis. Emma Baillargeon explores the heterogeneity of prefrontal responses to walking among older adults and describes the relation of prefrontal response with performance metrics. Qu Tian demonstrates trajectories of gait variability measures over time predict future dementia risk. Andrea Rosso investigates prefrontal activation as a biomarker of gait automaticity and its relation to community mobility. Finally, Melike Kahya demonstrates brain stimulation through transcranial direct current stimulation as a potential intervention to improve standing balance during cognitively challenging tasks and examines the mechanisms of its action through dual-task cost and electroencephalograph (EEG) recordings. Together, these studies will provide an overview of the current understanding of cortical control of mobility and its implications for clinical outcomes and interventions.
OLDER ADULT RESEARCH SPECIALISTS SEEK ENCORE CAREERS PROMOTING THE INCLUSION OF OLDER ADULT PEERS IN CLINICAL TRIALS
Authors: Nearing Kathryn , Waterhouse Jodi
Published: December 2023

The University of Colorado Multi-disciplinary Center on Aging trains and promotes the hiring of older adults from diverse backgrounds to pursue encore careers as Older Adult Research Specialists (OARS). Health navigation training is the foundation of these research navigators’ unique preparation for paid positions that focus on recruiting and retaining older adult peers in clinical trials. Specifically, OARS’ roles include: 1) developing effective communication and outreach strategies to engage older adult peers in research; 2) recruiting and consenting participants for clinical trials; 3) supporting retention by identifying barriers to study participation and connecting research participants with needed community-based resources/support; 4) educating research teams on key considerations for including older adults in research; and, 5) catalyzing research innovations to increase representation in, and the relevance and translational potential of, research for improved clinical and community-based practice. OARS, whose average age is 69 (range: 58-80), diversify our research workforce and enhance our capacity to include older adults -- an underrepresented population -- in clinical research. This initiative is advancing our Age-Friendly University work to promote encore careers, foster intergenerational learning, and catalyze research innovation. Ultimately, we aspire to increase the generalizability of research findings to improve healthcare and health outcomes for older adults by promoting the inclusion of older adults in our research workforce and in research studies to enhance the benefits to older adults of new drugs, devices and behavioral health interventions. During this session, we will share our training curriculum, how we created pathways to employment and our program outcomes.
THE EFFECTS OF PARTNERS’ HAPPINESS ON EACH OTHER: AN ACTOR-PARTNER INTERDEPENDENCE MODEL
Authors: Abaei Elnaz , Martin Peter
Published: December 2023

The study of happiness among older adults has attracted the attention of researchers and practitioners. Happiness is affected by multiple factors, including the relationship with a partner, as they spend more time together in later life. This research aims to evaluate an actor-partner interdependence model, assessing the association of respondent and spouse happiness affecting each other over time. A second aim is to examine the effect of age, gender, education, and whether parents are alive on the respondents’ and their spouses’ happiness. About 9,570 individuals over 50 years of age from the Health and Retirement Study (HRS) and their spouses were included. Respondents’ and their spouses’ happiness measured at two time points were included in the analysis, as were age, gender, education, and the parents’ living status. Multiple regression analyses in SPSS were computed, and the results demonstrated that past happiness is directly associated with present happiness for both respondents and spouses. Respondents’ happiness was also significantly associated with spouses’ happiness, as spouses’ happiness was associated with respondents’ happiness. Furthermore, older age, male gender, and higher education were associated with happiness. Parents’ living status was significantly related only to respondents’ happiness at the first time point, but not to spouses’ happiness. This study helps to understand an actor-partner interdependence model, which highlights partners’ influences on each other’s subjective well-being. Our exploratory study raises several opportunities for future research regarding the actor-partner interdependence model. More research will be necessary to find further variables affecting happiness among older adults.
MULTIPLE MEASURES OF FITNESS ASSOCIATION WITH MUSCLE MRNA SPLICING VARIANTS IN THE GESTALT STUDY
Authors: Donega Stefano , Banskota Nirad , Gonzalez-Freire Marta , Zenobia-Moore Ann , Ubaida-Mohien Ceereena , Fishbein Ken , De Supriyo , Ferrucci Luigi
Published: December 2023

Regular physical activity has been associated with higher skeletal muscle mass and strength as well as better mitochondrial function. Previous studies in master octogenarian athletes found a higher content of mitochondrial- and reduced spliceosome proteins compared to non-athlete age/sex-matched controls. These findings suggest that higher mitochondrial function is associated with down-regulation of the spliceosome. In this study we aimed to detect mitochondrial respiration associations with expression of specific genes and differentially spliced isoforms. We performed RNA-seq from vastus lateralis skeletal muscle biopsies in 82 male/female participants in the GESTALT study (Genetic and Epigenetic Signatures of Translational Aging Laboratory Testing). We correlated gene expression, transcript usage and splicing events with I) self-reported level of physical activity in daily life, II) peak oxygen consumption assessed during an incremental treadmill stress testing, III) muscle oxidative capacity assessed by p31 MR Spectroscopy and IV) mitochondrial-respirometry assessed on permeabilized muscle fibers, using regression models adjusted for age, gender, and batch. Except for IV), all three mitochondrial measures positively correlated with each other, and were downregulated along the Aging axis. We detected 423, 219, 178 and 226 differentially expressed genes (p-value<0.01), respectively for the 4 mitochondrial fitness measures. Gene-set-enrichment analysis (GSEA) detected up-top TCA cycle and mitochondrial respiration kPCr and mito-respirometry detected the highest number of AS events (448 and 412). Dissimilarities among transcriptomic profile associated to these four bioenergetic outcomes provide insight into the biological mechanisms that connect them to mitochondrial function and suggest that mitochondrial function is not the only correlate of movement behaviors.
THE PROMINENT ROLE OF HOME CARE AIDES IN END-OF-LIFE CARE DURING A PUBLIC HEALTH EMERGENCY AND BEYOND
Authors: Kim Patricia , Franzosa Emily , Moreines Laura , Boafo Jonelle , David Daniel , Brody Abraham , Aldridge Melissa
Published: December 2023

Many patients and families rely on paid aides to provide personal care services at the end of life, but the COVID-19 pandemic caused widespread delays and disruption in this care. Our study examined COVID-related care disruptions among patients in a large, New York City health system who died between March 1, 2020 and March 1, 2021. We linked the electronic health records of 124 patients cared for by a geriatric outpatient practice and referred to hospice to the hospice’s electronic health records, and conducted an in-depth qualitative thematic analysis. We found many home health aides continued caring for existing patients after hospice enrollment, often in tandem with hospice aides. But, patients and families experienced disruption in both usual and hospice aide services due to patient or aide illness, COVID isolation policies, and the exacerbation of ongoing workforce shortages. Aides experienced emotional strain and escalation of care responsibilities including the provision of more clinically-focused end-of-life tasks (e.g., wound care, oxygen administration) usually performed by hospice nurses. When the hospice team was unable to provide home visits, the aide became the primary source of patient information. Hospice staff supported aides in care tasks and provided emotional and spiritual care, often virtually, to aides and patients’ families. Findings highlight the critical role of aides within the care team and its intensification in a crisis, suggesting opportunities to better integrate aides into hospice care teams while providing formal training and support to help aides manage end of life care tasks and emotional demands.
PRESIDENTIAL SYMPOSIUM: BUILDING BRIDGES ACROSS THE SCIENCES TO CATALYZE SLEEP DISPARITIES RESEARCH
Authors: Lincoln Karen , Lincoln Karen
Published: December 2023

This BSS Presidential Symposium brings together scholars from Sociology, Social and Family Dynamics, Human Development and Family Studies, Occupational Science and Medicine to highlight a multidisciplinary approach to sleep disparities research. Sleep is essential for restoration of healthy brain function, the immune system, and overall physical and emotional well-being. Conversely, sleep deficiencies are associated with a wide range of poor physical and emotional health outcomes, health behaviors and premature mortality. Strong empirical evidence indicates that sleep health is socially patterned, such that minoritized populations are generally more likely to experience sleep disruptions, disorders, and difficulties. These sleep deficiencies are also observed across indicators of socioeconomic status, such as income and educational attainment. Despite documentation of sleep disparities, studies that examine underlying health disparity causal pathways contributing to sleep health disparities are limited. This symposium is aligned with recommended strategies to address sleep health disparities from the National Institutes of Health, including: a) develop and promote integrative research on sleep health disparities, b) investigate the health and social causes and consequences of sleep health disparities, and c) develop multilevel, culturally tailored interventions to address sleep health disparities. By placing people and place at the center of their research, these scholars demonstrate their approach to addressing current research gaps, challenges and opportunities in sleep and health disparities research among middle-aged and older adults that are important to advance this emerging field.
SLEEP DISORDERS AND RISK OF MID- TO LATE-LIFE SUICIDE ATTEMPT
Authors: Byers Amy , Dolsen Emily , Li Yixia , Gibson Carolyn , O’Donovan Aoife , Neylan Thomas , Kuffel Randall
Published: December 2023

Sleep is a compelling target for suicide prevention in later life, as 50% of older adults experience sleep difficulties. The primary objective of the current study was to evaluate whether sleep disorders increase risk of late-life suicide attempt and death by suicide. We examined a nationally based cohort of over 5 million US veterans 50 years and older, who used Department of Veterans Affairs (VA) health services. Veterans with a sleep diagnosis (i.e., sleep apnea, insomnia, hypersomnia, and others) at baseline (October 1, 2011, to September 30, 2013) or earlier (October 1, 2007, to September 30, 2011) were propensity matched 1:1 with patients without these diagnoses based on demographic characteristics and Charlson Comorbidity Index (Total N=1,990,362; 995,181 each group). Secondary analyses examined psychiatric disorders as potential moderators. Fully adjusted models (additionally adjusted for psychiatric disorders) demonstrated that patients with sleep disorders had a 23% increased risk of any suicide attempt (HR 1.23, 95% CI [1.20-1.27]), while risk mitigated for lethality of attempt (HR 0.98, 95% CI [0.92-1.03]). Depression, PTSD, and generalized anxiety disorder were all approximately twice as prevalent among the sleep disorder group. Among veterans with a psychiatric disorder, any sleep disorder diagnosis was associated with a 28% increased risk for suicide attempt, which attenuated among those without a psychiatric diagnosis. In conclusion, sleep disorder diagnoses conferred increased risk for suicide attempt, especially in older adults with psychiatric disorders. These findings suggest that treatment of sleep disorders may mitigate risk of suicide attempts in older vulnerable veterans.
DISASTER PREPAREDNESS OF COMMUNITY-DWELLING OLDER ADULTS
Authors: Peterson Lindsay
Published: December 2023

Older adults who depend on others for care are especially vulnerable to harm in a disaster. However, the extent to which they are protected depends on the setting in which they live. State and federal regulations require nursing homes and assisted living communities to have preparedness plans that specifically address the needs of their residents. For older adults living at home, however, protections are far less prescriptive, and in some cases lacking altogether, despite the increasing numbers of disabled older adults receiving care in their homes. In this policy-based study, we examined disaster preparedness for community-dwelling older adults in high-disaster states with high populations of older adults. We found that while many of the states required home-based providers to respond to the post-disaster needs of their older adult clients, few took steps to ensure that before the storm they were prepared. In this study, the state of Florida was an exception, with policies calling for service providers to identify and contact at-risk clients before and after an event. The plan further identifies disaster preparedness as a key component of a livable community. Hurricane Ian struck Fort Myers, Florida, in September 2022. Older adults made up a majority of the 148 killed during and immediately after the storm. Many others lost their homes. In the context of this recent event, we will discuss not only the state and local policies, but the practices that affect the health and well-being of community-dwelling older adults faced with a major disaster.
PSYCHOTROPIC MEDICATION USE AND CHANGES DURING THE HOSPITAL STAY
Authors: Galik Elizabeth
Published: December 2023

The purpose of this study was to build on prior research and describe the current use of psychotropic medications among the first 365 older hospitalized patients living with dementia participating in a study focused on optimizing physical activity [The Function Focused Care for Acute Care Using the Evidence Integration Triangle Study (FFC-AC-EIT)] and consider the impact of current recommendations for decreasing use of psychotropics. It was hypothesized that controlling for age, gender, race, comorbidities, cognition, and hospital site (exposure or not to the Function Focused Care Intervention), that there would be a decrease in use of psychotropic medications from admission to discharge. Age, gender, race, comorbidities, admitting diagnosis, and medications (antidepressants, antianxiety medications, anticonvulsants, dementia drugs, antipsychotics, sedative-hypnotics, and opioids) were obtained at baseline and medications were obtained as well at discharge. To compare change over time generalized estimating equations were used. The participants were mostly female (63%), White (69%), and 83.06 years (SD=7.90) old. There was no treatment effect. Antidepressant, antianxiety, anticonvulsant, dementia medication, sedative hypnotic and opioid use remained unchanged. Antipsychotic medication use increased significantly from 16% to 21% at discharge. Some changes were made across drug groups such as change from haloperidol to second generation antipsychotics to decrease risk of side effects. A more focused deprescribing intervention is needed to best address psychotropic medication use among individuals living with dementia when hospitalized.
VISUALIZING AGING EQUITY: CROSS-SECTORAL PARTNERSHIPS TO CREATE MAPPING TOOLS FOR SOCIAL CHANGE
Authors: Scher Clara , Greenfield Emily , Harrell Rodney
Published: December 2023

This symposium will feature ways in which gerontologists are advancing the development of online, interactive mapping tools on aging. Utilizing GIS mapping technology and leveraging cross-sectoral partnerships, the speakers will present case illustrations of efforts to develop aging-focused mapping tools that aggregate data sources at the municipal, state, and national levels to advance a spatial awareness of supports for older adults across diverse communities. First, as an example from the nonprofit sector, the New York Academy of Medicine will present on IMAGE:NYC, The Interactive Map of Aging. This presentation will describe the utility of this tool for policymakers, planners, researchers, and social service providers. Representing work from within the academic sector, the Rutgers School of Social Work will describe an academic-public sector partnership to adapt the IMAGE:NYC map for two counties in New Jersey. Next, presenters from the University of North Texas will describe their partnership with the City of San Antonio to develop an intelligent demand responsive transportation system for older adults and individuals with disabilities. This project involves the use of GIS mapping tools and qualitative research methods to identify place-based transportation gaps and strategies for improvement. Focusing on the national level, the National Council on Aging will describe its work developing mapping tools, including a map that displays area-level rates in eligibility gaps for three federal benefit programs. With an orientation to aging equity, these tools hold promise for fostering inclusive and healthy communities where older adults of diverse intersectional socio-spatial positions can age well. This is an Environmental Gerontology Interest Group Sponsored Symposium.
DEVELOPING AN INTERACTIVE COUNTY MAPPING TOOL TO ADVANCE AGE-FRIENDLY PROGRESS IN NEW JERSEY
Authors: Greenfield Emily , Scher Clara , Alexander Karen , Fetzko Joanne , Marxen Lucas , Pestine-Stevens Althea , Topchishvili Davit , Pagan Michael
Published: December 2023

This presentation will describe how a multidisciplinary team at Rutgers, The State University of New Jersey, leveraged a small, internal grant opportunity to partner with leaders of two County government systems to develop a “proof of concept” age-friendly County mapping tool. Based on the Image:NYC mapping tool, the team designed the tool to display the spatial locations of high concentrations of older adults with shared characteristics (e.g., by health status, income) alongside the spatial locations of assets in local communities (e.g., libraries, senior activity centers) at the census tract level within each of the two counties. The presenters will explain how gerontological expertise—in combination with insights, data, and resources from other disciplines and project contributors—were essential to design, produce, and disseminate the map. The presenters will describe how the mapping tool is one component of a growing body of work across the public, private, and academic sectors in New Jersey to advance and support the age-friendly communities movement. The presenters also will reflect on how the age-friendly mapping tool has served to kickstart age-friendly planning and systems change at the county level, with implications for advancing both state- and municipal-level efforts.
TRANSETHNIC META-ANALYSIS OF INTERACTIONS BETWEEN GENETICS AND EARLY-LIFE SOCIOECONOMIC CONTEXT ON COGNITION
Authors: Faul Jessica , Kho Minjung , Zhao Wei , Rumfelt Kalee , Yu Miao , Mitchell Colter , Smith Jennifer
Published: December 2023

Later-life cognitive function is influenced by genetics as well as early- and later-life socioeconomic context. However, few studies have examined the interaction between genetics and early childhood factors. Using gene-based tests (interaction sequence kernel association test [iSKAT]/iSKAT optimal unified test), we examined whether common and rare variants in 39 gene regions previously associated with cognitive performance, dementia, and related traits had an interaction with childhood socioeconomic context (parental education and financial strain) on memory performance or decline in European ancestry (EA, N = 10,468) and African ancestry (AA, N = 2,252) participants from the Health and Retirement Study. Of the 39 genes, 22 in EA and 19 in AA had nominally significant interactions with at least one childhood socioeconomic measure on memory performance and/or decline; however, only one, SLC24A4 x father’s education, remained significant after multiple testing correction (false discovery rate [FDR] < .05). In trans-ethnic meta-analysis, 2 genes interacted with childhood socioeconomic context: MS4A4A x mother’s education on memory performance, and SLC24A4 x father’s education on memory decline. Both interactions remained significant after adjusting for respondent’s own education, apolipoprotein-ε4 allele status, lifestyle factors, body mass index, and comorbidities. For both interactions in EA and AA, the genetic effect was stronger in participants with low parental education. Examination of common and rare variants in genes discovered through genome-wide association studies shows that childhood context may interact with gene regions to jointly impact later-life memory function and decline. Genetic effects may be more salient for those with lower childhood socioeconomic status.
BMI POLYEPIGENETIC SCORES PREDICT FUTURE CHRONIC CONDITIONS AND CHOLESTEROL
Authors: Smith Trey , Karadimas Thomas , Meier Helen , Mitchell Colter , Faul Jessica
Published: December 2023

Body mass index (BMI) is an established risk factor for chronic conditions such as high blood pressure, diabetes, cancer, lung disease, heart condition, stroke, emotional/psychiatric problems, arthritis, and sleep disorders. Poly-Epigenetic Scores (PEGS) have emerged as a promising tool for predicting the risk of chronic diseases. We evaluated the predictive power of BMI PEGS for incident chronic conditions, mortality, and cholesterol levels using data from the Health and Retirement Study, a population representative study of US adults over age 50 years. Three PEGS (Wahl, McCartney, Hamilton) were created from existing epigenome-wide association studies of BMI for participants from the 2016 HRS Venous-Blood study (N=4018). We used element-wise, least-squares regressions to assess the association between each BMI PEG and phenotypes of interest, controlling for demographics, socio-economic status, health-behaviors, and cell type proportions. BMI PEGS were significant predictors of incident chronic conditions in 2020 and these associations were robust to adjustment for covariates. BMI PEGS were also found to be significant predictors of cross-sectional cholesterol levels, a known risk factor for heart disease and stroke. Our study highlights that PEGS can have wide predictive power for future health conditions. These findings can inform personalized interventions for disease prevention and early intervention in the US aging population.
NEUROSCIENCE AND AGING
Authors: Valdez Gregorio
Published: December 2023

In this symposium, experts will highlight discoveries that are beginning to bridge the gap between basic neuroscience research and development of therapies to mitigate the ravages of normal aging and age-associated neurological diseases on the nervous system. The symposium will cover cellular, molecular and behavioral approaches to researching aging of the nervous system. It will provide insights about how aging impacts the fate of neurons and their synapses and how age-related changes in cellular maintenance, molecular signaling, and glial function ultimately diminish cognitive and motor function. Dr. Miranda Orr will provide insights about the contribution of senescent cells to age- and disease-associated degeneration of the nervous system. Dr. Julie Andersen will present on how cells in the nervous system use their own organelles to repair damages to avoid dysfunction during aging and in Alzheimer’s Disease. Dr. Gregorio Valdez will review recent discoveries revealing the initial cellular and molecular changes that impair voluntary movements during aging. Dr. Scott Pletcher will present evidence that cellular and molecular processes important for feeding, mating and avoiding danger in flies also play key roles in healthy aging of the nervous system. The information provided by the speakers will foster discussion among all attendees about the challenges and opportunities to accelerate translation of discoveries to protect the nervous system from aging and associated diseases.
DEMENTIA-FRIENDLY ENVIRONMENTS IN THE COMMUNITY – AN INTERNATIONAL PERSPECTIVE ON CONCEPTS AND INTERVENTIONS
Authors: Wolf-Ostermann Karin , Verbeek Hilde , Boltz Marie
Published: December 2023

Dementia is one of the major age-related societal challenges and causes enormous demands for persons living with dementia (PlwD). Although dementia is one of the major reasons for relocation into a nursing home, most PlwD want to live as long as possible in a familiar domesticity. Therefore, innovative care concepts for community-dwelling PlwD are being developed worldwide as alternative to traditional long-term care settings. Efforts are made to learn more about dementia-friendly environments in order to improve quality of care and quality of life of PlwD. This international symposium will therefore provide four presentations as well as a concluding discussion addressing new concepts for innovative care environments and measuring dementia-friendliness of the built environment as well as nonpharmacological interventions to support high quality person-centred care. The first presentation explores the functions of 24-hour green care farms as alternative to nursing homes and how these can be transferred to other care settings. The second presentation discusses the impact of moving from traditional care environments to innovative care settings for residents and staff. The third presentation presents results of a cluster randomized controlled trial in German shared housing arrangements where a complex nonpharmacological intervention led to significantly less hospital admissions for PlwD. And the final presentation describes an innovative approach to evaluate the wayfinding infrastructure in urban areas for PlwD and to promote dementia-friendliness in urban living structures. The discussant will synthesize the research findings and lead a discussion of research implications and future directions for policy and practice.
PREVALENCE OF CEREBRAL VENOUS DRAINAGE STENOSES ON RETROSPECTIVELY ANALYZED CTA FOR STROKE TRIAGE
Authors: Hui Ferdinand
Published: December 2023

Cerebral venous congestion (CVC) has been identified as a hypothetic cause of cognitive impairment. Prior work has estimated that 15-30% of the population may have jugular venous narrowing, a potential cause of CVC, based on reviews of CT angiography (CTA) performed at a large academic medical center. However, few comprehensive studies exist. Therefore, for the current work, we reviewed fifty CTAs that were obtained for ischemic stroke triage and thrombectomy planning at a comprehensive stroke center in Hawaii (Queens Hospital, Honolulu HI). These brain CTAs were analyzed for arterial and venous variants and other abnormalities that might place the patient at increased risk for arterial injury and/or venous congestion, both of which may result in cognitive decline. The CTAs were analyzed retrospectively for every known level of venous and arterial stenosis, and CVC-associated pre-morbid symptoms were analyzed. Preliminary data support the hypothesis that venous anatomical anomalies may be a risk factor for cognitive impairment. CVC may be an under-diagnosed contributor to cognitive impairment, particularly in older patients.
CREATING A DOCUMENTARY CAPTURING THE NARRATIVES OF MEN ATTENDING IRISH MEN’S SHEDS
Authors: Heinz Melinda , Gleissner Laura
Published: December 2023

How do we engage more individuals to consider and care about issues impacting older adults? Diversifying the mediums of how older adult stories are told offers one solution. Filmmaking is one medium where the narratives of older adults can be captured. Seeing and hearing directly from older adults speak about the issues that affect them provides a distinct way to understand experiences of aging. I interviewed men in County Limerick about how Men’s Sheds promoted purpose and meaning in the lives of older men. After transcribing each interview, I partnered with a filmmaker to help create a documentary to tell the story of how Men’s Sheds create an inclusive atmosphere for older adult men to continue feeling useful in older adulthood. This presentation will explain how researchers who conduct interviews with older adults are uniquely positioned to collaborate with filmmakers to help tell the stories of older adults.