bluuebunny/crossref_metadata_2025 huggingface dataset:
Is “Culture” Needed in Aboriginal Elder Care Station? An Study from the Perspective of Service Providers
Authors: Liu Li-Chuan
Published: December 2021

Many studies show that cultural perspective is an important factor in caring for elderly tribal adults. To understand the level of attention that the Cultural Health Station of Indigenous People attaches to culture during its operation, this study selected Taitung County as the region of study. A qualitative focus group research method and quantitative questionnaire, we try to understand “What are the demands of elderly tribal adults?” “Do services provided by the Tribal Cultural Health Station satisfy the demands of elderly tribal adults?” and “What are the gaps between the service demands and provided to elderly tribal adults?” The results showed that service providers believe that culture is markedly important to elderly tribal adults, that culture-based care designs offered by the Tribal Cultural Health Station is currently insufficient, and that to enhance the capacity of the multiethnic Tribal Cultural Health Station, the cognition and understanding of policy makers and enforcers must be elevated.
Measurement Invariance of a Latent Dementia Index by Gender in the Aging, Demographics, and Memory Study
Authors: Saenz Joseph , Kim Alice , Beam Christopher
Published: December 2021

Population-based aging studies allow researchers to study dementia and its correlates. Few include dementia diagnoses. Latent variable models have been used to create latent dementia indexes (LDI) using cognitive and functional ability to approximate dementia. The LDI is applied across diverse populations, but it is unclear whether gender affects its measurement properties. We assess whether the LDI can be used to measure dementia equivalently for men and women. We use the 2001-2003 Aging, Demographics, and Memory Study (n=856, 355 men, 501 women). Cognitive ability was assessed using memory, executive function, attention, spatial ability, orientation, and language tasks. Functional ability was informant-reported. We used confirmatory factor analysis to test factorial invariance across gender and compare latent means to determine which group had lower means, consistent with greater dementia likelihood. Model fitting results suggest metric invariance of the LDI but only partial scalar invariance across gender. Latent mean differences in the LDI were observed (Mdiff = .39, SE = 0.19, p = .042), with women lower, on average, than men. Correlations between LDI and dementia diagnosis were stronger for both men (r=-.82) and women (r=-.85) than correlations between dementia and Mini-Mental Status Exam scores (-.69 and -.73, respectively). The LDI may be reliably and validly used to measure and compare dementia likelihood in men and women. Results suggest lower LDI scores in women, indicating greater dementia likelihood. Gender differences may be partially attributed to differences in measurement properties of items, possibly due to gender differences in educational returns and employment factors.
Montani Semper Liberi: Age And Depression Among Veterans In Appalachia
Authors: Dang Alex , Nimako Maxwell , Fiske Amy
Published: December 2021

Depression is higher in rural areas and military veterans (Kimron et al., 2019; Bedard-Gilligan et al., 2018). West Virginia, the only state contained entirely within Appalachia, has a higher percentage of military service among its citizenry than other states. Thus, the purpose of the current study was to examine the association between veteran status and depression among adults in WV. Using 2018 WV data from the CDC’s Behavioral Risk Factor Surveillance System, we examined depression as a function of veteran status and age, among 612 younger adults, 1813 middle-aged adults, and 2445 older adults (N = 4,870; 12.4% veterans). Our ANOVA revealed a significant overall effect, F(5, 4864) = 14.64, p < .001, a main effect for veteran status (18.8% of veterans and 26% of non-veterans reported depression), and an age effect emerged, with more younger (28.6%) and middle-aged adults (30.5%) reporting depression than did older adults (20.3%). No significant interaction between age and veteran status emerged, F(2, 4864) = 1.75, p = .175. Of note, 25% of the sample reported having depression. Given that place-based mental health disparities exist, this finding is not unexpected. But fewer older adults and fewer veterans reported depression. At least three possibilities warrant further investigation. Future studies should examine whether these age and veteran status differences in depression reflect differences in resilience, differences in reporting, and/or differences in selective survival.
Outcomes and Treatment Costs of Skilled Nursing Facility Patients with Pressure Injuries and Malnutrition
Authors: Kerr Kirk , Brunton Cory , Arensberg Mary Beth
Published: December 2021

Skilled nursing facilities (SNF) provide care for individuals requiring skilled care while transitioning to a more permanent residence post hospitalization. This analysis shows that diagnosed malnutrition and pressure injuries (PI) adversely impact SNF patients’ health and recovery. Length of SNF stay, total charges, and discharge disposition were analyzed using SNF claims from 2016-2020 Centers for Medicare & Medicaid Services (CMS) Standard Analytical File databases. An average of 4.5% SNF patients had diagnosed PIs, and 4.9% had diagnosed malnutrition. Patients with diagnosed malnutrition were more likely to have PIs than patients without diagnosed malnutrition (11.9% vs 4.1%). Patients with PIs had higher charges ($12,304 vs. $10,937), were less likely to be discharged home (11.1% vs 18.9%), and more likely to be discharged to a hospital (15.8% vs 11.0%) or deceased (2.8% vs 1.6%). Patients with diagnosed malnutrition displayed a similar pattern for charges ($11,587 vs $10,969), and discharge to home (14.5% vs 18.8%), hospital (13.5 vs 11.1%) or deceased (2.8% vs 1.6%). Length of SNF stay did not differ between patients with and without PIs (18.5 vs 18.6) and was slightly shorter for patients with diagnosed malnutrition (17.3 vs 18.9). While higher probability of rehospitalization or death could impact these results, drivers behind these differences need further investigation. Because malnourished patients were more likely to have PIs and both PI and malnutrition are associated with poorer patient discharge outcomes and higher costs, efforts to identify malnutrition and implement proper nutrition interventions should be prioritized as part of SNF quality improvement initiatives.
Poor Performance in SNF-VBP Program is Associated with Worse COVID-19 Outcomes in Nursing Homes
Authors: Hefele Jennifer Gaudet , Aldag Matt , Elmor Riad , Kaushik Charanya , Ballard Jessica Simpson
Published: December 2021

Skilled Nursing Facility Value-Based Purchasing (SNF-VBP) was a new Medicare payment program when COVID-19 began. SNF-VBP aims to improve care through payment bonuses and penalties. However, studies have shown that minority-serving nursing homes (NHs) tend to fare worse under SNF-VBP (more likely to receive penalties, less likely to receive bonuses). This study sought to examine whether SNF-VBP performance prior to the pandemic was associated with COVID-19 outcomes and whether associations varied in NHs where the majority of residents are Black/African American (majority-Black/AA). Using publicly available data on COVID-19 outcomes and vaccinations, SNF-VBP performance, and NH characteristics, we found that majority-Black/AA NHs were less likely to have zero infections; had higher case fatality rates; and had lower resident and staff vaccinations rates compared to NHs where the majority of residents are White. Across all NHs, worse SNF-VBP performance was associated with worse COVID-19 outcomes (the bottom quintile of SNF-VBP performers were more likely to experience COVID-19 infections and had lower vaccination rates; the highest performers had higher vaccination rates). However, in stratified analyses, SNF-VBP performance was not significantly associated with COVID-19 outcomes in majority-Black/AA NHs compared with majority-White NHs. The association between poor SNF-VBP performance and poor COVID-19 outcomes is concerning. Overall findings suggest that SNF-VBP performance prior to the pandemic is an important indicator of subsequent COVID-19 outcomes. However, it is unclear whether poor SNF-VBP performance is signaling overall poor quality or whether it is signaling a financial disadvantage caused by the program itself that in turn impacted COVID-19 outcomes.
The Impact of Supervisor Support on the Job Satisfaction of Immigrant and Minority Long-Term Care Workers
Authors: Hawes Frances , Wang Shuangshuang
Published: December 2021

The need for long-term care workers (LTCW) will grow significantly as the American population ages. Understanding the factors that impact job satisfaction of this workforce has important implications for policy and practice. Previous research has demonstrated the effect of supervisor support on the job satisfaction of these workers; however, much less is known about how this effect differs among different race/ethnicity or immigration groups. This study examined how supervisor support mediates the associations between race/ethnicity, immigration status, and job satisfaction among nursing assistants (NAs). Data of 2,763 NAs were extracted from the National Nursing Assistant Survey (2004). Race/ethnicity groups included White (54%), African American (30%), Asian (2%), Hispanic (10%), and others (4%). Immigration status included U.S.-born citizens (87%), naturalized (7%) and resident/alien (6%). Bivariate analyses showed that Asian NAs perceived higher levels of supervisory support than other races, whereas U.S.-born NAs reported lower levels of supervisory support than naturalized and residents/aliens. Findings from multivariate analyses indicated that non-Hispanic Asians and Resident/Alien workers reported significantly higher levels of job satisfaction than their counterparts, and the associations were fully mediated by NAs’ perceived supervisor support. These findings support prior research that supervisor support is important to improving job satisfaction and contribute to the literature that Asians/Residents/Aliens long-term care workers may be more sensitive to supervisory support and may be more grateful if they received support from supervisors. Managers should be aware of these racial differences and by being supportive they may improve NAs job satisfaction and reduce turnover rates.
Using Taiwanese Universal Health Insurance Data to Estimate LTC Needs with Machine Learning
Authors: Chen Kuan-Ming , Hsiang Chen-Wei , Chao Shiau-Fang , Lin Ming-Jen , Tseng Kuan-Ju , Chou Yu-Hsuan , Hsieh Ji-Lung , Chen Ya-Mei
Published: December 2021

One of the core issues in long-term care (LTC) policy is the growing imbalance between demand and supply of LTC services due to aging population. To estimate the imbalance and allocate LTC resources, the government regularly conducts surveys. These surveys are expensive given the sample size requirements and imprecise given their subjective nature. This study links the administrative records of the universal health insurance database with LTC program usage records in Taiwan to explore this issue. Machine learning algorithms are used in projecting LTC needs from administrative records. LTC program usage records provide detailed LTC needs information and the amount of service each individual used. In addition, health insurance claim data provides rich health information. Specific LTC needs are predicted for each individual. By further extrapolating to future demographics, long-term LTC needs could be projected. There are several findings in this study. Prediction of difficulties in activities of daily livings (ADL), measured by Barthel index, works best using the Gradient Boosting algorithm. The mean absolute error is 17.67 out of a 0 to 100 scale. In addition to dementia and stroke, diagnosis of pressure ulcer (ICD 10 code: L89) and pneumonia (ICD 10 code: J18) have high predictive power for LTC needs. Prediction of Instrumental ADL (IADL) also performs well with a mean absolute error 1.31. The prediction model suggests high LTC needs and excess demand as the demographics changing. Our study provides a reliable way of using rich information to estimate future LTC needs without conducting additional costly surveys.
Accelerometry-Based Assessment of Physical Activity in Older Adults During COVID-19 Pandemic
Authors: Choudhury Renoa , Thiamwong Ladda , Garcia Oscar , Xie Rui , Stout Jeffrey , Park Joon-Hyuk
Published: December 2021

COVID-19 pandemic has caused a severely detrimental effect on the physical, psychological, and functional well-being of older adults by forcing them to limit their social activities. This study investigates the amount and intensity of daily physical activity (PA) in older adults, living under the social distancing guidelines during COVID-19 pandemic. In this cross-sectional study, 124 community-dwelling older adults (Age:60–96 years, mean:75±7.14) were recruited via word-of–mouth and key person approach between March 2021-August 2021. Participants completed an online survey on COVID-19 questionnaires and wore an ActiGraph GT9X accelerometer on their non-dominant wrist for consecutive 7 days in free-living conditions. Euclidean Norm Minus One cut-points were used to estimate the total time spent in sedentary behavior (SB), light PA (LPA) and moderate-to-vigorous PA (MVPA). Results showed that, 7% had COVID-positive, 55% perceived moderate severity of COVID in their area, 31% reported fear of COVID, and 14.5% were afraid of losing their life to COVID. On average, participants obtained 12.43±2.1 hours/day of SB, 3.47±1.05 hours/day of LPA and 42.71±29.71 minutes/day of MVPA. MVPA minutes/day was significantly higher (P = 0.006) in participants aged 60-85 years than those aged 85+ years (45.38 minutes/day vs 14.25 minutes/day). When age-adjusted data was compared to pre-COVID-19 studies, we found COVID-19 pandemic had negatively impacted the physical activity level in older adults (29.33% decrease in MVPA and 39.2% increase in SB). These findings can be useful in developing guidelines and/or interventions to promote physical activity and healthy aging among older adults, particularly those in social isolation.
Analyzing the specific role of cognitive functioning on successful aging
Authors: Mendoza-Ruvalcaba Neyda Ma , Arias-Merino Elva Dolores , Flores-Villavicencio Maria Elena , Rodriguez-Diaz Maria Elena
Published: December 2021

Introduction The cognitive functioning, as a general measure, is a criterion commonly used to define and operationalize successful aging. (Project-Conacyt-256589) The aim of this study is to analyze specific domains of cognitive function and its relationship with the successful aging in older adults. Methods Population based, random sample included n=453 community-dwelling older adults 60-years and older (mean age=72.51,SD=8.11 years,59.4% women). Cognitive functioning was assessed by a comprehensive battery including working memory(Digit Span Backward WAIS-IV), episodic memory, meta-memory(self-report), processing speed(Symbol Digit WAIS-IV), attention(TMT-A), executive functioning(TMT-B), learning potential(RAVLT), language(FAS), visuospatial skills(Block Design WAIS-IV). Successful aging was operationalized as no important disease, no disability, physical functioning, cognitive functioning, and being actively engaged. Sociodemographic and health data were also asked. Data were analyzed in SPSSv24, MANOVAs and size effects were calculated. Results In total 11.2% were successful agers and 11.4% had Mild Cognitive impairment. Global cognitive functioning was significantly related to the achievement of successful aging criteria. Cognitive functioning had a significant effect on successful aging, specifically executive functions (F=1.07,p=.000) explained 32.7% of the variance, attention explained 29.8% (F=1.19,p=.006), processing-speed 21% (F=1.38,p=.000), and learning potential 21.5% ((F=1.12,p=.005). Language, visuospatial skills, working memory and meta-memory had a very small effect. Conclusion Knowledge generated by this study reveals the specific role of cognitive domains on successful aging, and sets a scenario to promote successful aging, through alternatives centered in the improvement of cognition in the older adults.
Assisted Living Administrators’ Mental and Emotional Health During the COVID-19 Pandemic
Authors: Tunalilar Ozcan , Winfree Jaclyn , Kyler-Yano Jason , Hasworth Serena , Carder Paula
Published: December 2021

Little is known about assisted living (AL) administrators’ mental and emotional health, particularly during a global pandemic in which most of their residents are highly vulnerable to infection, hospitalization, and death. Considering that administrator turnover and burnout have been associated with negative outcomes such as decreased quality of resident care, low staff morale, and reduced financial solvency, this study examined how AL administrators described their mental and emotional state throughout the first year of the COVID-19 pandemic. Using thematic analysis, our team coded 18 qualitative interviews conducted from May-August 2021. The themes included declining physical health due to stress, feelings of inadequacy and self-doubt, and increased burnout. Many administrators described increased staffing challenges as directly impacting their daily stress levels. Some administrators described feeling guilty and doubting their interpretation or implementation of regulations, particularly in incidents that further distanced residents from peers and loved ones. A few administrators described their disposition or personality changing due to what they experienced during the pandemic. One administrator stated, “I'm not an anxiety person, but I feel anxiety about a lot of things. In fact, my doctor has talked to me about starting some medications to help with that.” Multiple administrators made comments such as, “I don't know that there could be a more stressful position than executive director of assisted living…the COVID pandemic reinforced that. This is rough.” Understanding AL administrators’ mental and emotional health during a public health crisis allows for understanding, supporting, and retaining critical leaders in long-term care communities.
Descriptive Evidence of COVID-19’s Impact on Black LGBTQ Adults Amidst Ongoing Health Inequities
Authors: Flohr Charleigh , Burton Cassandra
Published: December 2021

Black LGBTQ people significant challenges and discrimination as they face the barriers of living at the intersection of multiply marginalized identities, which have worsened during the coronavirus pandemic. At a baseline, LGBTQ people exhibit elevated risk of being negatively impacted by the pandemic across health, economic and other social outcomes (Cahill et al., 2020; Heslin & Hall, 2021; Human Rights Campaign, 2020). Black LGBTQ people have also suffered significant economic losses (Human Rights Campaign Foundation, 2020) . Methods: The Human Rights Campaign Foundation and AARP supported and partnered with Community Marketing & Insights to conduct a survey of 1,815 Black LGBTQ adults in the United States. The online survey was fielded between September 21 and October 30, 2020. Many Black LGBTQ adult participants report healthcare discrimination in the last three years, with 19% reporting racial discrimination and 11% reporting sexual orientation-based discrimination. Furthermore, 31% of Black transgender adults report healthcare discrimination in the last three years. Preventing or treating COVID-19 is an important health concern to 67% of Black LGBTQ adults aged fifty-five and older, 63% of Black LGBTQ adults aged thirty-five to fifty-four and 53% aged eighteen to thirty-four. Overall, Black LGBTQ adults report being significantly impacted by the pandemic, including negative impacts on their social health (60%), mental health (44%), the physical health of their close friends and family (33%), their finances (30%), and their employment status (22%). Overall, one-quarter (25%) of Black LGBTQ adults had at least one close friend or family member die from coronavirus illness.
Does Retirement Age Impact Functional Limitations in Later Life?
Authors: Xu Ziyao
Published: December 2021

The US government is gradually shifting the full retirement age in Social Security to age 67. However, previous studies suggest that this shift could negatively impact the mental and physical health of retirees. To understand the potential impact of raising the full retirement age on the functional health of retirees, this longitudinal study examined changes in physical functioning over time in retirees by age at retirement. Twelve waves of the Health and Retirement Study (1994 – 2018) were used. A total of 8,261 retirees was included. The retirement age was a categorical variable: very early age (<62), early age (62-64), traditional age (65-67), and late age (>67). Physical functioning was measured using 15 Activities of Daily Living and Instrumental Activities of Daily Living. A GEE model was used to assess the relationship between the retirement age category and the number of functional limitations. In the adjusted model, after controlling for all the other variables including baseline health and functioning, late retirement was associated with an 8.9% increased risk of functional limitations compared to traditional age retirement (IRR: 0.91, 95% CI:0.84 –0.98). Compared to late retirees, the risk of functional limitations was increased by 28.6% in very early age retirees (IRR: 1.29, 95% CI:1.21–1.36). Compared to those retiring at traditional retirement age, those retiring late, after 67, have increased the risks of functional limitations. Although levels of disability could influence age of retirement, these results suggest that for some workers efforts to increase age of full retirement, could have negative effects.
Dyadic Perceptions of COVID-19 Pandemic Impact on Everyday Life
Authors: Margrett Jennifer , Reese-Melancon Celinda , Russell Dan , Stratton Lauren , Harrington Erin , Savla Jyoti
Published: December 2021

It is important to understand the effects of the COVID-19 pandemic not only on individuals’ daily lives, but also their close partners. Current literature suggests that the COVID-19 pandemic has impacted older adults’ lives in several ways, including the frequency of social interactions and change in various life habits (Lesbrasseur et al., 2021). Data from 42 middle-aged and older, long-term married or cohabitating dyads were collected as part of an ongoing study of everyday cognition and functioning among couples. Participant age ranged from 40-85+, and couples were partnered for 9-60+ years. During this study, COVID-19 pandemic impact was assessed using six items (1 = No change to 4 = Severe change) examining daily routines, medical and mental health access, social contacts, and pandemic and family-related stress; reports ranged from six to 19. On average, women reported significantly higher COVID-19 pandemic impact compared to men. For both partners, the greatest disruptions reported related to routines and social contacts. Further analysis examined COVID-19 pandemic impact in dyads. For eight dyads, both partners reported relatively lower COVID-19 impact (6-11), whereas for six dyads, both partners reported higher impact scores (14-19). Discussion focuses on within-dyad and between-dyad differences related to perceptions of the pandemic’s impact.
Explore the Role of Abeta in Axonal Trafficking Deficits Induced by Alpha Synuclein in Parkinson Disease Mouse Model
Authors: Castro Alfredo
Published: December 2021

Alpha synuclein (ASYN) is a neuronal protein that is observed in significant amounts in the brain and is encoded for by the SNCA gene, it functions as a regulator for the trafficking of synaptic vesicles. It has been noted that the buildup of alpha synuclein has been found in the form of Lewy bodies in studies involving patients with Parkinson’s diseases (PD). Gathering an understanding for the manner in which alpha synuclein affects the synaptic structure and the movement of axonal trafficking will help further our understanding towards the formation of Lewy bodies. Experimenting with the way in which ASYN affected the intervention of Abeta was important, to see the toxicity of Abeta in axonal trafficking. The PD and SynKO mouse models treated with Abeta both showed an effect on the anterograde moving speed of both the PD and SynKO neurons. Synaptic formation was examined, and it was found that ASYN had a large negative influence on the synapse formation in PD neurons. This was due to the significantly reduced colocalization that was found in the treated neurons. It was confirmed that ASYN caused neuronal atrophy through the over expression of GFP-ASYNWT wild type or the GFP-ASYNA53T. Comprehending ASYN effect on the axonal trafficking and the synaptic structure of PD neurons can help understand the mechanism that may be present which possibly stimulates Alzheimer’s Disease in PD patients.
Feasibility of combining noninvasive brain stimulation and personalized counseling to increase physical activity
Authors: Lo On-Yee (Amy) , Mulvey Connor , Lee Christine , Gagnon Margaret , Lipsitz Lewis , Manor Brad
Published: December 2021

Few older adults meet recommended physical activity guidelines. Behavioral interventions may be more effective when combined with other modalities to promote activity. Transcranial direct current stimulation (tDCS) designed to increase the excitability of the left dorsolateral prefrontal cortex (dlPFC) — a brain region subserving motivation and executive function — has the potential to augment behavioral interventions. We designed a randomized, double-blinded trial to examine the feasibility of combining personalized behavioral counseling and tDCS targeting the left dlPFC to improve physical activity and related outcomes in sedentary older adults living within the supportive housing. Participants wore a Fit-Bit throughout the study period. Baseline step counts were determined for two weeks, then participants completed four bi-weekly personalized counseling sessions over eight weeks. They were also randomized to receive 10 sessions of tDCS or sham stimulation over the two weeks after the baseline. Physical, cognitive, and patient-reported outcomes were assessed at baseline, after ten brain stimulation sessions, and after four behavioral sessions. 33 individuals were screened and 16 enrolled (age=80±7, 13 females). 13 participants completed the study, including 100% of study assessments, 99±5% of brain stimulation sessions, and 98±7% of behavioral sessions. Fit-Bit adherence rate was 93±13%. Daily step counts were 3197±1480 at baseline and 4722±2553 over the last two weeks of the intervention. While the study is ongoing and blinded, these preliminary results indicate that it is feasible to conduct a controlled study of tDCS combined with personalized behavioral counseling to increase physical activity in sedentary older adults living within supportive housing.
Hippocampal Knockout of p300 Affects Learning and Memory in Mice
Authors: Rector Chase , Wang Lin
Published: December 2021

Aging has been associated with cognitive decline, as seen in various learning and memory processes. Specifically, p300, a lysine acetyltransferase, has been shown to decrease with age, which could have an effect on cognition. In a series of behavioral tests, the effect of the knockout of p300 was studied in mice. In the water T maze test and the object recognition test, the results conveyed that the mice’s learning skills had not been impacted by the knockout of p300. But the water T maze test results further showed that the p300 knockout mice had a decline in their cognitive flexibility to new information. These findings suggest that the knockout of p300 has a negative impact on cognition. We expect that the overexpression of p300 in older mice will restore the cognition that might have been lost with aging.
It Takes a Village - Atypical Presentation Warrants Teamwork for Sepsis Care
Authors: Cranston Teresa , Bailey Nicole
Published: December 2021

Sepsis is the body’s overwhelming response to infection that can lead to tissue damage, organ failure, and death. Sepsis, disproportionately, affects older adults due to an aging immune system and chronic illness. Older adults present atypically delaying diagnosis and intervention. This delay has been associated with increased morbidity and mortality. However, with early detection and rapid treatment there can be a reduction in poor outcomes. It is key, that clinicians practice collaboration and communication when diagnosing & treating patients that may have a different presentation. Early detection, monitoring, and intervention are crucial to survival of the older septic patient. The Continuous Monitoring Unit (CMU) consists of RNs, who monitor telemetry, video, and the Sepsis BPA/Checklist 24 hours/7 days a week. These nurses evaluate all active ED and acute care BPA data points. With their specific training, they dismiss the irrelevant and align the significant data while looking for possible notes of infection. They do not act upon the BPA unless the patient meets criteria. If there is confirmation of the BPA, the nurse collaborates with the primary provider to initiate recommended sepsis care. Since the beginning of August 2021, the CMU RN is utilizing the Sepsis Checklist, a customized tool built into the EMR that allows the CMU nurse to monitor the key elements of the Sepsis Bundle and intervene concurrently to complete the CMS SEP1 recommendations. Recommendations are based on the Surviving Sepsis Campaign.
The African American United Memory and Aging Project: AD Knowledge and Family History as It Relates to Cognition
Authors: Gamaldo Alyssa , Caban-Holt Allison , Brown-Hughes Travonia
Published: December 2021

This study explores the influence of Black adults’ Alzheimer’s disease (AD) knowledge and family history of AD on cognition. A sample of Black adults (n=66, age range=45-84) completed a computerized cognitive (CogState Brief) battery and surveys of AD knowledge, family history of AD diagnosis, and health. On the 14-item AD knowledge survey, participants correctly answered a mean of 10.80 (SD=1.50) items. Approximately, 56% reported a biological family member diagnosed with AD, of these 30% reported this being a mother or father. Linear regression models suggested no significant association between AD knowledge and cognitive performance. However, adults with a family member diagnosed with AD had worse visual learning accuracy even after adjusting for age, education, and income. Increased age was associated with worse processing speed, particularly in adults with a mother diagnosed with AD. These findings demonstrate the importance of examining the influence of family history on Black adults’ cognitive health.
Longitudinal Associations of Physical Touch with Loneliness among Older Adults
Authors: Brown Taylor , Giddens Reese , Wilson Stephanie
Published: December 2021

Older adults in the US face heightened risks for social disconnection, and the COVID-19 pandemic has further exacerbated this crisis. Physical touch is a key dimension of social connection that uniquely predicts physical and mental health benefits. However, most studies have been limited by cross-sectional designs, and no prior work has examined the long-term effects of physical touch on loneliness. To investigate the prospective association between physical touch and loneliness among older adults, this study utilized data from 1626 older adults (Mean age = 68, range = 57-85) who participated in Waves 1 and 2 of the National Social Life, Health, and Aging Project (NSHAP). Participants reported on their loneliness and physical contact with family and friends, as well as with pets, at both waves. Results revealed that more frequent physical contact with family and friends predicted larger decreases in loneliness over the subsequent five years (p<.0001), controlling for age, race, gender, health conditions, marital status, frequency of social interaction, and baseline levels of loneliness. Physical contact with pets had no unique effect (p=.136). To further assess directionality, models tested whether lonelier people experienced decreased touch over time, and the effects were null (p>.250). Taken together, this longitudinal study is the first to identify the unique contribution of human physical touch to prospective changes in loneliness, beyond the well-established effects of covariates, including social interaction frequency. Touch represents a compelling mechanism by which social isolation may lead to loneliness, which in turn raises risks for poor health and premature mortality.
Measuring Utility of VASS Elder Mistreatment Screener Within Community Dwelling U.S. Chinese Older Adults
Authors: Tuseth Natalie , Dong XinQi , Bergren Stephanie
Published: December 2021

Elder mistreatment (EM) is often underreported, making potential screening a valuable tool. There is limited literature on the screening utility, especially for minority populations. This abstract aims to study sensitivity and specificity of a commonly used 10-point EM screener compared to a detailed EM questionnaire among Chinese older adults. This study used data from a representative sample of 3,157 community-dwelling U.S. Chinese older adults 60+. Chi-squared test was conducted between VASS 10-questionare screener and EM measured by 56 items on psychological, physical and sexual mistreatment, caregiver neglect and financial exploitation subtypes. Sensitivity and specificity was calculated using the Bayes Theorem. In this sample, average age was 72 and 59% female. 637 (20.30%) reported any EM while 475 (15.14%) older adults screened positive for EM. Of participants reporting any EM, 365 (57.30%) did not screen positive for EM. The screener had a sensitivity of 42.70% and specificity of 91.88% for all EM subtypes. Gaps between reported EM and negative EM screener is smaller in psychological (sensitivity 72.85%, specificity 91.07%) and physical (sensitivity 63.64%, specificity 86.66%) EM subtypes, but much larger in financial exploitation (sensitivity 34.60%, specificity 86.85%) and neglect (sensitivity 14.11%, specificity 84.75%). The VASS screener demonstrates poor sensitivity but acceptable specificity rate for any EM. The screener showed better sensitivity and specificity for physical and psychological mistreatment, but performed worse for more common forms of mistreatment like financial exploitation and neglect. Modifying this screener may improve sensitivity and specificity in identifying EM.
Quality of Life and Wellbeing in Peripheral Arterial Disease: A Qualitative Study
Authors: Byrnes Mary , Dillaway Heather , Aaron Bryan , Heximer Alisha , Valbuena Valeria , Corriere Matthew , Osborne Nicholas
Published: December 2021

Peripheral arterial disease (PAD) is a vascular condition disproportionately affecting adults > 60 and the leading cause of disability for adults > 50. Because PAD is marked by severe leg pain and sometimes lower extremity amputation, quality of life (QOL) and wellbeing may be compromised however, we understand little about these constructs in this population. Furthermore, surgical care providers lack a comprehensive understanding of how individuals think about wellbeing and what is important to individuals during surgical care. We conducted a qualitative photographic elicitation study (n = 60) in one academic multidisciplinary PAD clinic to understand specific aspects of QOL of older individuals with PAD. Guided by interpretive description, a methodology pioneered in nursing, we analyzed data within and across five clinical symptom severity categories to examine for QOL constructs, impact on everyday life, understanding of disease, and desired treatment. Results demonstrate that individuals do not fully understand PAD diagnosis or its implications (e.g., “[I] have never heard of it. Do I have that?”). Disease-specific knowledge was prevalent among patients experiencing lower extremity amputation but those suffering from wounds or gangrene had limited understanding. Furthermore, patients’ descriptions of QOL conflicted with the conceptualization of QOL in clinical practice and research. That is, many participants describe QOL based on activities they are capable of performing despite limitations. Results demonstrate the need for integrating gerontological knowledge into clinical care to improve quality of care for older adults.
Representation of Older Adults in COVID-Related Newspaper Coverage
Authors: Jeong Mijin , Jen Sarah , Kang Hyun , Riquino Michael , Goldberg Jaime
Published: December 2021

Based on clinical and epidemiological evidence, COVID-19 infection can occur in people of all ages; however, the media typically focuses its attention on the vulnerability of older adults and individuals with chronic illnesses. This study aims to explore the representation of older adults during the first month of the pandemic in the U.S. by comparing the narratives of older adults and younger adults in national media sources. A systematic search identified 115 articles published in four major newspapers in the U.S. included USA Today, The New York Times, Los Angeles Times, and The Washington Post between March 11 and April 10, 2020 in which older adults and younger adults were quoted on topics related to the intersection of COVID-19 and aging. Quotes were inductively reviewed using thematic content analysis. In 115 articles, there were 265 quotes from older adults (n=104, 39%) and younger adults (n=161, 61%). When comparing patterns that were common or distinctive between older and younger individuals quoted, three key themes emerged: 1) impacts of COVID-19 on older adults and resulting vulnerability, 2) debated perspectives over the value of older adults’ lives, and 3) a counternarrative of resiliency among older adults. This study provides the opportunity to understand how the pandemic may impact representations of older adults and findings emphasize the importance of voice among older adults to combat ageist messaging and promote counternarratives to assumptions of vulnerability. Also, it suggests for policymakers and practitioners to insight into how the representation of older adults is disseminated by media.
Safety and Tolerability of an Ad26.RSV.preF-based Vaccine in a Phase 2b Study in Older Adults
Authors: Falsey Ann , Williams Kristi , Gymnopoulou Efi , Bart Stephan , Ervin John , De Paepe Els , Heijnen Esther , Comeaux Christy
Published: December 2021

Respiratory syncytial virus (RSV) may cause severe lower respiratory tract disease in older adults and there is currently no approved vaccine. We assessed the safety and reactogenicity of an Ad26.RSV.preF-based vaccine in a randomized, double-blind, placebo-controlled Phase 2b proof-of-concept trial in adults aged ≥65 years (CYPRESS; NCT03982199). Prior to the RSV season, participants were randomized 1:1 to receive an Ad26.RSV.preF-based vaccine or placebo. Solicited adverse events (AEs; fatigue, headache, nausea, myalgia, fever, injection site reactions) and unsolicited AEs were assessed from time of vaccination to Day 8 and Day 29, respectively, in a safety subset of 695 participants (vaccine, n=348; placebo, n=347). All participants were followed for serious AEs (SAEs) until the end of the RSV season or 6 months after vaccination, whichever occurred later. A total of 5728 participants were randomized and received vaccine or placebo (n=2891 in each group). In the safety subset, the frequency of solicited AEs and Grade ≥3 solicited AEs was 51.4% and 3.2% in the vaccine group and 20.2% and 0.6% in the placebo group, respectively. The most frequent solicited AEs in the vaccine group were fatigue, myalgia, headache, and injection site pain/tenderness. The rates of unsolicited AEs and Grade ≥3 unsolicited AEs were similar between the vaccine (16.7% and 1.7%) and placebo (14.4% and 1.4%) groups. In the overall study population, the rate of SAEs was similar between groups (vaccine, 4.6%; placebo, 4.7%); none were considered related to the vaccine. The Ad26.RSV.preF-based vaccine was safe and well tolerated in adults aged ≥65 years.
Structural Racism is Associated with Assisted Living Location
Authors: Smith Lindsey , Carder Paula , Thomas Kali , Baker Robin , Wallace Neal
Published: December 2021

Our objective was to measure the association between structural racism, a previously unmeasured but theoretically causal factor, and assisted living communities (ALCs) location as fewer ALCs are located in counties with a greater percentage of the population reported as Black (PPB). We used a recently developed measure of structural racism—the racial opportunity gap (ROG), which compares the economic mobility of Black and White people who grew up in the same area with parents who had similar incomes. We estimated a multilevel mixed-effects bivariate regression model to examine the factors contributing to the presence of ALC. We relied on state and county random effects. The likelihood of an assisted living being located in a census tract in 2019 was significantly positively associated with the percent of the population over the age of 65 (OR=150.1573, p=<0.001), the PPB (OR=2.9916, p=0.004), and higher median incomes (OR=1.0, p=<0.001). In contrast, rurality (OR=0.5656, p=<0.001), unemployment rates (OR=0.0288, p=<0.001), and census tracts that have a high PPB in addition to a high county ROG (OR=.0058, p=0.0137) are all associated with a lesser likelihood of an ALC. The interaction coefficient between the ROG and PPB reverses the previously documented negative association between the PPB and ALC presence. This result empirically supports the premise that structural racism, not population race alone, is a negative determinant of where an ALC is located within a county.
Developing Synergistic Relationships between Age-Friendly Universities and Age-Friendly Communities
Authors: Montepare Joann , Rogers Wendy
Published: December 2021

The Age-Friendly University (AFU) initiative was designed to support the Global Network for Age-Friendly Cities and Communities (WHO, 2018) and offers a range of opportunities for institutions of higher education to help communities adapt to their new age-diverse social structures as a result of shifting age demographics. In turn, age-friendly community partnerships are helping to fuel campus efforts to advance age-inclusivity through education, research, and community engagement. At present over 70 institutions have joined the AFU global network, as more campuses prepare to become age-friendly partners. In this collaborative symposium (Directors of Aging Centers and AFU Interest Groups), campus leaders will describe synergistic relationships between their age-friendly campus efforts and the age-friendly efforts of their neighboring communities. Montepare (Lasell University) will provide an overview of the AFU initiative and its set of 10 principles, and make the case that campuses and communities are necessary partners for creating and developing age-friendly efforts. Demonstrating this assertion, Pastor and Rogers (University of Illinois Urbana-Champaign) will describe linkages between their community and campus initiatives, including developing a Panel of Elders, television programming for older adults, and hosting joint events. Black and Andel (University of South Florida) will discuss the intersection between the AFU principles and the processes undertaken by age-friendly communities. Revell and Viveiros (University of Massachusetts Dartmouth) will show how campus collaborations with nearby communities are instrumental in sustaining age-friendly efforts, especially during a pandemic.
Successful Aging: Memory and Smart technology implications.
Authors: Mendoza-Ruvalcaba Neyda Ma , Arias-Merino Elva Dolores , Vázquez Núnez Karla Patricia , Rodriguez Marlene Alvarado
Published: December 2021

The cognitive functioning as a general measure, is a criterion commonly used to define and operationalize successful aging(SA). The aim of this study is to analyze the specific role of memory (objective and subjective) and its relationship with the use of smart technology (ST) and SA.(Project-Conacyt-256589) Population based, random sample included n=453 community-dwelling older adults 60-years and older (mean age=72.51,SD=8.11 years,59.4%women). Memory was assessed through working memory(Digit Span Backward WAIS-IV), episodic memory, metamemory(self-report), subjective memory, and learning potential(RAVLT). SA was operationalized as no important disease, no disability, physical functioning, cognitive functioning, and being actively engaged. Participants were asked if they use cellphone, computer, or tablet. Pearson′s correlation test and linear regression models were performed. In total 11.2% were successful agers.53.6% used cellphone,14% computer,8% tablet, 44.1% any devise.Results show significant correlation between SA and subjective memory, learning potential and the use of ST. Results of the multiple regression analysis emerged on a significant model using the entered method:F=26.05,p>.000, explaining 21.4% of the variance of SA. Although objective memory measurements were no significant for SA, all memory measurements were related to the use of ST. Knowledge generated by this study reveals the specific role of the metamemory on the SA, underlining the relevance of subjectivity on aging. We need to reflect about the limitations of older adults to access to a digital world in order to achieve a SA.
Age-Friendly Universities (AFU): Necessary Partners for Age-Friendly Communities
Authors: Montepare Joann
Published: December 2021

The pioneering Age-Friendly University (AFU) initiative, endorsed in 2016 by GSA’s Academy for Gerontology in Higher Education (AGHE), calls for institutions of higher education to respond to shifting demographics and the needs of aging populations through more age-friendly campus programs, practices, and partnerships. The case will be made that AFU institutions can also play vital roles in helping neighboring communities develop, launch, assess, and sustain their age-friendly efforts through research and related endeavors that engage students and faculty. In addition, AFU campus-community partnerships can play a critical role in breaking down age-segregation that fuels ageism, building intergenerational connections, and increasing aging literacy among rising community members - all of which are necessary steps for building age-friendly communities.
Disparities Research at the Deep South Alzheimer’s Disease Center of the University of Alabama at Birmingham
Authors: Pisu Maria , Geldmacher David
Published: December 2021

Residents of the US Deep South (Alabama, Georgia, Louisiana, Mississippi, and South Carolina) have a 20–30% higher risk of developing Alzheimer’s disease or related dementia (ADRD). Moreover, >20% of African Americans, who are at higher ADRD risk than whites, live in this region. Therefore, one important goals of the Deep South Alzheimer’s Disease Center (DS-ADC) of the University of Alabama at Birmingham is to spearhead research to address these disparities. This panel presents current DS-ADC research, with two presentations focusing on the local patient population and the last two on the Deep South population compared to the rest of the nation. Addressing the challenge of recruiting representative samples in clinical research, the first paper is part of a research program to understand difference that may exist between African American and white research participants. The second paper examines patients with multiple conditions, in particular dementia and cancer, showing a marked disadvantage in cognition outcomes for African Americans. The next two papers take a broader perspective to better understand the population of older adults with ADRD in the Deep South and in the rest of the US. The third paper examines socioeconomic and medical contexts of African American and white older Medicare beneficiaries with ADRD, and the fourth paper examines differences in utilization of specialists, ADRD drugs, and hospitalizations in the two regions taking these contexts into account. The discussant will close the session by placing these studies in the larger context of the disparities research at the DS-ADC.