bluuebunny/crossref_metadata_2025 huggingface dataset:
ASSOCIATION BETWEEN UPPER EXTREMITY FUNCTION AND ADVERSE OUTCOMES IN OLDER ADULTS WITH COPD
Authors: Asghari Mehran , Ruiz Martha , Peña Miguel , Johnson Haley , Parthasarathy Sairam , Toosizadeh Nima
Published: December 2022

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the United States. COPD adverse outcomes are required to identify vulnerable patients and enhance bronchodilator therapies. Although the 6-minute walk distance test is commonly used to assess functional capacity in COPD and predict adverse outcomes, it is not feasible for older adults with mobility impairments. Previously, we demonstrated that a simple upper-extremity function (UEF) test could identify frailty and cognitive impairment. We developed two indexes to predict the physical frailty (20-s rapid arm test) and cognitive impairment (60-s normal speed dual-task arm test and counting) among older adults. UEF tests were performed by 76 eligible older adults (age=67.421±6.363). All participants were followed up for one month to record the adverse outcomes. The measured health outcomes included: in-hospital outcomes (death, complication, and excessive length of stay), and 30-day outcomes (30-day death or readmission). Based on the results, 54% and 30% of patients had in-hospital and longitudinal adverse outcomes, respectively. The frailty index was significantly associated with all measured outcomes (p< 0.018). However, cognitive score showed significant association only with 30-day longitudinal outcomes (p< 0.021), but not for in-hospital outcomes (p>0.05). Among all the associations the highest effect size was observed between frailty score and longitudinal outcomes (p< 0.007; effect size=0.94). The results of this study suggest that a 20-s UEF test is a practical quick measure for predicting adverse in-hospital and 30-day outcomes among COPD patients.
METABOLOMIC PROFILES FOR THE EXPLORATION OF BIOMARKERS IN SEVERE SARCOPENIA AMONG OLDER MEN
Authors: Shin Hyung Eun , Kim Miji , Lee Daehyun , Jang Jae Young , Won Chang Won
Published: December 2022

The pathophysiology of sarcopenia is complex and multifactorial; however, it has not been fully elucidated. This preliminary study explored novel biomarkers of severe sarcopenia through a metabolomic analysis of plasma metabolites in community-dwelling older men. Twenty older men (mean age: 81.9±2.8 years) were randomly selected from the Korean Frailty and Aging Cohort Study. Participants with severe sarcopenia were compared to healthy, age-, and body mass index-matched controls (n = 10 each). Severe sarcopenia was diagnosed using the Asian Working Group for Sarcopenia 2019 criteria. Non-targeted metabolomic profiling of plasma metabolites was performed using capillary electrophoresis time-of-flight mass spectrometry. Among the 191 plasma metabolic peaks, 10 metabolites differed significantly between healthy controls and participants with severe sarcopenia. The plasma concentrations of l-alanine, homocitrulline, n-acetylserine, gluconic acid, n-acetylalanine, proline, and sulfotyrosine were higher, while the concentrations of 4-methyl-2-oxovaleric acid, 3-methyl-2-oxovaleric acid, and tryptophan were lower in participants with severe sarcopenia than in healthy controls (all, p < 0.05). Of the 57 metabolites quantified in target metabolites, L-alanine (area under the receiver operating characteristic curve [AUC] = 0.760, p = 0.049), gluconic acid (AUC = 0.800, p = 0.023), proline (AUC = 0.785, p = 0.031), and tryptophan (AUC = 0.800, p = 0.023) predicted the presence of severe sarcopenia. In conclusion, plasma metabolomic analysis demonstrated significant changes in amino acid, arginine, proline, and pentose phosphate metabolism in participants with severe sarcopenia. The identified metabolites could be helpful in understanding the underlying pathophysiology of sarcopenia.
THE POWER OF DAUGHTERS: THE ROLE OF SIBSHIP GENDER COMPOSITION IN MOTHER-ADULT CHILD RELATIONS
Authors: Frase Robert , Suitor J Jill , Gilligan Megan , Kincaid Reilly , Stepniak Catherine
Published: December 2022

Prior scholarship demonstrates that older mothers receive more care from daughters, prefer daughters as caregivers, and have stronger emotional bonds with daughters. Despite these clear gendered differences in care, care preferences, and closeness, less is known about whether the presence of daughters in a family affects mother-adult son relationships or whether the presence of sons in a family affects mother-adult daughter relationships. Drawing from theories of gender socialization and social exchange, we propose that mothers would, given the choice between daughters and sons, prefer to receive care from and engage in emotional exchanges with daughters. Therefore, we predict sons’ care to and emotional closeness with older mothers will be inversely related to the number of daughters in the family. We test our hypotheses with mixed-method data from 1,577 mother-adult child dyads nested within 420 families collected as part of the Within-Family Differences Study-II. Findings support our hypotheses. The larger the number of daughters, the less likely sons are to provide care to their mothers, whereas the likelihood of daughters providing care is unaffected by the number of sons. Similarly, the larger the number of daughters, the lower closeness mothers report with their sons, whereas mother-adult daughter closeness is unrelated to the number of sons. In sum, our findings show ways in which both an adult child’s gender and the gender composition of their sibship affect mother-adult child relationships, as well as highlighting the applicability of theories of gender socialization and social exchange to the context of aging families.
IMPACT OF THE COVID-19 PANDEMIC: HEALTH AND MENTAL HEALTH CAPACITY OF CAREGIVERS AND CARE RECIPIENTS
Authors: Miyawaki Christina , Tahija Nina
Published: December 2022

We developed a depression intervention, Caregiver-Provided Life Review (C-PLR) for people living with dementia and their family caregivers in 2018 and pilot-tested (N=19 caregiver (CG)-care recipient (CR) dyads). Encouraged by the outcomes, in 2020 we expanded the study to long-term care facility (LTCF) residents. Due to the COVID-19 pandemic, we adapted the in-person mode to virtual and recruited CGs who provided care for >8 hours/week and CRs who were community-dwellers or LTCF residents with mild depression and dementia. Between August 2020 and December 2021, we contacted 195 LTCFs, 29 senior/community centers, and 148 community-dwellers and recruited 12 dyads nationwide. CGs were on average 54 years old, working (67%), college-educated (83%), female (92%), and in good-excellent health (75%). CRs were 83 years old (mean), single (58%), female (92%), and in fair health (50%). CRs’ depression score significantly improved (p=0.0004), however, CG’s burden and positive aspects of caregiving scores worsened (p=0.02). Amid the pandemic, LTCF closures and staff turnover made recruitment challenging. Despite a small sample, we found CRs enjoy the LRs alleviating depressive symptoms. However, CGs experienced more burden, which could be due to COVID fatigue and the LR as an additional responsibility. These results reminded us of the COVID impact and adjusted the C-PLR model further. Instead of a weekly visit, each dyad can meet at its own pace. We developed the C-PLR to improve the health of the dyads. Thus, we must consider both CGs’ and CRs’ health capacity because CR’s wellbeing is dependent on that of CGs.
“HE JUST WANTS HIS SERVICES BACK”: IMPACTS OF HOME CARE WORKER DISRUPTIONS ON PATIENTS AND CAREGIVERS DURING COVID-19
Authors: Xu Emily , Kim Patricia , Zhang Meng , Reckrey Jennifer , Ornstein Katherine , Franzosa Emily
Published: December 2022

Home care workers (HCWs) have played a critical role in keeping homebound older adults safely at home during COVID-19, yet their essential work is often understudied. This study characterized the roles of HCWs during COVID-19 and examined how HCW service disruptions impacted patients and their caregivers. We performed a thematic analysis of medical records from 53 patients with HCWs in a home-based primary care practice in New York City. We abstracted unstructured clinical notes into a priori and emergent categories and identified core themes via team discussion. The following themes emerged: 1) Shifts to remote medical care and changing patient needs led to task shifting and new tasks for HCWs (i.e. getting food for patients experiencing food insecurity), 2) The risks associated with HCW tasks, such as exposure from caring for patients with COVID-19, increased during the pandemic, 3) Patient and family refusal of HCW services to avoid COVID-19 exposure as well as abrupt loss of HCW services due to HCW precarity or COVID-19 exposure left family caregivers with additional caregiving responsibilities, 4) Regulations surrounding return to work following COVID-19 exposure created additional difficulties in reinstating HCWs and left patients without adequate care, putting them at risk of hospitalization. In conclusion, pandemic-related disruptions created barriers to adequate home care, putting both patients and caregivers at risk. This analysis suggests a need for more robust HCW training and established regulations to protect HCW safety as well as a need for policies to support caregivers and ensure continuity of care during emergencies.
LONG-TERM CARE RESIDENT PERSPECTIVES ON PERSON-CENTERED CARE: INTERSECTIONS OF PRACTICE AND THEORY
Authors: Ciolfi Mary Lou , Taylor Catherine , Ericson Tracy , Wihry David , Crittenden Jennifer , Hunt Angela , Kaye Lenard , Nebenzahl Paul
Published: December 2022

The Designation of Excellence in Person-Centered Long-Term Care is a multi-year study to redefine standards of long-term care delivery according to the preferences of residents, family, staff, and leaders. During 2021, as one component of the study, 247 residents from 23 communities across the country engaged in a participatory message board activity inquiring about their lived experiences of receiving care and services in their long-term care communities. Residents commented on their personal care, personal and shared spaces; family, friends, and community; and wishes and feelings. Using a phenomenological approach to data analysis to better understand the universal and the unique aspects of the experience of living in long-term care, key themes centered on the importance of staff (1) knowing, responding, and being attentive to the details of residents’ life history, care needs and preferences; (2) treating residents respectfully and as mature adults; and (3) demonstrating care and connection in resident interactions. These key themes and their related sub-themes intersect with several social science theories that underscore those factors promoting adaptability to changed environments while trying to preserve identity, belief systems, and values. Applying a conceptual lens to resident comments suggests programmatic strategies that long-term care providers can prioritize for promoting and operationalizing person-centered care. The poster will present a graphic representation of the intersections of person-centered care and existing theoretical frameworks using resident remarks to highlight central tenets of continuity theory, person-environment fit theory, and social identity theory.
A SCOPING REVIEW OF HOW NURSING HOME STAFFING LEVELS AND QUALITY OF CARE ARE MEASURED
Authors: Zhang Mutian , Brown Shelby , Tang Weizhou , Tucker-Seeley Reginald
Published: December 2022

The Centers for Medicare & Medicaid Services (CMS) is the largest payer of nursing home care in the US. CMS defines staffing levels as hours per resident day (HPRD) and staff turnover rates; it defines quality of care as nurse staffing levels, hospitalization rates, resident outcomes, and deficiencies (violations of regulations). However, these definitions have been inconsistently applied in the research literature, which has led to equivocal results in research on the association between staffing levels and the quality of care in nursing homes. We conducted a scoping review of how nursing home staffing levels and quality of care have been defined and measured in the research literature, guided by the PRISMA (Preferred Reporting Items for Systematically reviews and Meta-Analyses) framework. Out of the N=423 initially identified studies through PubMed, N=67 articles were selected, based upon the following inclusion criteria: 1) published after January 1, 2010; 2) published in the US; 3) focused on determinants of nursing home staffing levels or determinants of quality of care. Two independent reviewers conducted abstract screening and data extraction. The findings from our review showed that approximately 50% of studies partially adopted the definitions from CMS. For example, HPRD and deficiencies were utilized to measure staffing levels and quality of care in N=37 and N=12 studies, but none of them included all suggested measures. Future studies should carefully consider the approriate definitions as specific measures can yield contradictory associations between staffing level and quality of care, easily leading to confusion for policymakers.
ADIPOSITY CHANGE IN ADULTS: THE IMPACT OF TRAIT NEUROTICISM
Authors: Alderson Jacob , Willard Meredith , Turiano Nicholas
Published: December 2022

Increased body weight is a risk factor for poor health and shortened life expectancy. Thus, it is imperative to understand how body weight changes across adulthood and to identify factors that predict weight gain so effective prevention strategies can be implemented. It is well-known that eating habits and physical activity are two of the most important factors (along with genetic factors) contributing to weight gain. However, we seek to determine if personality levels predict weight gain because individual differences in personality are thought to be the root-cause of many behaviors related to weight gain. We utilized longitudinal data on over 6,000 adults (aged 20-75 at baseline) from the Midlife Development in the U.S. Study (MIDUS). The Big 5 personality traits, body weight, waist circumference, and body mass index were measured three times from 1995-2015. We estimated a growth curve model to determine whether each adiposity measure changed over 20 years, controlling for age, gender, and education. There was a significant increase in all adiposity measures over time. The rate of adiposity change over time varied among persons (random: weight b = 0.543; waist b = 0.008; BMI b = 0.009; p values < .05). Higher levels of neuroticism predicted this variability (fixed: weight b = 0.211; waist b = 0.027; BMI b = 0.029; p values < .05) such that those scoring higher in trait neuroticism had a steeper increase in all three adiposity measures. These findings suggest that personality traits are important in the progression of weight-gain in adults.
PERSPECTIVES ON THE RISK FACTORS ASSOCIATED WITH MISSING INCIDENTS IN PERSONS LIVING WITH DEMENTIA
Authors: Daum Christine , Perez Hector , Miguel-Cruz Antonio , Letts Elyse , Rutledge Emily , Liu Lili
Published: December 2022

Persons living with dementia are at higher risk of getting lost and going missing. The adverse outcomes of missing incidents are stressful for persons living with dementia and those who care for them. This study aimed to identify and describe the perspectives of persons with dementia, caregivers and community support organizations on risk factors. Generic qualitative description informed our methods. We conducted 30 virtual interviews with persons who live with dementia, professional and family caregivers and community support organization representatives. We used a card sort to elicit and describe perspectives on the importance of 27 risk factors commonly associated with missing incidents in persons living with dementia. Interviews were digitally recorded, transcribed verbatim, and subjected to content analysis to determine the presence of relevant words, themes, and concepts. Participants reported multiple experiences of a person going missing, impressions, and suggested relationships between factors such as environmental contexts. The most critical risk factors associated with getting lost and going missing were cognitive impairment, unmet needs, and inadequate concentration of services and resources. In contrast, race, education, and gender were perceived as unimportant pertaining to risk factors related to missing incidents in persons living with dementia. An understanding of the perceived importance of risks associated with missing incidents enhances a person-centered approach to addressing unmet needs, services and resources that balances quality of life with maintaining safety.
DEFICIENCY CITATIONS ON INAPPROPRIATE PSYCHOTROPIC MEDICATION USE WHEN CARING FOR BEHAVIORAL SYMPTOMS OF DEMENTIA
Authors: Yoon Jung Min , Trinkoff Alison , Galik Elizabeth , Brandt Nicole
Published: December 2022

The National Partnership to Improve Dementia Care in Nursing Homes in 2012, initiated by the Centers for Medicare and Medicaid (CMS), helped decrease antipsychotics use. However, inappropriate psychotropics use to control behavioral symptoms associated with dementia remains. Nursing homes (NHs) can be flagged for inappropriate psychotropics use as a deficiency of care citation (F-758 tag). The purpose of this study was to explore the nature of inappropriate psychotropic medication use deficiency, F-758 citations, in caring for NH residents with dementia using a mixed-methods study design. During the first quarter of 2018 (January–March), 444 NHs received F-758 tags related to care of residents with dementia. Information on deficiencies were obtained from 2018 Certification and Survey Provider Enhanced Reporting (CASPER) data. Deficiency reports were obtained from CMS Nursing Home Compare and ProPublica. Quantitative analysis was done to examine the frequency of involved psychotropic medications, scope and severity of F-758 tags, and reasons for the citations. Qualitative data analysis was conducted using content analysis with an inductive coding approach to summarize the inspection reports. Antipsychotics were the most involved drug category for F-758 tag citations. The three most common reasons for F-758 citations included failure to: identify and/or monitor behavioral symptoms (178 NHs), attempt gradual drug reduction (131 NHs), and maintain 14-day limitations on PRN psychotropic orders (121 NHs). This study suggests areas for improvement that could potentially reduce inappropriate psychotropics use. Supporting quality dementia care workforce and improving cooperation within healthcare professionals are recommended to ensure proper non-pharmacological and pharmacological interventions.
USING ACTIGRAPHY TO ASSESS CHRONOTYPE AND PHYSICAL ACTIVITY IN OLDER ADULTS
Authors: Hicks Hilary , Losinski Genna , Thangwaritorn Pilar , Laffer Alex , Watts Amber
Published: December 2022

Chronotype refers to the time of day that people prefer to be active or to sleep and varies predictably across the lifespan. In younger samples, the morning-chronotype is related to greater levels of physical activity (PA) and improved health outcomes. It is unclear whether this pattern holds in older adults, a group that commonly exhibits an “early bird” preference. We investigated differences in PA patterns between chronotypes in 109 older adults (Mage = 70.45 years) using wrist-worn ActiGraphs in a free-living environment. ActiGraphs captured data about PA and sleep using a novel approach to measuring chronotype with the mid-point of the sleep interval. We categorized participants as morning-, intermediate-, or evening-chronotypes. We used ANCOVA to predict total and average peak PA from chronotype, adjusting for age, sex, education, and BMI. Total PA significantly differed between chronotypes such that evening-types engaged in less PA than both morning- and intermediate-types, F (2,102) = 4.377, p =.015. Average peak activity did not differ between chronotypes, p =.112. Consistent with findings in younger samples, our evening type participants engaged in less overall activity. A unique finding was that evening-types did not differ from their morning- and intermediate-chronotype peers in peak activity levels. This implies a key distinction between total activity and peak activity levels consistent with recent trends in PA research using a 24-hour-a-day framework instead of average or total activity levels. Future research should consider whether these differences in activity patterns translate into meaningful differences in health benefits in this age group.
SENSE OF PURPOSE IN LIFE AND ALLOSTATIC BURDEN IN TWO LONGITUDINAL COHORTS
Authors: Lewis Nathan , Hofer Scott , Hill Patrick
Published: December 2022

Sense of purpose in life has been linked with better physical health, longevity, and reduced risk for disability and dementia, but the mechanisms linking purposefulness with diverse health outcomes is unclear. Chronic activation and dysregulation of neural, immune, and other bodily systems, known as allostatic load, may contribute to these underlying mechanisms. Specifically, sense of purpose may promote better physiological regulation in response to stressors and health challenges, leading to lower allostatic burden and disease risk over time. Data from the nationally representative US Health and Retirement Study (HRS) and English Longitudinal Study on Ageing (ELSA) (Total N=5846; Mean Age=67.24, SD=10.68, 59.08% female) were used to examine associations between sense of purpose and repeated assessments of allostatic load across 8 and 12 years of follow-up. Allostatic load scores were constructed from 12 blood-based and anthropometric biomarkers of cardiovascular, metabolic, immune, and lung function, with higher scores representing higher allostatic burden. Population-weighted multilevel models revealed that sense of purpose in life was associated with lower overall levels of allostatic load in HRS (b = -0.22, 95% CI: -0.27,-0.17) and in ELSA (b = -0.19, 95% CI: -0.35,-0.03). Sense of purpose in life did not predict rate of change in allostatic load in either sample. Associations with sense of purpose were highest among cardiovascular and immune biomarkers, suggesting that preservation of these bodily systems may underlie associations between purposefulness and reduced risk for chronic health conditions. Discussion will focus on biological and behavioral pathways connecting sense of purpose in life and health.
GOAL ADJUSTMENT CAPACITIES DURING COVID-19: CONTEXT-DEPENDENT BENEFITS FOR EMOTIONAL WELL-BEING
Authors: Hamm Jeremy , Barlow Meaghan , Tan Jaron , Garcia Odalis , Duggan Katherine
Published: December 2022

Increased constraints and lost opportunities inherent in the COVID-19 pandemic can threaten important life goals and erode emotional well-being. Theories of lifespan development have identified goal adjustment capacities (goal disengagement and goal reengagement) as core self-regulatory resources that can buffer against declines in well-being. However, little is known about the pandemic-related contextual circumstances under which goal adjustment capacities may become more or less beneficial for well-being. Using longitudinal data from a nationally-representative sample of Americans across the adult lifespan (aged 18-80, n=286), we examined the consequences of goal adjustment capacities for emotional well-being under circumstances when individuals reported lower or higher constraints than normal in their lives. Specifically, multilevel models tested whether the influence of between-person differences in (Level 2) goal disengagement and goal reengagement on well-being were moderated by (Level 1) within-person fluctuations in perceived constraints. Analyses controlled for age, sex, education, and income. We observed cross-level Goal Reengagement x Perceived Constraints interactions for depressive symptoms, perceived stress, and positive affect (bs = -.11 to .07, ps < .05), but not negative affect. Results showed that the benefits of goal reengagement for depressive symptoms, perceived stress, and positive affect were pronounced on occasions when participants reported lower (vs. higher) than average perceived constraints in their lives. Findings point to the moderating role of pandemic-related contextual circumstances and suggest that goal reengagement may be most beneficial when individuals have fewer constraints than usual in their lives and may thus able to capitalize on opportunities to pursue new attainable goals.
WELL-BEING BEFORE AND DURING THE COVID-19 PANDEMIC: ASSOCIATIONS WITH RESILIENCE AND CHRONIC CONDITIONS
Authors: Kayser Jay , Smith Jacqui
Published: December 2022

Adults over the age of 60 tend to have higher well-being than younger adults, and high well-being is associated with a range of favorable mental and physical health outcomes. Resilience is related to the maintenance of well-being in the presence of challenging circumstances and stressors. Chronic health conditions are common in older adults and represent a stressor. Using longitudinal data, we address two research questions: 1) Are chronic health conditions and resilience predictive of changes in well-being before and during Covid-19? 2) Does the number of chronic health conditions and resilience interact in predicting changes in well-being before and during Covid-19? To answer these questions, we analyzed data from participants in the Health and Retirement Study (HRS) who completed both the 2016 and 2020 waves (N = 2276). On average, these participants were age 71.44 (SD = 7.35) and reported 2.40 chronic conditions. In unadjusted models, both the number of chronic conditions (β = -.21) and resilience (β = .09) were related to changes in well-being (R2 = .32). When covariates were added, these values were attenuated but remained statistically significant. The interaction between resilience and chronic health conditions was not statistically significant. Though the number of chronic health conditions and resilience play an important role in well-being for older adults, high resilience does not moderate the relationship between the number of chronic health conditions and changes in well-being. Further investigations using longitudinal data are needed to understand the relationship between resilience and well-being for those with chronic health conditions.
INTERPERSONAL DYSFUNCTION PREDICTS SUBSEQUENT FINANCIAL EXPLOITATION VULNERABILITY IN OLDER ADULTS
Authors: Han Duke , Lim Aaron , Mosqueda Laura , Nguyen Annie , Mason Tyler , Weissberger Gali , Fenton Laura , Lichtenberg Peter
Published: December 2022

The goal of this study was to test whether interpersonal dysfunction, characterized by loneliness and/or dissatisfaction with relationships, is an imminent predictor of financial exploitation vulnerability (FEV) among older adults within a 6-month observation period. This study also tests whether FEV prospectively predicts interpersonal dysfunction. Twenty-six adults aged 50 or older completed a study involving baseline data collection and 13 follow-ups over 6 months. Linear mixed models were used for primary analyses. After adjustment for demographic, psychological, and cognitive covariates, there were between-person effects of FEV and interpersonal dysfunction across follow-ups, suggesting that those with generally higher interpersonal dysfunction compared to other participants also reported greater FEV (B(SE)=1.09(.33), p=.003). There was a within-person effect (B(SE)=.08(.03), p=.007) of elevated interpersonal dysfunction predicting greater FEV two weeks later across all follow-ups. Within-person effect of FEV was not predictive of interpersonal dysfunction (B(SE)=.25(.15), p=.10). Among older adults, individuals with higher interpersonal dysfunction relative to others in the study reported greater FEV throughout the 6-month observation period. Increased loneliness and social dissatisfaction, relative to one’s average level, predicts subsequent increases in FEV, and may be an imminent risk factor for exploitation.
THE PROTECTIVE EFFECT OF RESILIENCE ON SHRINKAGE OF FRIENDSHIP IN LATER LIFE
Authors: Sugawara Ikuko , Takayama Midori , Ishioka Yoshiko
Published: December 2022

The purpose of this study was to examine the protective effect of trait resilience, a positive personality characteristic that enhances individual adaptation to life events and adversity, in the face of declining social relationships in later life. Social relations have a significant effect on our development and well-being throughout life. However, it is known that a decline in physical, cognitive, and mental functioning makes it difficult to maintain active participation in society and leads to shrinking social networks in later life. Therefore, it is important to identify protective factors that enable people to maintain positive social relations when functioning in daily life declines in old age. We analyzed longitudinal survey data from a representative sample of older Japanese adults aged 74 to 86 years (N=1064). The interaction effect of resilience in the relationship between functions (physical, cognitive, and mental) and relationships with friends (social support exchange and companionship) was examined using multi-group Structured Equation Modeling (SEM). Respondents were divided into upper quartile and lower quartile groups according to their Resilience Scale (RS-14) scores. The results showed significant group differences for the effect of cognitive function on friendship. The positive correlation between cognitive functioning and friendship was stronger among respondents with low resilience. For high resilience participants, cognitive functioning was not associated with friendship. The results suggest that resilient older adults cope well with poor cognitive health and maintain positive social relationships in very late life.
CHILDHOOD MALTREATMENT AND PROSOCIAL BEHAVIOR: A QUALITATIVE COMPARATIVE STUDY OF IRISH OLDER ADULT SURVIVORS
Authors: Rohner Shauna , Salas Aileen , Carr Alan , Thoma Myriam
Published: December 2022

Although childhood maltreatment can have lasting effects into later life, positive outcomes have also been observed, including an increased tendency towards prosocial behavior. However, little is known about the link between childhood maltreatment and later life prosocial behavior. Therefore, this study aimed to explore older adult’s experiences of childhood maltreatment and identify mechanisms linked to prosocial behavior in later life. The individual level, but also broader cultural and contextual mechanisms, were considered by comparing two adversity contexts and applying conceptual frameworks (socio-interpersonal framework model of trauma and recovery, motivational process model of altruism born of suffering). Semi-structured interviews (60-120 minutes) were conducted with 29 Irish (older) adult survivors of childhood maltreatment: 17 institutional (welfare care) abuse survivors (mean age: 61 years, range: 50-77), 12 familial abuse survivors (mean age: 58 years, range: 51-72). Interviews were analyzed using Framework Analysis. In both groups at the individual level, enhanced empathy, amelioration, and identity-related mechanisms were linked to prosocial behavior, with connections to caring roles and coping strategies from childhood. On a social contexts level, the limited resources or opportunities for help in childhood, and the social norms and beliefs of that time, influenced participants’ motivation to help others in later life. Group-specific mechanisms were also observed, such as compassion fatigue in the familial sample; and denouncing detrimental societal values in the institutional sample. The identification of individual, adversity-context, and culture-specific mechanisms linked to later-life prosocial behavior can promote a greater understanding of resilience and adaptability in older adult survivors of childhood maltreatment.
STRATEGIES TO ENSURE AUTHENTIC PARTICIPANTS AND VALID DATA WITH ONLINE RECRUITMENT OF FAMILY CAREGIVERS
Authors: Armah Henrietta , Vickers Jasmine , Wang Danny , Pickering Carolyn
Published: December 2022

Over the past years, recruitment of participants for behavioral and biomedical research through the internet has become more popular. Online has become an advantageous approach to recruitment, especially since the covid pandemic has posed a great challenge to most in-person research activities. Typically, internet-based recruitment strategies include website posting, emailing list of potential participants as well as using social media such as Facebook, Twitter, and Instagram to deliver recruitment information to groups who are often unrepresented in research. Although this mechanism has reduced barriers to participation, it has posed serious threats to data quality and validity. For example, some studies on data validity estimate that up to 90% of online survey responses are fraudulent when they rely on screening questions and CAPTCHA alone. Others have shown that vetted panel data such as Mechanical Turk (mTurk), has high rates of participant misrepresentation. Therefore, the aim of this paper is to highlight the challenges associated with internet-based recruitment of family caregivers and describe strategies for researchers to ensure data integrity. We discuss multi-faceted approaches to detect and prevent fraudulent and suspicious activities such as duplicate and automated enrollment by software applications known as bots as well by fraudulent human participants. We discuss data on several strategies that have proven effective in our previous and ongoing trails. We will also demonstrate the need to implement several strategies and a “fail-safe” to detect fraud after enrollment. It is imperative that researchers understand the need to address these challenges to preserve data integrity and replicability.
TIME IS OF THE ESSENCE: RELIABLE MEASUREMENT OF HEART RATE VARIABILITY IN OLDER ADULTS
Authors: Pinheiro Cristina , Segerstrom Suzanne , Karr Justin
Published: December 2022

Heart rate variability (HRV) decreases with age and is an important correlate of psychosocial and physical health. Recommendations for the minimum duration of EKG to accurately derive HRV vary from 1 minute to several minutes. However, the definition of “accuracy” or reliability depends on study design, including whether the focus of the study is on stable or momentary between-person differences or within-person changes in HRV. In a sample of 216 older adults (Mage = 72.7, 62.5% women), ECG was measured at 1000 Hz for 10 minutes every 6 months for up to 6.5 years. HRV was high-frequency power (0.15–0.40). A generalizability study determined the variance due to minute, occasion, person, and their interactions. The most variance was due to idiosyncratic occasion differences (46%), followed by stable person variance (18%). A decision study determined how accuracy in HRV measurement could be achieved. Between-person differences in HRV at a specific occasion could be reliably measured with 6 minutes of ECG (.80); within-person changes in HRV between occasions could be reliably measured with 3 minutes of ECG (.83). For stable individual differences, 10 or more occasions of 1-minute duration produced a more reliable estimate (.73) than increasing the length of a single ECG recording to 10 minutes (.25). The necessary duration of ECG for measuring HRV reliably depends on the study design and research question. Ultra-short durations (1-2 minutes) are generally not recommended for older adults.
THE EFFECTS OF SLEEP DEFICIENCY ON MULTIMORBIDITY AMONG OLDER ADULTS IN THE PHILIPPINES AND VIETNAM
Authors: Chen Tuo-Yu , Cruz Grace , Vu Nguyen , Saito Yasuhiko
Published: December 2022

Multimorbidity increases the risks of disability and death and are prevalent among older adults. Evidence shows that sleep might play an important role in multimorbidity. However, previous research studies sleep quality and quantity in isolated manners, where in reality sleep quality and quantity are likely to affect each other. Besides, no study has been done to understand such relationship among older adults in low- and middle- income counties where the prevalence of multimorbidity increases rapidly. This study investigated the relationship between sleep deficiency (i.e., poor and insufficient sleep) and multimorbidity among community-dwelling older adults in the Philippines and Vietnam. Cross-sectional data were obtained from the Longitudinal Study of Ageing and Health in the Philippines (N = 3,562) and the Longitudinal Study of Ageing and Health in Vietnam (N = 3,936). Multimorbidity was defined by having two or more of chronic conditions (i.e., heart disease, heart attack, cardiovascular disease, hypertension, diabetes, lung diseases, renal diseases, liver diseases, and arthritis). Sleep deficiency was conceptualized as self-reported short sleep duration (< 6 hours), having trouble with falling asleep or maintaining sleep, and/or experiencing non-restorative sleep. Logistic regression was used to analyze the data adjusting for demographics, body mass index, sleep medications, naps, mental health, and lifestyle. The results showed that having deficient sleep was significantly related to increased odds of experiencing multimorbidity by about 81% in the Philippines and Vietnam. Our findings revealed that treating sleep deficiency among older adults in the Philippines and Vietnam can potentially reduce the risks of multimorbidity.
THE MEDIATING ROLE OF FATIGUE/SLEEPINESS BETWEEN STATE MINDFULNESS AND SUBJECTIVE COGNITION
Authors: Rehman Aziz , Mu Christina , Lee Soomi
Published: December 2022

Previous studies have established a connection between higher mindfulness and cognitive abilities; however, few studies have considered the mechanism underlying this relationship. The cognitive benefit of mindfulness may be through reduced fatigue and daytime sleepiness. This study examined if higher, naturally occurring mindfulness is associated with higher subjective cognition and whether lower fatigue or sleepiness mediate this relationship. Two independent samples of nurses (N1=60 inpatient (IP); N2=84 outpatient (OP)) completed 14 days of ecological momentary assessment (EMA). Fatigue/sleepiness, mindfulness, and subjective cognition (mental speed, processing sharpness, memory) were assessed using EMA. The 5-item Mindful Attention Awareness Scale assessed state mindfulness. Multilevel mediations were conducted in Mplus to account for the nested data. At the within-person level, daily subjective cognition was higher than average on days when mindfulness was higher in both OP and IP samples. This association was mediated by lower levels of fatigue (IP indirect effect: B=2.08, p<.001; OP indirect effect: B=2.57, p<.001) and lower sleepiness (IP indirect effect: B=1.72, p=.001; OP indirect effect: B=0.92, p=.027). The daily indirect pathways were found after controlling for between-person differences; those with higher mindfulness reported higher subjective cognition through lower fatigue, and this effect was only significant in OP nurses (indirect effect: B=11.61, p=.001). Results highlight the importance of monitoring momentary mindfulness and intervening on daily fatigue and sleepiness as these may influence one’s subjective cognition and ultimately their objective performance. These findings may help identify modifiable factors to promote quality of care in nurses and their own well-being.
NEIGHBORHOOD IMPACTS ON KOREAN OLDER ADULTS’ DEPRESSION
Authors: Kim Seon
Published: December 2022

Older adults are more influenced by their neighborhood than young adults, however neighborhood impacts on older adults are little known. In response to the increasing depression of older adults in Korea, this study aims to identify the effect of perceived and objective neighborhood characteristics in depression and find differences between rural and urban areas. This study uses the Korean Elderly Survey conducted in 2020 on 10,097 older adults aged 65 and over residing in 17 states, and Korean administration data by connecting them. Multilevel modeling results show that after controlling individual characteristics, depression decreases when older adults perceive their housing condition (b=-.64, p<.001), interaction with neighbors (b=-.29, p<.001), overall neighborhood environment (b=-.26, p<.001) positively. Although objective neighborhood characteristics do not significantly reduce depression in older adults living in urban area, for older adults living in rural areas, the number of social worker (b=- .42, p <.001), the number of senior center (b=-6.70, p<.001), and home care services (b=-49.5, p <.001) are negatively associated with depression in older adults. This study discusses that neighborhood characteristics may play an important role in older adults’ depression, and that their effects may differ between rural and urban areas. This study encourages policy makers to consider neighborhood characteristics to improve the mental health of Korean older adults.
THE ROLE OF SPIRITUALITY IN LATER LIFE: A STUDY OF OLDER ADULT UNIVERSITY STUDENTS IN PORTUGAL
Authors: Casanova Giuliana
Published: December 2022

In Portugal, little has been done to investigate spirituality and its impact on later life. This study aims to discover whether spirituality contributes to successful aging in the lives of Portuguese older adults. This mixed-methods research study is based in Porto, Portugal. The sample size is 58 students from universities of the third age, ages 65 to 89 with no cognitive deficit. Data was collected by a demographic questionnaire, Spirituality Scale, Scale of Psychological Well-Being, and a mix method questionnaire. The data analysis was conducted by descriptive statistics and thematic analysis.

Results: Participants rated high in both the Spirituality Scale and the Psychological Well-Being Scale. The data also showed a significant and positive correlation between the dimension of hope/optimism from the Spirituality Scale and the dimension of autonomy from the PWB Scale; as well as between global spirituality and the dimension of autonomy. The mix-methods questionnaire showed 90% of the participants believe in God or a higher power, 81% considered themselves spiritual while 89.4% felt spirituality had always been a part of their lives. The three most significant themes that emerged were the connection to a higher power/divine, personal well-being, and the importance of spirituality throughout their lifetime. Discussion: Spirituality demonstrated to be correlated with the participant's ability and perception of autonomy and independence; having their spirituality as a coping mechanism to deal with life′s adversities while being able to look at the future with optimism. Spirituality can provide purpose, guidance, and meaning in the later years of life.
A ROUTINE BLOOD PARAMETER BIOLOGICAL AGE COMPOSITE IS ASSOCIATED WITH FRAILTY IN THE BERLIN AGING STUDY II (BASE-II)
Authors: Demuth Ilja , Vetter Valentin , Drewelies Johanna , Duezel Sandra , Spira Dominik , Steinhagen-Thiessen Elisabeth , Bertram Lars , Gerstorf Denis
Published: December 2022

High-quality biomarkers are needed to predict age-related phenotypes and evaluate health-related interventions. Telomere length has been known as a biomarker of aging for some time, however, its potential for clinical use is limited. Epigenetic age estimators and biological age (bioage) composites have been developed and refined over the past decade and their evaluation is ongoing. Aim of the current study was to further evaluate a recently developed bioage composite based on 12 routine laboratory blood parameters which have been shown to individually predict mortality risk. To this end, we assessed the relationship between the bioage composite, frailty and a number of functional assessments. The bioage composite was calculated for participants of the Berlin Aging Study II (BASE-II) aged ≥ 60 years (N=1,278, mean age 68.6 ±3.7 years, 53.3% women). Frailty was operationalized by Fried’s five-point frailty score. Functional capacity was assessed with a battery of tests including the Tinetti mobility test, finger-floor distance (FFD), Mini-Mental State Examination (MMSE), Center for Epidemiologic Studies Depression Scale (CES-D), activities of daily living (ADL) and instrumented ADL (IADL). In covariate adjusted regression analyses the deviation of the bioage composite from chronological age was significantly associated with frailty (beta = -0.014, p= 0.014), the CES-D and ADL in men, and with the FFD in women. These results will be discussed with respect to their clinical relevance and compared to previously reported BASE-II data on the relationship between frailty, functional assessments and the biomarkers of aging derived from epigenetic clock algorithms and telomere length.
OLDER PEOPLE LIVING WITH DEGENERATIVE SPINE DISEASE WHO UNDERGO SPINE SURGERY—TRYING TO BE NORMAL
Authors: Strayer Andrea , King Barbara
Published: December 2022

Lumbar degenerative spine disease (DSD), a consequence of aging, occurs globally in 266 million persons annually. As the population ages, the number of spinal surgeries will increase. The purpose was to investigate older peoples’ understandings of living with and having surgery for DSD and the process they engage in to return to normal. Grounded theory (GT) was used to guide this study. Fourteen older people (≥ 65yrs) were recruited for 2 in-depth interviews (audio-recorded/transcribed verbatim) at 2-time-points: T1 during hospitalization and T2, 1-3-months post-discharge. All 14 interviewed at T1; 10-T2 (1mo); 2-T2 (2mo); 2-T2 (3mo) post-discharge (N=28 interviews). Consistent with GT, purposive and theoretical sampling was used. Data analysis (interdisciplinary team) included open, axial, and selective coding. A conceptual model was developed illustrating the phases older persons with DSD go through in their trajectory of trying to return to normal. Three key categories were identified (1) Losing Me (2) Fixing Me and (3) Recovering Me. All described a prolonged process of losing functional independence and being able to socialize. Fixing Me was proving they needed surgery and preparing for surgery. Recovering Me involved monitoring and ongoing progress. Conditions, including setbacks and delays, slowed recovery. Throughout, participants had to continually adjust their expectations. The conceptual model details how older people engage in living with and undergoing DSD surgery. Our model can serve as the foundation for developing interventions to guide older patient education programs, improve care transitions and develop patient-centered approaches for treating older people with DSD and spine surgery.
STRUCTURAL EQUATION MODELING OF HEALTH-RELATED QUALITY OF LIFE AMONG PEOPLE WITH VISUAL IMPAIRMENT
Authors: Yang Eunjin , Chang Sun Ju
Published: December 2022

Visual impairment can lead to limited accessibility and activities and a decreased quality of life. This study aimed to test a hypothetical model based on the International Classification of Functioning, Disability, and Health to predict the health-related quality of life (HRQOL) of people with visual impairment. Data from 202 people with visual impairment were collected from August 2020 to November 2020 via telephone or e-mail. The overall fitness indices of the model for physical HRQOL (Normed χ2=2.076, GFI=.878, TLI=.900, CFI=.928, RMSEA=.073) and the model for mental HRQOL (Normed χ2=2.232, GFI=.884, TLI=.904, CFI=.932, RMSEA=.078) complied with the recommended criteria of structural equation model fitness, indicating that the models were appropriate for predicting the HRQOL of people with visual impairment. The socioeconomic status, multimorbidity, perceived environmental barriers, and activity limitation/participation restriction directly affected the participants’ physical HRQOL. Moreover, depression, disability identity, and activity limitation/participation restriction directly affected participants’ mental HRQOL. Age, socioeconomic status, depression, social support, and perceived environmental barriers affected the participants’ physical and mental HRQOL by means of activity limitation/participation restriction. The findings of the study suggest that the strategies aimed at increasing the activity/participation of people with visual impairment will be helpful in improving their HRQOL. Based on the results of this study, nursing intervention programs and services for people with visual impairment should be developed and implemented to provide more comprehensive care for this group and expand nursing science.