bluuebunny/crossref_metadata_2025 huggingface dataset:
STRATEGIES TO INCREASE MINORITY PARTICIPATION IN A HEALTHY AGING AND NEIGHBORHOOD STUDY
Authors: Churchill Linda C , Siden Rachel , Aguirre Annabella , Ruiz Marline , Cheng Jie , Clarke Anthony , Kane Kevin , Li Wenjun
Published: November 2019

Adequate minority participation is critical to health disparity research. Conventional direct mails are less effective in minority recruitment. The Healthy Aging and Neighborhood Study developed a multifaceted, community-engaged, culturally and linguistically appropriate method to recruit community-living older adults (≥65y) in Worcester County, Massachusetts. The research team is bilingual, racially and culturally diverse. A direct mail campaign was conducted in a geographically diverse random sample of residents from neighborhoods with high concentrations of minorities, stratified by rurality. To increase minority participation, the mailings included an invitational letter or a flyer with a graphic that portrays diverse racial/ethnic background. We engaged communities by presenting the study at senior and community centers, and faith-based organizations that are frequented by minorities and by posting study information in minority social media groups (e.g., Chinese resident associations). Participants promoted the study to friends while staff promoted through professional or social networks. To recruit non-English speaking minorities, all materials were printed in age-friendly large fonts in Spanish or Chinese, and interviews were conducted using their preferred language. Within 9 months, we enrolled 326 participants, including 216 Whites, 57 Hispanics, 21 Blacks, 31 Asians, and 1 Native American. An additional 38 Asians are on the waiting list. Blacks were more likely to respond to community presentations. Hispanics were most likely to respond to the colorful flyer. Older minorities (>76y) were more likely to respond to presentations (57%) while the younger (<75y) to the mailings (60%). In summary, this multifaceted recruitment approach is effective in minority recruitment.
FOOD ASSISTANCE PROGRAMS AND REDUCED HOSPITALIZATIONS FOR OLDER ADULTS WITH DIABETES
Authors: Johnson Monyca L , Walsh Sarah E
Published: November 2019

Diabetes is a an increasingly common and costly condition for older adults. Each year, as many as 1 in 3 Medicare dollars is spent to treat and manage diabetes and associated comorbidities for people with diabetes. To control health care spending in the US, it is imperative that we identify factors for reducing hospitalizations for these individuals. We used data from round five of the National Health and Aging Trends Study to identify predictors of hospitalization in the past 12 months for Medicare recipients ages 65 and older with diabetes. Previous research on the social determinants of health has demonstrated that social stressors like poverty and exposure to racism are associated with poorer health outcomes overall, but we did not find a statistically-significant association between race, gender or Medicaid dual-eligibility and hospitalization for our study population. Notably, receipt of SNAP benefits, Meals on Wheels services or other food assistance was associated with a 43% reduction in the risk of hospitalization in the past 12 months. As previous research has linked food insecurity with poorer medication adherence among individuals with Type II diabetes, food assistance programs appear to be an effective strategy for reducing hospitalizations associated with diabetes and its comorbidities.
RACIAL DIFFERENCES IN CONTEMPLATIVE PRACTICES IN LATER LIFE: EXAMINING THE ROLE OF SES AND HEALTH DISADVANTAGE
Authors: Lekhak Nirmala , Bhatta Tirth , Goler Timothy
Published: November 2019

Substantial scholarly attention has been placed on prayer as a buffer of life events’ adverse influences on well-being in later life. The disproportionate distribution of adverse life events among Black adults has also attracted scholarly interest in racial differences in contemplative practices. Black adults have been found to more likely engage in private prayer than White adults, whereas studies have observed an opposite pattern for meditation. The contribution of stratification in socioeconomic status and health to racial differences in contemplative practices, especially in meditation has received relatively less attention. Drawing from a subsample from Health and Retirement Survey (N = 1102), this study takes a next necessary step to assess the contribution of socioeconomic status, multimorbidity, and depressive symptoms to racial differences in both prayer and meditation use in later life. Consistent with prior studies, the odds of engaging in private prayer (OR=2.78, p<0.01) was higher among Blacks than White older adults. Our findings of higher odds (OR=2.92, p<0.001) of meditation among Black older adults than White older adults, however, do not align with previous studies. The disadvantage in socioeconomic status, health, and psychological well-being completely explain racial differences in prayer, but this difference in meditation persist even after adjusting for those factors. Our findings call for further research on contextually influenced underlying individual motivations that drive older adults of different racial and social economic groups to engage in various contemplative practices. Further research is also warranted on how older adults, particularly Blacks differentiate between private prayer and meditation.
AGING IN RURAL ETHIOPIA: IMPACT ON FILIAL RESPONSIBILITY AND INTERGENERATIONAL SOLIDARITY
Authors: Adamek Margaret E , Gebremariam Messay , Zelalem Abraham
Published: November 2019

As migration and urbanization continue to progress in developing nations, the filial support and traditional support mechanisms that serve as buffers against the plight of older people are diminishing. Agrarian families find themselves in a rapidly changing world that severely limits their ability to assume caregiving roles for elders. With these trends in mind, a phenomenological approach was used to explore the lived experiences of 10 rural elders in Ethiopia. Prominent themes in the elders’ narratives was the nostalgia of filial responsibility and intergenerational solidarity in the “good old days” and a strong sense of devaluation. Elders expressed feeling devalued by their children, grandchildren, and youth in general. As one elder shared, “These days, there is no respect for an older person. We are treated like a broken utensil thrown away which is considered as useless anymore.” Compared to how they treated their own parents, elders believed that their children’s sense of moral obligation was weak and unreliable. Interactions with children and grandchildren were described as abusive, undermining, and embarrassing, triggering deep sorrow. Elders were pessimistic about the prospect of reliable caregivers, even expressing a wish to die before they become dependent on others for care. Despite the challenges they face in their daily lives, all participants viewed aging as a privilege that should be celebrated. As traditional family support structures in developing nations continue to deteriorate, new models of community-based care are needed to ensure that elders can expect adequate care throughout their lives.
A PHENOMENOLOGICAL PERSPECTIVE OF INTERGENERATIONAL ENGAGEMENT, SOCIAL ISOLATION, AND AGE SEGREGATION
Authors: Steward Andrew , McDevitt Kimberly
Published: November 2019

Intergenerational engagement and its impact on social isolation is an area of critical importance within the broader topic of healthy aging. This phenomenological study involved individual qualitative interviews with older adults (60+ years of age without cognitive impairment). Participants (N=9) were recruited using fliers and referrals from assisted living staff. Purposive sampling was utilized, and researchers attempted to diversify the sample by selecting participants from multiple settings and cultural backgrounds. This study was guided by two overarching research aims: 1) To understand the nature of intergenerational engagement and its impact on reducing social isolation, and 2) To understand how intergenerational experiences have changed over time. Interviews were conducted by the study PI, lasted 60-minutes and took place in participants’ homes or agreed-upon public settings. Two researchers (the PI and an MSW intern) participated in the data collection and analysis process, which helped strengthen inter-coder reliability. Two important themes emerged from the data. First, participants often described intergenerational engagement as stimulating and stated that they enjoy feeling “younger” or “childlike” when engaging with younger generations. Second, participants reflected that intergenerational connections were more naturally built into their communities as young people and that society today appears to be increasingly age-segregated. Further development of internalized ageism measures may lead to a better understanding of both the positive and negative aspects of internalized ageism. Future studies should also explore, from the perspective of older adults, recommendations for re-building intentionally intergenerational communities that facilitate authentic engagement and enhanced well-being for all generations.
NAO TAKES A BOW: USING SOCIAL ROBOTS TO ENHANCE THE MOOD OF OLDER ADULTS LIVING IN RESIDENTIAL CARE SETTINGS
Authors: Fields Noelle L , Greer Julienne , Xu Ling
Published: November 2019

Social robots have been utilized in research with older adults, however, few studies have integrated participatory arts (e.g. theatre) into social robotic platforms with this population. An interdisciplinary team designed an intervention integrating theater and social robotics with the aim of improving the mood of older adults. A purposive sample of persons age 65 and older (N = 15) participated in this 3-session pilot study that involved a Shakespeare activity using the robot, NAO. Mixed methods included interview questions as well as short survey measures of depression, loneliness, and a simplified face scale for mood pre and post each session. Results from Repeated Measurement Analysis of Variance (ANOVA) showed that face scale scores significantly decreased across six time periods (F = 2.72 (5, 50), p <. 05) and this decrease marginally differed between participants with dementia (M = 2.50, SD = 1.73) and those without dementia (M = 1.62, SD = 0.52). In addition, depression scores marginally significantly decreased after intervention (F = 2.28 (5, 40), p <. 10) and these declines were also marginally significantly different for participants with (M = 0.67, SD = 0.58) or without dementia (M = 0.86, SD = 0.69). Qualitative findings suggest that participants were highly engaged and responsive to the intervention. We discuss the promising aspects of using social robotics as a platform for participatory arts interventions with older adults and offer recommendations for future interdisciplinary studies involving the use of innovative technology in residential care settings.
ANTICIPATED NEED FOR NURSING HOME PLACEMENT AMONG LESBIAN, GAY, BISEXUAL ADULTS AGES 50-64: FINDINGS FROM THE HRS
Authors: Singleton Mekiayla , Gassoumis Zach , Enguidanos Susan
Published: November 2019

By 2030, the population of LGBTQ older adults is expected to exceed 6 million. Yet little is known about the expected use of nursing homes (NH) among LGBTQ older adults. Prior research has found NHs lack cultural sensitivity, and that LGBTQ NH residents are going “back into the closet” and not disclosing their sexual orientation due to discrimination and quality of care concerns. Using data from 2016 HRS, we describe bivariate differences between the LGB and heterosexual population, ages 50 to 64, and conduct a linear regression to determine the impact of LGB status on self-reported chance of moving to a NH in the future. Compared with the heterosexual population (n=4,049), these LGB adults (n=158) had a higher mean self-reported chance of moving to a NH (p<.01), fewer children (p<.01) and reported a slightly higher health rating (p<.05). LGB adults ages 50-64 also were more likely to be unmarried (71%, p< .001), white (59%, p< .001) and have a college degree (51%, p<.001). After controlling for sociodemographic variables, there were no significant differences between LGB and heterosexual adults’ self-reported chance of moving to a NH. Although anticipated chance of moving to a NH is no different for LGB adults ages 50-64 when controlling for their sociodemographic profiles, as a group they have a higher anticipated chance than heterosexual adults. These findings support the need for improved education, training, and structural changes within long-term care settings to better serve the growing older adult LGB population.
EFFECTIVENESS OF HOME- AND COMMUNITY-BASED SERVICES IN DECREASING HEALTH CARE EXPENDITURE IN TAIWAN
Authors: Chen Ya-Mei , Yu Hsiao-Wei , Wang Ying-Chieh
Published: November 2019

Ideally, continuum of care involves wide-ranging health and long-term care (LTC) services. Taiwan’s National Health Insurance scheme and 10-Year Long-term Care Plan attempts to provide universal and fundamental services of continuum care. However, the accessibility of these services for care recipients remains unclear. This study aims to examine the effectiveness of continuum care in decreasing the healthcare expenditure of LTC recipients using home- and community-based services (HCBS). Data collated from the 2010–2013 Long-Term Care Service Management System (N = 77,251) were subjected to latent class analysis to identify subgroups of recipients using HCBS. Subsequently, the 1-year primary care expenditure after receiving HCBS was compared through generalized linear modeling. Three discrete HCBS subgroups were found: home-based personal care (HP), home-based health care (HH), and community-based care (CC). No difference in the number of visits to doctors and the average primary care expenses was observed between the HP and HH subgroups. However, considering physical and psychosocial confounders, care recipients in the CC subgroup recorded a higher number of visits to doctors (β = 3.05, SD = 0.25, p < 0.05) and lower primary care expenditure (β = -98.15, SD = 43.17, p = 0.02) than the other two subgroups. These findings suggest that LTC recipients in Taiwan may obtain better continuum care only for CC service recipients. Additionally, community-based LTC services may lower the cost of health expenditure after 1 year.
WHEN A LITTLE GOES A LONG WAY: EXPANDING HOME CARE SERVICES TO ADULTS WITH DISABILITIES
Authors: Hasworth Serena , Winfree Jaclyn , Tunalilar Ozcan , White Diana
Published: November 2019

Policy makers are increasingly interested in reducing public spending while maintaining quality of life. Since 1975, Oregon Project Independence (OPI) has supported community-based adults aged 60 and older to avoid or delay the need for residential long-term care services by increasing access to personal and home care services. The program also aims to prevent the need for Medicaid by optimizing personal resources and natural supports. In 2014, the OPI Expansion (OPI-E) pilot project began to serve adults aged 18-59 with disabilities in seven of Oregon’s seventeen Area Agencies on Aging (AAAs). This poster describes the evaluation of the expansion using three data sources: administrative data about consumer characteristics compiled by the AAAs and State of Oregon from 2015-2017 (N=3,824 traditional consumers, N= 581 OPI-E consumers), qualitative interviews conducted with AAA directors and OPI-E case managers (N=23), and a survey of current OPI-E consumers (N=126). Compared to traditional OPI consumers, OPI-E consumers were somewhat more likely to be men and people of color. Interviews with AAA staff highlighted the need for outreach, lack of service provider capacity, unique characteristics of younger consumers, and issues related to data management and rural access. Staff reported valuing the program, noting how “even low levels of service go a long way.” Qualitative and quantitative consumer responses showed consumers found OPI-E services invaluable. The majority stressed their appreciation for the program, with several describing it as “lifesaving.” These three sources informed recommendations for expanding the OPI-E program statewide.
THE MEDIATING ROLES OF HEALTH LOCUS OF CONTROL AND COPING ON THE PAIN-DEPRESSION PATHWAY
Authors: Costlow Kyrsten , Parmelee Patricia A , Harralson Tina
Published: November 2019

The literature on health locus of control (HLC) suggests that individuals who believe that their health is internally determined are more likely to use active coping strategies than those who believe their health is determined by chance or powerful others (Brosschot, Gebhardt, & Godaert, 1994; Gibson & Helme, 2000). Coping strategies (Klapow et al., 1995) and HLC (Campbell, Hope, & Dunn, 2017) have been found to influence the relation between chronic pain and depression. We hypothesized that the relation between osteoarthritis pain and depression would be serially mediated by HLC and coping. Self-report measures of osteoarthritis pain (Meenan, Mason, Anderson, Guccione, & Kazis, 1992; Parmelee, Katz, & Lawton), HLC (Wallston, Wallston, & DeVellis, 1978), coping strategies (Felton & Revenson, 1984; Rosenstiel & Keefe, 1983), and depression (Radloff, 1977) were examined in 367 older adults with osteoarthritis of the knee. Hayes’ (2013) PROCESS macro was used to test the hypothesized serial multiple mediation for three subscales of HLC: internality (IHLC), chance (CHLC), and powerful others (PHLC). After controlling for age, the hypothesized serial mediation was statistically significant for IHLC and CHLC but not PHLC. More specifically, osteoarthritis pain significantly increased CHLC, which increased negative coping and depression in turn. Osteoarthritis pain significantly decreased IHLC, which was associated with both positive and negative coping strategies in a complex serial mediation. These findings suggest that interventions targeting HLC and/or coping strategies may be able to alter the pain-depression pathway for older adults with chronic osteoarthritis pain. (Supported by R01-MH51800, P. Parmelee, PI).
LATENT PROFILE ANALYSIS OF ANXIETY, DEPRESSION, ANGER, AND ADHD IN OLDER ADULTS
Authors: Israel Sarah M , Szkody Erica , Nadorff Michael R , Segal Daniel L
Published: November 2019

Older adults are generally happier, less likely to have depression or anxiety, and have better emotion regulation abilities than earlier in life. While older age predicts more hostile beliefs about others, older adults report less hostile behavior and no difference in covert hostility, compared to other age groups. However, brain regions associated with executive function and emotion regulation are impacted by even normal aging. Using latent profile analysis (LPA) we aimed to better understand what factors contribute to a dysregulated profile in older adults and how age altered the dysregulation profile. The current archival study includes data from 518 older adults between the ages of 60 and 95 years (M = 70.73, SD = 7.34). Participants completed the Coolidge Axis II Inventory (CATI) database. The CATI is a 250-item psychopathology and neuropsychological inventory that assesses over 40 clinical and neuropsychological disorders utilizing official DSM-5 criteria. A Dysregulated Profile was identified using an LPA of diagnosis subscales (i.e., Anxiety, Depression, Anger, and ADHD) that have been previously associated with dysregulation in children and young adults. Results demonstrated that female participants reported more ADHD symptoms (more impairment in executive function) than men. Furthermore, the dysregulated profile (high on all subscales) and age interacted such that, as age increased, scores on the Depression and Anger subscales decreased. No significant differences were found for any other interactions. Our findings are consistent with existing literature. Even in the dysregulated profile, participants reported less anger and depression with older age.
NEGATIVE SOCIAL SUPPORTS AND DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS: A CROSS-LAGGED ANALYSIS
Authors: Cone Nicholas , Lee Gina , Martin Peter
Published: November 2019

The purpose of the study was to examine how negative social supports and depressive symptoms affect older adults over time. A subsample of participants (N = 3,084) from the Health and Retirement Study was used in this study. Summary scores for each negative social supports (spouse, children, family members, and friends) and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to conduct two cross-lagged regression analyses for each negative social support type from waves 2010 and 2014. Covariate variables for this study included gender, years of education, self-report of health, and age. Results were computed for two age groups (i.e., 65 to 79, and 80+). Results from both age groups indicated high stability for negative social supports and depressive symptoms from waves 1 to 2. The younger age group showed no significant cross-lag or interaction effects when stabilities were included or excluded in the analyses. However, in the older group, wave 2 negative child and family member social support was predicted by wave 1 depression scores. Moreover, the older age group showed significant interaction effects of age by CESD scores on negative child and family member social supports. In conclusion, initial depressive symptoms predict higher negative social supports in children and family members at a second time point in the older age group. Future research could examine whether depressive symptoms continue to predict negative social supports in new waves. In addition, other factors, such as loneliness, or anxiety, may provide further understanding into older adults’ negative social supports.
HEARING IMPAIRMENT, DEPRESSION, AND THE ROLE OF SOCIAL ACTIVITY AMONG CHINESE OLDER ADULTS
Authors: Xu Shu , Wang Haowei , Connelly Caitlin
Published: November 2019

Studies suggest that depression is closely linked to hearing impairment, which is highly prevalent among older adults in the United States. There is evidence that social engagement may be impacted by hearing impairment in older adults. However, there is relatively little research on these associations among Chinese older adults. This study examines the relationships between hearing impairment, social activities, and depressive symptoms among older adults in China. Using nationally representative data from the China Health and Retirement Longitudinal Study 2011, we conducted cross-sectional analysis on adults age 60 years and older (n=10,994). Depressive symptoms were assessed by the 10-item Center for Epidemiologic Studies Depression scale and we considered self-reported hearing status (if participants wear a hearing aid and how they would rate their hearing), and social activities (i.e., volunteering, dancing, attending courses, etc.). Models were controlled for age, gender, education, and other covariates. Descriptive analysis showed that 9% of older adults experienced hearing impairment. Multiple linear regression analyses revealed that hearing impairment was positively associated with depressive symptoms among older Chinese adults (β=1.32, p<.001). Social activities were found to partially mediate the relationship between hearing status and depressive symptoms. Respondents with hearing impairment were less likely to engage in social activities (OR=.78, p<.01) and those who did not participate in social activities reported more depressive symptoms (β=1.28, p<.001). These findings suggest that Chinese older adults experiencing hearing loss are at greater risk of depression and that social activities play an important role in the relationship between hearing status and depression.
WHEN AND HOW I WANT: FEASIBILITY AND EFFECTS OF EMBEDDING PHYSICAL ACTIVITY INTO NURSING HOME CARE
Authors: Barrett Eva , Gillespie Paddy , Newell John , Casey Dympna
Published: November 2019

Physical activity (PA) is essential to maintaining health into older age. However, older adults living in nursing homes (NHs) remain highly inactive. This study tested the feasibility of a PA programme embedded into NH care and its potential effects on older adults’ function and quality of life (QOL). A cluster-randomised controlled pilot feasibility study, including qualitative and economic components, was conducted. Intervention participants (n=18) performed Morning Movement (morning-time walking and sit-to-stand exercises) and Activity Bursts (bouts of activity throughout the day in standing), 3 times weekly for 12-weeks. Participants in the control NH (n=16) received usual care. At baseline and 12-weeks, feasibility and economic data were collected, function was measured using the Timed Up and Go (TUG) and 10-Metre Walk Test (10MWT) and QOL was measured with the Nottingham Health Profile (NHP) and Investigating Choice Experiments for the Preferences of Older People-CAPability (ICECAP-O). Semi-structured interviews were conducted with staff and participants at mid- and post-intervention and analysed thematically. The PA programme was acceptable to staff and participants and study procedures were feasible. Mean TUG improved by 10.2 (±21.6) seconds in the intervention group and was unchanged -0.2 (9.5) seconds in the control group (95% confidence interval of between-group difference in improvement -2.5 to 23.3 seconds). 10MWT scores stayed stable in the intervention group and disimproved in the control group. ICECAP-O and NHP scores were unchanged. While this study contained a small sample, it demonstrated a feasible, acceptable and potentially effective NH PA intervention and provides guidance for a definitive trial.
CAN GOLF INFLUENCE GAIT AND COGNITION IN OLDER ADULTS?
Authors: Marcione Nicole , Bois Andrea Du , Castle Steven , Salem George
Published: November 2019

Gait speed and cognition are important predictors of successful aging. Both slow gait speeds and cognitive decline are associated with poor health outcomes, including hospitalization, falls, institutionalization and death. Exercise interventions can improve both gait and cognitive performance in older adults. Golf is a multimodal, cognitively-challenging physical activity. The purpose of the present study was to examine the influence of a 12-week golf intervention on walking performance and cognition in older adults. Gait speed and cognition were measured in intervention (INT) and control (CON) groups (n=20) before and after a 12-week period. The INT participated in a 12-week golf training program (2 x weekly; 90 min per session). All participants completed six-minute walk test (6MWT), fast single-task gait speed (STGS), fast dual-task gait speed (DTGS) with a subtraction by 3s task, California Verbal Learning Test (CVLT) and National Institute Health Toolbox-Cognition (NIH-C). 2x2 (Time*Group) Mixed ANOVA revealed significant time*group interactions for 6MWT (p=0.05), STGS (p=0.02), DTGS (p=0.01), CVLT (p=0.01), and NIH-C Fluid Cognition (p=0.06) had a trend towards significance. Post-hoc t-tests demonstrated that INT significantly improved their pre-to-post 6MWT, STGS, DTGS, CVLT, and NIH-C Fluid. CON had no significant pre-to-post intervention changes. Participants in the 12-week golf training program improved gait and cognitive performance, compared to CON. These results provide evidence that golf, as a cognitively-challenging physical activity, may improve physical and cognitive function, leading to attenuated risk for poor health outcomes, maintaining independence and improved quality of life.
TIME SPENT IN SEDENTARY BEHAVIOR DOMAINS AND PHYSICAL FUNCTION IN U.S. OLDER ADULTS
Authors: Gell Nancy M , Bouldin Erin D , Rosenberg Dori
Published: November 2019

Previous studies have reported associations of sedentary time with worse health outcomes in older adults. Yet, little is known about the relationships between the contexts of sedentary time and health outcomes. The purpose of this study was to examine associations of physical function with time spent in a variety of sedentary behavior domains. We analyzed data from the 2016 National Health and Aging Trends Study, a nationally representative sample of community-dwelling Medicare beneficiaries. Estimated time being sedentary by domains (e.g., TV watching, computer use, resting/napping, eating, transportation, socializing, sitting and doing hobbies) were collected from a subset of the sample population (N=2157). The Short Physical Performance Battery (SPPB) measured physical function. Linear regression models were conducted adjusting for sociodemographics, health conditions, pain, and dementia. More time watching TV and resting/napping was significantly associated total SPPB scores (p < 0.01). In adjusted models, lower SPPB scores were significantly associated with more time/day spent sitting and watching television or resting (ɮ =-0.16 hours; 95% Confidence Interval (CI): -.024, -0.08 for TV watching and ɮ =-0.63 hours; 95% CI: -0.80, -0.46 for resting). Average time in computer use, eating, transportation, hobbies, or social activities did not differ by physical function level. Associations between physical function and sedentary time vary by the context. Social or engaging sedentary activities do not appear to be associated with physical function limitations in the same way as passive sedentary domains like television viewing and resting. Context should be considered in evaluating relationships of sedentary time with health outcomes.
ACTIVITY EFFORT, SELF-MANAGEMENT AND INFLAMMATION IN OLDER MEXICAN AMERICANS WITH OSTEOARTHRITIS
Authors: Harrison Tracie C , Thill Lauren , Schmidt Bianca R , Blozis Shelley
Published: November 2019

We extend our ongoing investigations of the health effects of activity effort among Mexican Americans (MA) with mobility limitations, specifically those with osteoarthritis (OA) (Harrison, 2009). Our previous research linked activity effort with co-morbidity and social participation in women with mobility limitations, finding significant variations between Non-Hispanic White and MA with physical disabilities. This bio-behavioral study takes the next step by examining the relationships between inflammatory measures (TNF-alpha & CRP), Mexican American-specific self-management behaviors (MA-SM), and activity effort (AE) in a sample of MA men and women. Over 5 months, 62 men and women, age 40 to 83, provided survey responses, blood, and saliva for analysis. After ensuring reliability of measures, we used Pearson correlations to provide initial associations. Findings indicated a significant negative correlation between AE and TNF-alpha (-.376, 0.005), which linked behaviors to inflammatory response; and between MA-SM and AE (-.254, 0.05), which linked the self-management to the behavior. These findings provide support for the biological impact of perceived activity effort on inflammation, as well as the positive effects that Mexican American specific self-management activities might have on health.
SOCIAL NETWORKS AND NEIGHBORHOOD SATISFACTION OF AFRICAN AMERICAN OLDER ADULTS: AN ATLANTA STUDY OF RELOCATION
Authors: Reed Nia
Published: November 2019

Atlanta was the first major city to offer federally-funded public housing and it is one of the first to demolish it. Unlike other cities undergoing public housing transformation through demolition under Housing for People Everywhere Program (HOPE VI), the Atlanta Housing Authority (AHA) targeted senior housing as part of the demolition process. Investigators conducting the Urban Health Initiative (UHI) study collected three waves of data (baseline, 6-month post-relocation, and 24-month post-relocation) from relocated seniors and a comparison group of seniors who aged-in-place. To understand the interactions between public housing residents and varied components of their environments, including social networks and neighborhood satisfaction, I will use place attachment theory to frame my research, as sense of place is rooted within the interplay of community cultural wealth components. I will also use aging-in-place theory, which refers to individuals’ ability to grow old in their own homes and communities, while adjusting to needed modifications associated with aging and mobility. Analysis of Covariance will be applied to understand the relationship between social networks, relocation, and neighborhood satisfaction among older adults who age-in-place, compared to those who relocated.
BUILDING SOCIAL CAPITAL: LESSONS FROM A SWISS ACTION-RESEARCH INTERVENTION
Authors: Ehsan Annahita
Published: November 2019

Social capital interventions to promote healthy aging seem promising, but recent evidence has questioned how social capital is constructed. In order to understand how social capital is built among older adults, this study draws from the diagnostic phase of one ‘Neighbourhoods in Solidarity’ (NS) intervention, which uses action research to promote wellbeing for older adults (55+) in Swiss communities. These findings arose from ethnographic fieldwork with 77 hours of observation during group gatherings and informal interviews with participants who identified and debated issues in their community. It became evident that the geographic space and the sense of identity that citizens attached to it (herein referred to as ‘place’) played a role in how the NS intervention developed. The community was divided into two groups with distinct identities: one in the north and one in the south. The sense of place for both groups was simultaneously disrupted when outsiders moved to both areas, exacerbating tensions. The NS brought the two groups together and helped develop social capital between them. This was highlighted by the changing willingness of citizens to navigate unfamiliar spaces, to create social ties, and to trust others. The NS helped create a new sense of place for citizens, which ultimately facilitated the creation of social capital in the community. The findings suggest that identities are dynamic and play a role in constructing social capital, as well as who benefits from social capital and who may be excluded. Lessons from this research may inform future social capital interventions.
INTERGENERATIONAL RELATIONSHIPS AMONG OLDER ADULTS AND GRANDCHILDREN: SUPPORTIVE AND CONFLICTUAL RELATIONSHIPS
Authors: Humboldt Sofia von , Monteiro Ana , Leal Isabel
Published: November 2019

Objectives: To analyze how older adults conceptualize these intergenerational relationships. Methods: In this qualitative study, in-depth interviews were carried out with 316 older adults, aged 65-102, from three different nationalities who lived at home. Verbatim transcripts were examined. Results: Data analysis generated six themes representing intergenerational relationships: affection and reward; interest and integration; grandparent-grandchild interaction quality; privacy and boundaries definition; provision of support; and obligation of providing childcare, on two dimensions of ambivalence concerning their intergenerational relationships (supportive and conflictual). Conclusions: The empirical findings from this research indicate how ambivalence in intergenerational relationships is experienced by older adults and stress the contradictory expectations of older adults with grandchildren. Keywords: Ambivalence; conflict; intergenerational relationships; older adults; support.
CHANGING THE CULTURE OF ADVANCE CARE PLANNING, DEATH, DYING, AND BEREAVEMENT CARE IN NURSING HOMES
Authors: Miles Toni , Brown Amanda , O’Rouke Pamela
Published: November 2019

Cultural change, using an Eden Alternative metaphor, means that palliative care becomes ‘the servant of genuine human caring, not its master’. This project, funded through the Georgia Civil Monetary Penalty Fund Reinvestment Program (CMPRP), aimed to gather information from multiple stakeholders to promote changes in the culture of advance care planning, death, dying, and bereavement care in nursing homes. Staff, residents and families from nine nursing homes provided perspectives through qualitative interviews (n=70). Participants were drawn from both small facilities and corporate entities with multiple sites, and included residents in both short and long-stay beds. Qualitative analysis of interview data resulted in the publication and dissemination of Best Practice in Bereavement Care Guides, with separate versions for residents, families, and staff. This presentation will describe this project in terms of the process of consensuses building and obtaining funding, as well as development of the guides through qualitative interview data.
RISKS AND VULNERABILITIES AFFECTING ADVANCED CARE PLANNING FOR OLDER ADULTS INVOLVED IN ADULT PROTECTIVE SERVICES
Authors: Ernst Joy S
Published: November 2019

Adult protective services (APS) workers regularly engage in advanced care planning (ACP). This qualitative content analysis of 21 APS cases sought to extend knowledge and uncover characteristics that influenced the ACP process and increased vulnerability of older adults in cases of neglect. The case narratives were examined to identify themes of vulnerability and risk related to ACP. Vulnerabilities of the older adults included multimorbidities, geriatric syndromes, and functional limitations. Risks involving caregivers included health problems and cognitive impairment. Caregivers were overwhelmed or lacked insight into the older adults’ needs. Involvement of other family members was detrimental or non-existent while some advocated for improvements where the caregiver refused assistance. Findings support the development of methods of ACP, including the facilitation of difficult conversations, that would respect the autonomy and dignity of the older adult while meeting the multiple needs of caregivers and family members.
ADDRESSING DEMENTIA CLINICAL SYMPTOMS USING NONPHARMACOLOGICAL STRATEGIES: WHAT WORKS AND FOR WHOM?
Authors: Gitlin Laura N , Gitlin Laura N , Marx Katherine A , Piersol Catherine Verrier , Hodgson Nancy A , Huang Jin , Roth David , Lyketsos Constantine G
Published: November 2019

People living with dementia experience behavioral symptoms and functional decline and their caregivers (CG), reduced wellbeing. In an RCT (N=250 dyads), we tested whether tailoring activities to interests/abilities and providing CGs with instruction in their use (Tailored Activity Program, TAP) reduced clinically significant agitation/aggression (main outcome), functional decline and improved CG wellbeing (secondary outcomes) compared to CG education/support alone; with both groups receiving 8-sessions over 3-months. At 3-months,TAP had no effects on agitation/aggression compared to CG education/support but reduced functional decline (p=0.03), improved CG wellbeing (p=0.01) and confidence using activities (p=0.02). In secondary analyses, black vs. white CGs reported reduced agitation/aggression (p=0.01); female CGs reported reduced burden with TAP whereas male CGs reported reduced burden from education/support (p=0.04); spouses vs. non-spouses reported slower functional decline in participants (p=0.01). This trial suggests outcomes vary by subgroups. Different nonpharmacological approaches are needed for specific clinical characteristics: one size will not fit all.
REJECTION OF CARE IN PERSONS WITH DEMENTIA
Authors: Regier Natalie G , Choi Scott , Gitlin Laura N
Published: November 2019

Most individuals with dementia develop significant behavioral problems, also known as neuropsychiatric symptoms (NPS). One problem that continues to plague measurement of NPS is inconsistency of terminology used to describe NPS. For example, in the Neuropsychiatric Inventory-Clinician Rating Scale (NPI-C), a gold standard for measuring NPS, rejection of care (rejection) is not differentiated from agitation or aggression. Rather, behaviors indicative of rejection are categorized as agitation. Using data from 250 persons with dementia who participated in the Dementia Behavior Study, principle components analysis of the NPI-C domain of Agitation identified four behavioral clusters: 1=rejection of care, 2=restlessness, 3=exiting behaviors, and 4=hiding/hoarding. Rejection was associated with a more distant relationship with the caregiver, lower cognitive status, and more negative caregiver communication style. Rejection was predictive of higher levels of caregiver burden. Findings support the argument that rejection is a clinically distinct NPS, and likely requires different nonpharmacological management than agitation.
AGING STRONG 2020: INTERVENTIONS TO IMPROVE LONELINESS AMONG OLDER ADULTS
Authors: Yeh Charlotte , Russell Daniel , Schaeffer James
Published: November 2019

Research confirms serious and concerning health implications for lonely and socially isolated older adults. Studies consistently demonstrate that older adults who are lonely or socially isolated have higher rates of depression, more health conditions, and greater mortality. AARP Services, Inc. (ASI) and UnitedHealthcare (UHC) are committed to the health and well-being of insureds in AARP® Medicare Supplement Plans insured by UnitedHealthcare Insurance Company (for New York certificate holders, UnitedHealthcare of New York), recognizing that health and wellness should be promoted on a holistic level to ensure successful aging. As part of this commitment, a research initiative entitled Aging Strong 2020 has been developed. Its purpose is to impact insureds’ personal and social investments in their well-being Thus a related series of interventions are aiming to increase resilience by focusing on enhanced purpose in life, social connectedness, and optimism. This symposium will specifically discuss these efforts related to social connectedness and how they have improved well-being among lonely older adults. First discussed is the prevalence and outcomes of loneliness in a large national survey. Interventions include use of animatronic pets, a telephonic reminiscent memory program, and an online self-compassion mindfulness program. Findings from these initiatives demonstrate that interventions designed to improve loneliness and well-being among lonely older adults can contribute to the holistic model of health.
BUILDING NETWORKS TO ADDRESS AT-RISK OLDER ADULTS
Authors: Zubatsky Max , Tumosa Nina
Published: November 2019

With the rise of older adults and the number of chronic health issues in this population, comes the need for greater collaboration across organizations and health care settings. Age-friendly health systems offer the benefits of providing the best care possible to individuals and families, connect people to specific community resources, and optimize the best access to services and programs. The Gateway Geriatric Workforce Enhancement Program (GWEP) has combined the efforts of Saint Louis University and a rural, critical access hospital to establish a care network across Missouri. Together, this partnership has created a number of services, initiatives, and projects to help older adults maintain independence and offer families ways to take of their loved ones in more effective ways. In this symposium, presenters from Social Work, Marriage and Family Therapy, Geriatric Medicine, Psychology and Nursing disciplines will introduce several areas of this age-friendly network. The four abstracts for this symposium include: 1.) Assessing At-Risk Older Adults through the Rapid Geriatric Assessment, 2.) Cognitive Stimulation Therapy for Individuals with Memory Loss, 3.) Predictors of Falls in Older Adults Across Partner Settings, and 4.) Development of program initiatives such as the Rapid Geriatric Assessment screening, Cognitive Stimulation Therapy, Falls Assessment in Seniors, and Care for Persons with Dementia in their Environments will be covered in detail. At the end of the four presentations, the presenters will highlight the importance of this collaborative network and ways for audience members to consider building an age-friendly network in their community.
ASSESSING AT-RISK OLDER ADULTS THROUGH THE RAPID GERIATRIC ASSESSMENT
Authors: Berg-Weger Marla , Morley John
Published: November 2019

With the need to increase gerontological competency among all health/social service professions, the Rapid Geriatric Assessment (RGA) (Morley, 2017) is a tool that can be used in most healthcare settings. Designed as a rapid screening, the validated RGA assesses frailty, sarcopenia, anorexia, cognitive function, and advance care planning. Developed in 2015 through the Geriatric Workforce Enhancement Program (GWEP), 3,489 students and 5,643 faculty and practitioners have been trained in its use and have completed 10,881 RGAs in case-finding, screening, nursing home, PACE, and hospital and residential settings. Non-population-based findings show higher-then-national prevalence in all four health condition areas across settings: frailty (n=3,140; 30%), sarcopenia (n=4,458; 42.1%), weight loss risk (n=3,012; 28.4%), and cognitive impairment (n=2,509; 23.7%). Only 34.8% of the total sample had completed advance care plans. Data comparing results by gender, age, race/ethnicity, and setting will be presented along with strategies for curricular and practice integration.
CAREGIVING CULTURES: RACE, REGION, AND RELATIONS
Authors: Savla Jyoti , Roberto Karen A , Blieszner Rosemary
Published: November 2019

Although families have always cared for their aging members, changes in contemporary society have added to the stress and challenges of providing daily care and support for relatives experiencing physical and/or cognitive decline. Personal characteristics, geographic location, and family structures and relationships influence beliefs about family care; thus, recognizing differences within and across families is crucial for developing culturally informed caregiving programs and practices. This symposium focuses on four diverse groups of caregivers. Recognition of caregiving cultures and the barriers caregivers encounter is the central theme of all four papers. Using daily diary interviews and GIS data, Savla and colleagues discuss the unique cultural and geographical challenges caregivers in rural Appalachian Virginia face when caring for a family member with dementia. J. Angel employs quantitative and qualitative data from two nationally representative datasets to discuss the effects of immigration on family structures and caregiving for Mexican-American older adults with dementia. Miyawaki and her colleagues provide a profile of caregivers of older Vietnamese refugees, the resources they use and support structures they rely on. Finally, Roberto and Savla expand the definition of family caregivers to include extended and fictive kin who are providing dementia care and provide an in-depth view of the circumstances that influence the responsibilities they assumed, the type of care they provide, and the coping strategies they use. Dr. Rosemary Blieszner will discuss the presenters’ collective findings considering their unique caregiving practices and beliefs as well as the common grounds between the different races, regions and relationships.
CAREGIVERS OF OLDER VIETNAMESE REFUGEES: FINDINGS FROM THE VIETNAMESE AGING AND CARE SURVEY (VACS)
Authors: Miyawaki Christina E , Chen Nai-Wei , Meyer Oanh L , Tran Mindy T , Markides Kyriakos S
Published: November 2019

Since the fall of Saigon, over 1.3 million Vietnamese immigrated to the U.S. making Vietnamese the 4th largest Asian ethnic but most vulnerable group to disparities. There is a paucity of knowledge on the health of elders and their caregivers. The Vietnamese Aging and Care Survey (VACS) was developed, and health data on 67 caregivers were collected in Houston, Texas. Adult-child caregivers (n=44) were on average, 45.3 years old, married (64%), working (91%), female (61%) in good/excellent health (90%). Spousal caregivers (n=23) were 70.6 years-old, retired (57%), female (78%) in fair/good health (73%). Adult-child received more help (43%) than spousal caregivers (29%), however, felt more caregiver burden (p=0.01) and perceived stress (p=0.05). Living in a multi-generation household, sharing caregiving, and working may alleviate their financial burden and provide psychological support. Findings suggest healthcare professionals to encourage caregivers to utilize available culturally-relevant social services to further ease their caregiving experiences.