bluuebunny/crossref_metadata_2025 huggingface dataset:
Generativity in Life Review: Discovering Life Lessons and Wisdom in Naturalistic Intergenerational Conversations
Authors: Chilton Patricia , Woolverton Cindy , Glisky Elizabeth , Mehl Matthias , Grilli Matthew
Published: December 2021

According to the theory of generativity, one would expect older adults to inherently feature life lessons in naturalistic conversations with younger adults. Little though, is known about the process of these conversations, and to what extent they convey wisdom characteristics. In this project, intergenerational conversations between university students and older adults living in assisted and independent living communities were analyzed to identify life lessons within older adults’ informal life reviews. In the original study, 37 young and 52 older adults engaged in an intergenerational interaction as part of an undergraduate course. These conversations were recorded with participants’ consent, and transcribed with identifying information removed. For the current project, we analyzed 15 of these recorded conversations, averaging 46 minutes each between 10 students and 5 older adults to (1) develop a coding scheme and procedure to examine life lessons in intergenerational conversations, and (2) investigate whether wisdom characteristics are embedded into life lessons shared in this context. On average, each older adult referenced 4 life lessons (SD = 2) per conversation, which were coded for the following constructs: meaning making, personal growth, emotional valence, wisdom characteristics, life lesson type, and autobiographical memory type. Exploratory analyses suggest life lessons are inherently integrated into naturalistic intergenerational conversations, and that reflectivity is the most frequently expressed wisdom characteristic. This supports previous research identifying reflectivity as key to wisdom, and to the process of generativity. Further analysis is needed to illuminate the value of intergenerational conversations, particularly in a time of age segregation and ageism.
Impact of COVID-19 pandemic on mental health, social connectedness and cognitive performance of older adults
Authors: Souza-Talarico Juliana , Silva Fernanda , Jesus Maria Clara , Barbosa Breno J A P , Nitrini Ricardo , Brucki Sonia M D
Published: December 2021

The COVID-19 pandemic has profoundly impacted older adult's health and well-being worldwide. We explored the impact of the COVID-19 pandemic on daily activities and mental health and its relationship with cognitive performance in older adults. Methods: One-hundred individuals 60 years and older, without cognitive impairment and enrolled in the Brazilian Memory Study (BRAMS), a longitudinal study, were applied the UCLA Loneliness Scale, Perceived Stress Scale (PSS), Geriatric Depression Scale (GDS), and Mini-Mental State Examination (MMSE). Participants were asked whether they had changes in daily routine and social connectedness during the pandemic. Results: Almost half of the participants (48.4%) reported that the COVID-19 pandemic significantly affected their lives, 38.9% lost a relative or friend because of COVID-19, and 60% had daily routine changes. Relationships (40.5%) and emotion (22%) were reported as the most impacted area. Stopping physical activities and stay at home represented the main routine changed for 78% of participants. The use of voice messages through mobile phones to maintain social connectedness increased from 24.2% to 42.1%. For 38% of participants, their autonomy to daily decisions decreased, and 40% complained that memory got worse during the pandemic. More than 30% felt more stress, loneliness, or depression than in the pre-pandemic period. Controlling for age, sex, and education, higher loneliness scores were significantly associated with low MMES scores (p = 0.018). Conclusion: Significant changes in life, daily routine, social connectedness, and mental health-related to the COVID-19 pandemic were reported by older adult participants. Loneliness was associated with lower cognitive performance.
Lung Function Reserve and Physical Function in Healthy Older Adults: Findings from BLSA
Authors: Saavedra Joey , Karikkineth Ajoy , Ferrucci Luigi , Simonsick Eleanor
Published: December 2021

Forced Expiratory Volume in 1-second (FEV1) that falls below the lower limit of normal (LLN) is a well-established correlate of functional limitation and disability. However, less is known about the functional implications of gradations of lung function above the LLN. We examined the cross-sectional association between gradations of healthy lung function and usual gait speed, reported walking ability, and fast 400m walk performance in 750 persons (50.7% men) aged 55-95 free from respiratory disease and mobility limitations, participating in the Baltimore Longitudinal Study of Aging (BLSA). The 2012 Global Lung Initiative (GLI) reference equations were used to calculate FEV1 Z-scores, with healthy lung function categorized as follows: -1.6 < Z ≤ -1.0 (pre-clinical), -1.0 < Z ≤ -0.3 (low normal), -0.3 < Z ≤ 0.3 (normal), 0.3 < Z ≤ 1.0 (high-normal), and Z > 1.0 (high). Associations between gradations of healthy lung function and physical function were evaluated using multivariate linear regression, adjusting for age, sex, height, weight, and waist circumference. Compared to the ‘pre-clinical’ category, the difference in 400m walk time was 0.71 (p>.05), -6.60 (p>.05), -12.21 (p<0.05), and -15.52 (p<0.01) seconds for the ‘low normal’, ‘normal’, ‘high-normal’, and ‘high’ categories, respectively. No associations between gradations of healthy lung function and normal gait speed or walking ability were found (p>0.05). Higher levels of lung function reserve are associated with better 400m walking performance, thus efforts to promote and/or reduce loss of lung function reserve may help individuals maintain high functional capacity in later life.
Mapping the Endogenous Ketogenic System Across Ages, Sex and Diets
Authors: Eap Brenda , Nomura Mitsunori , Panda Oishika , Garcia Thelma , Newman John
Published: December 2021

Understanding how our cells maintain energy homeostasis has long been a focus of aging biology. A decline in energy metabolism is central to many age-related diseases such as Alzheimer’s disease, heart failure, frailty, and delirium. Intervening on pathways involved in energy homeostasis can extend healthy lifespan. When our primary energy substrate glucose, is scarce, our bodies use ketone bodies (i.e. beta-hydroxybutyrate, acetoacetate, acetone). Aging is associated with glucose intolerance and insulin insensitivity, yet what role ketone body metabolism might play in compensating for impaired glucose utilization in age-related diseases is understudied. Here, we investigated how the body’s endogenous ketone body production and utilization pathways are modulated by age across the lifespan of female and male C57BL/6 mice (4 mo old, 12 mo old, 22 mo old). We show how different ages have different metabolic and gene expression responses to 1-week ketogenic diet (KD) or ketone ester diet. We observed an apparently compensatory ketogenic response in older animals fed normal diet, with a stronger compensatory response driven by KD. We observed tissue-specific changes, including induction of ketone body production enzymes in the aging heart. When comparing the ketogenic capacity between sexes, females had a higher basal level and less variation with age, underscoring the importance of sexual dimorphism in metabolism. Overall, these findings suggest that older animals use ketone bodies to meet energetic demands in a normal diet context. This study supports the potential roles of ketogenic therapies such as exogenous ketones to improve energy homeostasis in conditions of aging.
NIA Coordinated Analysis of Dynamic Socioemotional Experiences and Well-Being during the Pandemic
Authors: Neupert Shevaun , Ali Sumbleen , Bouklas Isabella , Hu Rita , Kincaid Reilly , Nelson Niccole , Zhang Shiyang , Scott Stacey
Published: December 2021

We conducted a coordinated analysis of eight longitudinal studies with data collected during the COVID-19 pandemic. Our overarching aim was to examine within-person fluctuations in health and well-being during the pandemic that may differ across the adult lifespan. The studies are from different regions of the U.S. with data collected during different periods of the pandemic. These studies sampled heterogenous age groups, used diverse methods, and were harmonized on constructs. Four longitudinal studies (Notre Dame Study of Health & Well-being, Within-Family Differences Study, Social Relations Study, and the Einstein Aging Study [EAS] Covid Telephone Interviews) and four intensive, microlongitudinal studies (Daily Experience and Well-being Study, Daily COVID-19 Spring, Daily COVID-19 Fall, EAS), with data collected between March 2020 and August 2021 were analyzed. In three studies, older adults were consistently less variable (i.e., lower within-person standard deviation) in negative emotional well-being such as negative affect and depressive symptoms compared to younger adults. In four studies older adults were also less variable in stress. Evidence of better outcomes associated with social interactions was found in three studies, where within-person variability in social interactions was positively correlated with variability in positive affect across age. These findings point toward the complexities of dynamic socioemotional experiences that unfold across historical periods and across the lifespan. These within-person fluctuations could be used as a benchmark to examine long-term trajectories of well-being.
Adult Sibling Tension and Older Mothers’ Psychological Well-Being: The Moderating Role of Caregiving
Authors: Gilligan Megan , Suitor J Jill , Hou Yifei , Brottman Barbra , Lee Jeenkyoung , Kim Eunbea
Published: December 2021

The life course perspective concept of “linked lives” suggests that the lives of adult children and older parents are interconnected and consequential for the well-being of members of both generations. In this work, we consider the association between tension among adult siblings and older mothers’ psychological well-being. We focus specifically on tension in the adult sibling relationship because research has shown that negative relationship quality is especially consequential for well-being. We consider this association in the context of caregiving because this is a time when offspring are often required to coordinate with each other to provide assistance. We utilized data from 304 older mothers (average age = 78) and 736 of their adult children (average age = 49) from the Within-Family Difference Study (WFDS) II. First, we examined the direct association between adult sibling tension and mothers’ reports of depressive symptoms. Second, we examined whether the association between sibling tension and mothers’ depressive symptoms was moderated by mothers’ need for care. Preliminary results indicated no direct effect of sibling tension on mothers’ depressive symptoms. However, moderation analysis revealed that sibling tension was associated with an increase in mothers’ depressive symptoms among mothers who reported needing assistance. These findings highlight the importance of understanding the interconnected nature of adult family relationships especially in the context of later-life family caregiving. In particular, the findings reveal that older mothers in need of care are especially vulnerable to tension in the relationships among their adult children.
Non-Pharmacological Interventions to Manage Type 2 Diabetes in Older Hispanics: A Systematic Review
Authors: Vieira Edgar , Sherbutt Kayleigh , Scanlan Madison , Frederick Heather
Published: December 2021

Type 2 diabetes is a serious public health problem that affects millions of Americans. Hispanics are disproportionately affected and have high incidence of type 2 diabetes. Lifestyle modifications in diet and increased physical activity are recommended in addition to medication. The purpose of this systematic review was to analyze the scientific literature concerning the effects of exercise, nutrition, and combined diet and exercise interventions on type 2 diabetes management in older Hispanics. We searched three databases for studies that included dietary interventions, exercise interventions, or a combination to manage type 2 diabetes in older Hispanics. A total of 653 studies were screened and reviewed, with seven being included in the review. Our findings indicate that physical activity interventions significantly reduce glycosylated hemoglobin, and diet interventions also led to decreased levels of HbA1c. There is a significant effect in HbA1c levels on individuals receiving a combination of diet and exercise interventions compared to control groups. Implementing diet or exercise interventions in older Hispanics with Type 2 diabetes leads to significantly reduced glycosylated hemoglobin levels; the effects of combined diet and exercise interventions were not superior to the effects of single interventions in HbA1c levels. Exercise and diet seem to be effective non-pharmacological interventions to manage type 2 diabetes in older Hispanics, but additional research is needed.
Peak Expiratory Flow Predicts Incident Dementia in a U.S. Sample of Older Adults
Authors: Donahue Patrick , Xue Qian-Li , Carlson Michelle
Published: December 2021

Dementia is an increasingly important public health problem with known vascular contributors. Respiratory function, measured by peak expiratory flow (PEF), may be a novel modifiable risk factor in reducing the risk of dementia along the vascular pathway. We investigated the association between PEF and incident dementia in older adults from the National Health and Aging Trends Study (NHATS). Using NHATS criteria, participants were categorized as having or not having probable incident dementia during NHATS Rounds 2-4, spanning three years. Of 3,622 participants with available PEF and covariate data, 543 (15.0%) had incident cases of dementia. Quartile of baseline PEF was analyzed as a predictor of incident dementia using logistic regression models, while controlling for several health and sociodemographic covariates. The fourth quartile of PEF had statistically significantly decreased odds of incident dementia when compared to the first PEF quartile (OR = 0.27; 95% CI [0.19, 0.40]). Significantly reduced odds of incident dementia were found when comparing the third and second PEF quartiles to the first PEF quartile, as well (OR = 0.35; 95% CI [0.26, 0.47] and OR = 0.62; 95% CI [0.48, 0.80], respectively). These relationships were dose-dependent so that increasing PEF quartile levels were more protective against incident dementia. PEF may be considered as an easily administered, low-cost measure of respiratory function and a possible screening tool for dementia risk. Improving PEF may reduce dementia risk through vascular mechanisms (e.g., increased blood circulation and brain oxygenation). Future research should explore these potential causal pathways between PEF and dementia.
Piloting the “Anti-Oppressive Practice & Research with Diverse Older Adults” Training Program during COVID-19
Authors: Camacho David , Pacheco Kelly , Feldman Sabrina , Kaul Usha , Kim Patricia , Reid M Carrington
Published: December 2021

There is a critical need to develop our gerontological-sensitive workforce. Social workers (SW) frequently provide services to older adults yet there are few opportunities for them to train as gerontological clinicians and/or researchers. To provide an opportunity for SW students to gain gerontological knowledge, clinical practice, and research skills, we developed, and pilot tested the “Anti-Oppressive Practice and Research with Diverse Older Adults” virtual training program at a major medical facility in Manhattan, NY. We explored the feasibility, implementation, and impact of this novel program. The 21-hour weekly MSW field placement program followed an anti-oppressive framework and included: 1) supervision and training sessions; and 2) direct clinical and research practice (e.g., theory, funding, assessment, data collection etc.) and aging topical seminars (e.g., depression, loneliness, pain etc.). Racially diverse supervisors and graduate SW students engaged in reflective writing exercises, iterative discussions (recorded & transcribed) and a thematic analysis of data. All interns successfully completed the program and reported enhanced skills related to SW core competencies and research (e.g., standardized assessments), research and practice gap awareness (e.g., minority aging) and plans to pursue advanced research training and/or gerontological clinical work. Intern challenges included: 1) disconnect between MSW curricula and research placements; and 2) managing minority and contextual stressors (e.g., imposter syndrome, covid-19, civil unrest). Supervisory challenges included: 1) humanizing sensitive discussions via virtual communication and 2) resource constraints. Future research should systematically assess program effects (e.g., SW core competencies) and how to facilitate interprofessional collaborations to develop diverse gerontological SWs and researchers.
Psychological Effect of Anti-Asian Attitudes by COVID-19 on Asian Americans in Coastal Alabama
Authors: Min Hosik , Hanks Roma , Lewis Denise
Published: December 2021

This study aimed to understand how the anti-Asian attitude due to the COVID-19 affected Asian American communities in Alabama. We asked whether Asian Americans were worried about going out due to the anti-Asian attitude due to COVID-19. This study conducted online surveys to Cambodians or Laotians, who were 18 years and older, were living in Coastal Alabama, in May 2020. To avoid in-person contact, respondents answered questions online. A total of 353 respondents participated in the survey. In the Cambodian community, more younger adults participated in the survey, while more middle-aged adults participated from the Laotian community. Laotians had longer educational attainment and watched multiple media to obtain COVID-19 related information. Cambodians (72%) were afraid of COVID-19 infection more than Laotians (53%). More Cambodians (73%) were afraid to go out because of the anti-Asian attitude than Laotians (52%). The logistic regression analysis presented that people worried more about the COVID-19 infection were less likely to go out due to anti-Asian attitudes. Educational attainment did not have a protective effect. Watching multiple media sources decreased the worry about the anti-Asian attitude for Laotians. The age cohort showed both a protective and exacerbate the effect. Cambodians, who were in their thirties, were worried about going out. However, Laotian fifties and over did not worry about going out. This difference might be related to the length of the stay in the U.S. Hanks et al. found that Cambodians, compared to Laotians, had more new immigrants who recently came to the community to marry.
Sandwich Generation Caregiving Among Baby Boomer and Generation X Caregivers in the United States
Authors: Miyawaki Christina , Bouldin Erin , Jeffers Eva , McGuire Lisa
Published: December 2021

Sandwich generation caregivers are generally those who care for both a child and an older adult. Baby Boomer and Generation X belong to this age cohort. Using data from the 2015-2018 Behavioral Risk Factor Surveillance System Caregiver Module, we compared the prevalence and characteristics of sandwich caregivers across these two generations. Data represent adults from 44 jurisdictions. We categorized caregivers into generations using their age at the time of the survey (N=34,777). Sandwich caregivers were classified as those who lived with a child (≤18 years) and provided care/assistance to a parent/grandparent with a long-term illness/disability during the past 30 days. Prevalence ratios (PR) from log-binomial regression models that included generation, sandwich caregiver status, sex, and race/ethnicity were used to compare weighted estimates. Six percent of Baby Boomers and 31% of Generation X were sandwich caregivers (p<0.001). In adjusted models, sandwich caregivers had a lower prevalence of any chronic health condition (PR=0.77, p=0.01) and fair/poor health (PR=0.87, p=0.003) than other caregivers, but similar frequent mental and physical distress prevalence. Baby Boomer caregivers were more likely to report a chronic health condition, fair/poor health, and frequent physical distress than their Generation X counterparts, but less likely to report frequent mental distress. Sandwich caregivers in these generations appear to be in better health than other caregivers. Nonetheless, it is critical to support the needs of sandwich caregivers as they age, given their important role in meeting the needs of both children and older adults and the additional challenges created by the pandemic.
The Link Between Environment, Age, and Health in a Large Cohort of Companion Dogs from the Dog Aging Project
Authors: McCoy Brianah , Brassington Layla , Dolby Greer , Jin Kelly , Collins Devin , Dunbar Matthew , Snyder-Mackler Noah
Published: December 2021

Exposure to social environmental adversity strongly predicts health and survival in many species such as non-human primates, wild mammals, and humans. However, little is known about how the health and mortality effects of these social determinants vary across the lifespan. Using the companion dog, which serves as a powerful comparative model for human health and aging due to our shared biology and environment, we examined which components of the social environment impact health, and how the effects vary with age, in dogs. We first drew on detailed survey data from owners of 27,547 dogs from the Dog Aging Project and identified six factors that together explained 35% of the variation in dog’s social environment. These factors all predicted measures of health, disease, and mobility, when controlling for dog age and weight. Factors capturing measures of financial and household adversity were linked to poorer companion dog health, while factors associated with the social companions, like dogs and adults, were linked to better health. Interestingly, some of these effects differed across a dog’s lifespan: for instance, the effect of neighborhood disadvantage on disease instances was strongest in older dogs. Together, our findings point to similar links between adversity and health in companion dogs, and set up future work on the molecular and biological changes associated with environmental variation in order to identify ways to mitigate or even reverse the negative environmental effects.
The Relationship Between Dementia Severity & Caregiver Preferences for Decision Making Role Regarding Mammography
Authors: Frank Molly , Park Seho , Lane Kathleen , Torke Alexia , Schonberg Mara , Sachs Greg , Schwartz Peter , Fowler Nicole
Published: December 2021

The incidence of Alzheimer’s disease and related dementias (ADRD) and breast cancer increases with age. Despite being one of the most effective ways to diagnose breast cancer early, mammography in ADRD patients comes with an increased risk of treatment complications and false-positive results. Family caregivers are often involved in the decision-making process, and this study evaluates the relationship between dementia severity and caregiver preferences when making decisions about mammography with the patient alone, and with the patient and doctor. We included 181 caregivers from the Decisions about Cancer screening in Alzheimer’s Disease trial, which uses the Dementia Severity Rating Scale (DSRS) to assess dementia severity and a modified Control Preferences Scale (CPS) to assess each caregiver’s preferred decision-making approach. Multinomial logistic regression models evaluated the relationship between DSRS and CPS categories (active, passive, and collaborative), while controlling for the caregivers’ age, sex, race, education, and relationship to patient. Model 1 examined the caregivers’ preferred role with the patient, and it found a significant association between increased dementia severity and preference for a collaborative approach (p<0.001) or passive approach (p<0.05) compared to an active approach. Model 2 did not find a significant association between dementia severity and the caregivers’ preferred role when making decisions with the patient and doctor; however, those with increased age and education were more likely to prefer an active role. The association between dementia severity, caregiver characteristics, and decision-making preferences supports the need for approaches to support ADRD caregivers with medical decision making.
Touchscreen Technology to Improve Dementia Care Management for Older Adults Living in the Community
Authors: Brown Ellen , Ruggiano Nicole , Munoz mariateresa H , Roberts lisa , Framil C Victoria , Arroyo Bernardo , Bourgeois Michelle
Published: December 2021

Chronic disease management challenges for persons living with dementia (PLWD) often includes difficulties communicating how their feeling or describing symptoms to caregivers. To address this issue, an interdisciplinary team is developing a touchscreen mobile technology that will allow the assessment of clinical information about the PLWD, such as sleep quality, appetite, pain level, and mood. The mobile technology also allows caregivers to share this information with providers in real-time from their homes. In the team’s effort to incorporate a graphic measure to assess mood into the technology, a literature review revealed no such measurement tool has been established and validated for assessment with PLWD. This study focused on developing a graphic clinical assessment tool that can be used to assess mood for PLWD and establishing the face and content validity for this assessment tool. A team that included multidisciplinary clinical experts and a graphic artist designed a series of pictures of facial expressions and body language depicting a continuum of mood states (i.e., happy through depressed). The research team consulted with existing artistic depictions of sadness expression, including medical illustrations depicting depression. Multiple iterations have resulted in a series of images that represent moods from happy to very sad. The team considered a number of factors in developing the images including gender, ethnicity, and race. Consensus on the construct validity was achieved by the expert clinical panel. Details of a follow-up study to evaluate construct validity will be presented.
Use of Long-Term Care Decreased Over Time Among the Oldest-Old With and Without Dementia - A Register-Based Study
Authors: Aaltonen Mari , Forma Leena , Pulkki Jutta , Raitanen Jani , Jylhä Marja
Published: December 2021

Care policies for older adults emphasize aging-in-place and home care over residential long-term care (LTC). We explore how the use of residential LTC in the last five years of life among people with and without dementia changed between those who died in 2001, 2007, 2013, and 2017 in Finland. Retrospective data drawn from the national health and social care registers include all those who died aged 70+ in 2007, 2013, and 2017, plus a 40% random sample from 2001 (N=128 050). Negative binomial regression analysis was used to estimate the association of dementia with LTC use during the last five years of life (1825 days). The independent variables included dementia, age, marital status, annual income, education, and chronic conditions. In the total study population, the proportion of LTC users and the mean number of days in LTC increased until 2013, after which it decreased. Changes in LTC use differed between different age groups and by dementia status. Over time, the decrease in round-the-clock LTC use was steep in those aged 90≤ with dementia and in people aged 80≤ without dementia. The individual factors related to morbidity and sociodemographic factors did not explain these results. The changes in LTC care policy may have contributed to the decrease in LTC use among the oldest. However, according to national statistics, the availability of formal home care has not increased. This development may suggest that the oldest-old and those with dementia – a highly vulnerable group – are left without proper care.
Co-Designing a Virtual Reality Application to Enhance Reminiscence Therapy for Persons with Dementia
Authors: Sun Winnie , Quevedo Alvaro
Published: December 2021

Reminiscence therapy for persons with dementia is often being conducted by employing analog media including pictures and videos organized and presented by a caregiver. However, such media lacks the immersive experience to support patient engagement and successful recollection of reminiscence events. Recently, Virtual Reality (VR) is gaining momentum as a potential technological tool to support dementia care due to its increased immersion, presence, and embodiment. Haptic artifacts can be used to enrich reminiscence therapy as part of the multi-sensory stimuli to increase immersion and patient engagement, as well as improving social connectedness and cognitive health. The purpose of this project is to explore the use of VR application to advance reminiscence therapy for persons with dementia. We have prototyped an immersive and non-immersive VR framework that allows caregivers to deliver reminiscence therapy for persons with dementia with varying stages in their disease progression. These reminiscence therapy sessions are built by employing a narrative storyboard and content management through a series of co-designing sessions with content experts at the Geriatric Dementia Unit in Ontario, Canada. A caregiver-led VR framework will be adopted to enable the caregiver to guide the persons with dementia to safely navigate through the interactive VR environment, while allowing the patients to engage with the interactive VR elements using a point-and-pinch gesture approach. We anticipate that the VR experiences hold the potential for improving the interactions between persons with dementia and caregivers, as well as enhancing the reminiscence experiences to promote the maximal therapeutic benefit of patient’s recovery.
Communication Difficulties and their Association with Caregiving Burdens in Aphasic Dementia
Authors: Roberts Angela , Santos Haylie , Gill Nathan , Zhang Hui , Salley Elizabeth , Rogalski Emily
Published: December 2021

Primary progressive aphasia (PPA) is a clinical dementia syndrome for which there is no effective disease-modifying treatment. Impairments in language are the primary and persistent symptoms, and severely limit participation in everyday activities and family conversations. Despite this, there are no published studies examining the objective relationship between conversation difficulties and caregiving burden in PPA. We tested the hypothesis that the severity of care partner perceived conversation difficulties predicts caregiving burden using the Perception of Conversation Difficulty-Dementia Alzheimer’s Type and the Montgomery Borgatta Caregiving Burden Scale. The analysis included baseline data from 78 care partners (62% female) enrolled in the Communication BridgeTM-2 randomized control clinical trial of a speech-language intervention for PPA. Care partners had a mean age of 64.5 years (SD=10.76) and a mean relationship duration with the PPA participant of 38.6 years (SD=15.29). Eighty-six percent were spouses, 5% were adult children, and the remaining 9% were friends or siblings. Higher ratings of conversation difficulties were associated with increased caregiving burden for both objective burden (p < 0.001) and subjective stress burden (p < 0.001). The relationship between conversation difficulties and objective burden was mediated by dependence in activities of daily living and care partner depression, whereas the relationship with subjective stress burden was mediated by depression only. This is the first large scale study of care partner reported conversation difficulties and caregiving burden in PPA. The finding that conversation difficulties have a direct relationship with caregiving burden is an important consideration for interventions and outcome measurement in PPA.
Concurrent and Predictive Associations between the Life's Simple 7 & Brain Structure in Middle-Age and Early-Old Age
Authors: Warren Teresa , Williams McKenna , Fennema-Notestine Christine , Elman Jeremy , De Anda Jennifer , Kremen William , Franz Carol
Published: December 2021

American Heart Association’s (AHA) Life’s Simple 7 (LS7), an index of cardiovascular health risks, has been associated with worse brain outcomes but few examined this relationship in midlife. We examined whether LS7 scores at midlife were associated with brain morphometry in early old age. Participants were 471 men who participated in the Vietnam Era Twin Study of Aging. The LS7 index was assessed at mean age 62 (range 55-66) and 68 (range 61-71) and included smoking, physical activity, diet, body mass index, cholesterol, glucose, and blood pressure. Each factor was coded, per AHA criteria, on a 3-point scale (0/poor-2/ideal) and summed to create a composite score (0-14). At mean age 68, participants underwent structural magnetic resonance imaging, which was used to create the previously validated brain measures. Scores included: the ratio of abnormal white matter to white matter, and two Alzheimer’s disease brain signatures (cortical thickness/volume signature and a mean diffusivity (MD) signature). Analyses controlled for age, education, income, ethnicity, and APOE genotype. Concurrently at mean age 68, the LS7 was associated with cortical thickness/volume (F=4.85, p = .028), MD (F=10.89, p = .001) signatures and abnormal white matter ratio (F=14.04, p < .001). Prospectively, the LS7 at mean 62 was significantly associated with age 68 cortical thickness/volume (F=5.08, p = .025) and MD (F=5.54, p = .019) signatures but not with abnormal white matter ratio. These results suggest that prevention strategies that promote heart healthy behaviors could have implications for healthy brain aging.
Consequential Impacts of Tobacco Use on Cognitive Performance
Authors: Pahlen Shandell , Stallings Michael , Corley Robin , Wadsworth Sally , Reynolds Chandra
Published: December 2021

Tobacco use represents a pernicious lifestyle factor that may influence processes of aging, including cognitive functioning. As individuals tend to start smoking before adulthood, it may serve as an important factor in cognitive development and maintenance. We explored smoking history-cognition associations in a sample approaching midlife. Study data was derived from the Colorado Adoption/Twin Study of Lifespan behavioral development and cognitive aging (CATSLife 1; N = 1195 [53% F]; x̄age = 33.2 years, SD = 5.0). All cognitive measures were t-scored covering working memory, spatial reasoning, processing speed (WAIS-III Digit Span, Block Design, and Digit Symbol, and Colorado Perceptual Speed) and episodic memory domains (Picture Memory, immediate and delayed). Tobacco use measures included ever-smokers, current-smokers, and log-transformed packyears. Mixed-effects regression models were applied, accounting for sex, age, race, ethnicity, and clustering among siblings. Tobacco use was associated with worse episodic memory, spatial and speed performance, but not working memory. When educational attainment was included, patterns remained consistent though attenuated. Results suggested current-smokers scored 0.27 to 0.36 SD lower than non-smokers on speed and spatial reasoning tasks. Episodic memory performance was reduced by approximately 0.07 to 0.1 SD per log packyear. In a sample approaching midlife, the harmful impacts of tobacco use on cognitive performance may be already apparent with cumulative impacts of packyears on episodic memory and current smoking associated with spatial and speed performance. This work helps to elucidate the temporal associations of an important lifestyle factor that may influence cognitive functioning prior to midlife.
Creation of a Latin-American Dementia Advance Care Planning Guide
Authors: Cajavilca Moroni Fernandez , Solkowski Lauren , Utz Rebecca , Sanchez-Birkhead Ana , Aruscavage Nancy , Supiano Katherine , Iacob Eli , Dassel Kara
Published: December 2021

The LEAD Guide (Life-Planning in Early Alzheimer’s and Dementia) is an advance care planning conversation guide for use within the context of dementia (Dassel et al., 2019). Considering that Latino adults have the highest risk of ADRD, a culturally sensitive and translated Spanish version of the LEAD Guide was needed. Therefore, the objective of this study was to: 1) translate the LEAD Guide into a Latin-American Spanish version (i.e., LA LEAD) and 2) assess the applicability and acceptability of the LA LEAD through focus groups with Latino older adults. First, the LEAD Guide was translated into a “neutral” Spanish version. Second, forward and backward translation was conducted to create the LA LEAD. Third, two 1.5-hour focus groups with Spanish-speaking Latino adults age 50+ who were: a) healthy adults (N=7) or b) current or previous dementia caregivers (N=7) were held. The focus groups were recorded, translated, and transcribed for descriptive analysis, which revealed three domains regarding the LA LEAD: 1) Family Dynamics: the guide could help prevent family conflict, designate a health care proxy, and reduce burden; 2) Cultural Expectations: acknowledgement of cultural nuances between LA countries, the familial responsibility of caring for family in the home, and the influence of religion on end-of-life care decisions, and 3) Health Literacy: lack of knowledge about advance care planning conversations, documentation, and dissemination. This process resulted in the creation of a validated LA LEAD Guide, which is a culturally and linguistically appropriate and acceptable advance care planning tool for Latino older adults.
Examining the Impact of COVID-19 on Loneliness and Social Isolation Among Affordable Housing Residents
Authors: Mock Marilyn , Goebelbecker Roisin , Pomerantz Sherry , DeGennaro Jennifer , Perweiler Elyse
Published: December 2021

Loneliness and social isolation are serious public health concerns associated with higher risks of clinical depression, suicidal ideation, coronary artery disease, stroke, functional decline, an increased risk of developing dementia and cancer mortality. Recent reports indicate the prevalence and dangers of loneliness and social isolation have increased as a result of the COVID-19 pandemic, especially among older populations. In order to address these concerns among residents living at Northgate II (NGII), a 302-unit affordable housing development in Camden, NJ, Fair Share Support Services, Inc. (FSSS), the non-profit arm of Fair Share Housing Development, collaborated with the New Jersey Institute for Successful Aging (NJISA) and the DHHS-funded Geriatric Workforce Enhancement Program (GWEP) to develop a loneliness/social isolation survey using two evidenced-based tools, the UCLA Loneliness Scale and the Steptoe Social Isolation Index. FSSS piloted the loneliness and social isolation survey with 192 low-income minority older adults residing at NGII. Results indicate that 49% of the NGII residents surveyed fall into 5 "at-risk" categories: 1) lonely and isolated (9%), 2) lonely/somewhat isolated (8%), 3 ) lonely/not isolated (9%), 4) isolated/somewhat lonely (9%), and 5) isolated/not lonely (14%). FSSS, will utilize survey results and follow-up interviews to tailor social service/other interventions to meet the needs and preferences of residents with the goal of preventing serious health problems associated with loneliness and social isolation, allowing residents to age in place.
Focus Group Findings of Trial Participants in a Caregiver Psychosocial Intervention: Savvy Caregiver Program
Authors: Aranda Maria , Aguilar Iris , Maldonado Rene
Published: December 2021

Previous work highlights the importance of sociobehavioral interventions to address dementia caregiving health and wellbeing outcomes. By empowering caregivers to become objective managers of their loved one’s illness, and own self-care, they are less likely to exhibit negative outcomes. We are conducting a mixed-method, randomized trial to test manualized, multi-family psychoeducational group interventions: Savvy Caregiver Express, and Savvy Caregiver Program. This poster describes the qualitative findings of four focus group interviews recently conducted to elucidate the study participation experiences of family caregivers enrolled in the parent study. Twenty-five racially and ethnically diverse participants (21 women, 4 men) caring for a family member with cognitive decline participated in focus group interviews conducted via videoconferencing methods. We captured more nuanced experiences from the perspective of study participants with regards to the caregiver interventions and their research participation. Interviews were conducted by trained research personnel, lasted 60-75 minutes, and followed an open-ended questioning route. Based on thematic analyses, we identified the following themes: 1) Changing one’s mindset: Seeing life through their shoes; 2) Getting information in one place; 3) Expanding the personal experience; 4) Fears and vulnerability; 5) Time constraints vs. wanting more; 6) Not everyone is at the same place; 7) Technology: It’s going to be part of our lives; and 8) Research: Not always in sync. Our findings indicate high satisfaction with most components of the program while specific recommendations were offered to improve the intervention and study experience such as tailoring materials to stage-specific needs.
Genomic Sequencing of sod1D Yeast That Escape Spore Death
Authors: Adanlawo Temiloluwa , Wende Helen Vander
Published: December 2021

Amyotrophic lateral sclerosis (ALS) is a devastating neurodegenerative disease that impacts nerve cells and the spinal cord, which in some cases are linked to mutations in the Superoxide Dismutase 1 (SOD1) gene. Sod1 is an antioxidant within cells that converts reactive oxygen from superoxide into water using a copper and zinc ion to deactivate the oxygen. When the SOD1 gene is deleted, yeast cells are still able to undergo meiotic divisions and generate four spores, but the spores that are produced are inviable. However, we see that randomly, sod1∆ spores can grow on rich media. This leads us to hypothesize that somewhere in the genome, there is a suppressor mutation that allows these cells to grow. We tested this hypothesis by preparing samples for whole genome sequencing. By comparing the genomic sequences from our suppressor mutants to wild-type controls, we’re able to identify a single point mutation within a gene called NCA2, which codes for a protein that regulates expression of Fo-F1 ATP synthase subunits 6 and 8. Given this result, we are now working to try and understand the relationship between the sod1∆ spore death phenotype and the modulation of ATP synthase activity. In summary, the results from our work have the potential to further help us understand what role Sod1 plays in yeast meiosis and may be able to give us a deeper understanding for ALS cases that are linked to Sod1.
Goals of Care Conversations in Nursing Home and Assisted Living Care Plan Meetings
Authors: Towsley Gail , Tay Djin , Edelman Linda
Published: December 2021

Me & My Wishes is a novel systematic approach for long-term care residents living with dementia to record videos about their care preferences that can be shared with staff and families in care plan meetings. To understand how the videos were utilized in Goals of Care (GOC) conversations, we coded and analyzed transcripts of recorded care plan meetings at the time of sharing the video using a priori codes derived from GOC conversation elements. Coding discrepancies were resolved in team meetings; finalized codes were summarized to derive themes. Thirty-four care plan meeting conversations between residents (n=34), family members (n=29) and staff (n=35) were analyzed. Residents appreciated sharing personal histories and preferences via video, while staff members appreciated deeper understanding of residents’ care preferences. Two themes described care plan meeting conversations: Everyday Care - a checklist-style assessment of the resident’s daily care (e.g., help with activities of daily living), activities engaged in and satisfaction with care; and Clarifying Care Goals - checking the resident’s treatment preference (e.g., pain management, CPR), explaining hospice, or confirming the resident’s contact person. Several elements of GOC were not discussed (e.g., disease progression) and conversations lacked depth and comfort evidenced by apologetic language and abrupt transitions of topics rather than exploring alignment of goals with care preferences. Me & My Wishes videos are a mechanism for residents to voice preferences. Standardized guidance, which is lacking in long-term care, is needed to help care teams engage in meaningful conversations to ensure alignment of goals and treatment preferences.
How Can We Encourage Older Adults to Adopt Digital Services?
Authors: Xie Yutong , Wu Jiayi , Yow W Quin
Published: December 2021

Majority of older adults (OA) do not use technology frequently. For example, 84% of Singapore OA own a smartphone, however, only 22% have tried apps like online shopping. Similarly, 42% of US OA own a smartphone, yet one-third of them have never used the internet. Past research indicated poorly designed user interfaces as a barrier to technology use. Based on the Technology Acceptance Model (TAM), we hypothesize that OA-friendly user interfaces can increase perceived usefulness (PU) and perceived ease of use (PEOU) of technology, which would translate into increased digital services adoption rate. Forty healthy participants aged 65 to 86 (6 males, 34 females, mean age = 72.3) were recruited through OA activity centers in Singapore and assigned to either control or experimental groups. Both groups used an online website to perform specific shopping tasks and answered a TAM questionnaire. The control group used a website modeled after current websites while the experimental group used an OA-friendly website designed based on literature review and pre-survey, with features like OA-friendly mode, tutorial and online helpdesk. Data analysis was conducted using an independent sample t-test and bootstrapping. The experimental group showed a significantly higher proficiency in performing tasks (p=0.037), PEOU (p=0.049), and PU (p=0.044) than the control group. This suggests that user interfaces friendlier to OA increases their acceptance of technology, which could translate into a higher digital service adoption rate. Therefore, this research sets the basis for further research on digital services guidelines for older adults, including for telehealth and others.
Intake of Flavonoids and Odds of Frailty Onset in Adults in the Framingham Offspring Cohort
Authors: Nguyen Thuy Nga , Millar Courtney , Kiel Douglas , Hannan Marian , Sahni Shivani
Published: December 2021

Polyphenols (antioxidants derived from plant-foods) could play a role in inhibition of oxidative stress and frailty reduction, yet data on the polyphenol subclass of dietary flavonoids is limited. This study sought to determine the association between dietary flavonoids and frailty onset in middle-aged and older adults. This prospective cohort study included non-frail individuals from the Framingham Offspring Cohort (FOC) with total flavonoid intake (mg/day; defined as sum flavonols, flavan-3-ols, flavonones, flavones, and anthocyanins via Harvard Food Frequency Questionnaire), frailty (via Fried phenotype), and covariate information measured at baseline (1998-2001). Follow-up frailty was evaluated in 2011-2014. Logistic regression estimated odds ratio (OR) and 95% confidence intervals (95% CI) adjusting for relevant confounders. Participants (n=1,701; 55.5% female) had a mean age of 58.4 years (SD ± 8.3). Mean flavonoid intake was 309 mg/d (SD ± 266). After 12.4 years (SD ± 0.8), 224 (13.2%) individuals exhibited frailty. In age and sex adjusted models, every 50 mg/day of higher total flavonoid intake was associated with 3% reduced odds of frailty [OR (95%CI): 0.97 (0.94-1.00), p-value: 0.05). Further adjustment for smoking, energy and protein intake, and disease indicators did not appreciably change the association, and associations became non-significant (p-value=0.12). Thus, there was no association between flavonoid intake and odds of frailty onset in adults in the FOC. This could be due to participants' higher intake of flavonoids compared to average intake of ~200 mg/d in Americans.