bluuebunny/crossref_metadata_2025 huggingface dataset:
COACH2MOVE: THE STORY OF IMPLEMENTING A PERSON-CENTERED PHYSICAL THERAPY APPROACH IN CLINICAL PRACTICE
Authors: Heij Ward , Sweerts Lieke , Staal Bart , van der Wees Philip , van der Sanden Ria Nijhuis- , Hoogeboom Thomas
Published: December 2022

Coach2Move is a person-centered physical therapy approach to promote physical activity among community-dwelling older adults, which consists of motivational interviewing and other motivational strategies. Coach2Move has been implemented in the Netherlands with 52 physical therapists and 294 patients in 16 practices. Implementation has led to better outcomes (increased physical activity, improved functional mobility, and lower levels of frailty) in fewer treatment sessions compared with usual care physical therapy treatment. Implementing was carried out using the following steps: 1) an e-assessment to determine the baseline level of knowledge regarding Coach2Move of the participating therapists; 2) two education days in Motivational Interviewing and Coach2Move specific motivational strategies; 3) three unique peer-assessment meetings and 4) a retest of the e-assessment one year later. We will discuss our rationale for selecting implementation strategies and which barriers and facilitators we have experienced in implementing successful scientific research in daily clinical practice.
COGNITIVE TRAINING FOR OLDER CHINESE IMMIGRANTS IN THE US: AN EXPERIENCE-BASED CO-DESIGN APPROACH
Authors: Xu Hanzhang , McConnell Eleanor , Myers John , Wu Bei
Published: December 2022

Older Chinese Americans face many socioeconomic barriers including limited English proficiency, low educational levels, and limited access to care. These socioeconomic disadvantages not only contribute to an increased risk of developing dementia but also worsen inequitable access to effective strategies to promote cognitive health. Cognitive training is shown to be beneficial to maintain or enhance cognitive function. However, most prior interventions were tested exclusively in non-Hispanic Whites. To address this gap, we aim to adapt empirically supported cognitive training activities into a culturally and linguistically relevant mHealth cognitive training intervention. The adaptation process of the cognitive training includes focus groups (n=6/group) with older Chinese Americans (3 groups) and adult children (2 groups) to adapt cognitive training components to our target population. We will then organize an experience-based co-design workshop to further refine the intervention. Engaging end-users early will optimize the development of a culturally and linguistically relevant cognitive training intervention.
THE ART OF BALANCE: EMPOWERING DEMENTIA CARE PARTNERS TO OPTIMIZE THEIR WELLNESS, RESILIENCE, AND HEALTH
Authors: Sadak Tatiana , Borson Soo
Published: December 2022

By 2050, 140 million people will be living with dementia (WHO, 2021), most of whom will be cared for at home by family members, relatives, partners, friends, and neighbors, supplemented by help from paid caregivers. Because of their critical role in managing health and wellness for people living with dementia (PLWD), caregivers face unique stressors and challenges that can give rise to negative physical and mental health consequences. This symposium aims to strengthen our understanding about how to empower care partners to optimize health and wellness for themselves and PLWD in everyday living and during periods of health crisis. The first presentation characterizes behaviors care partners adopt that promote resilience in the face of dementia-related health crises (Zhou et al); the second describes facilitators and barriers to adoption of self-care behaviors that can promote resilience (Sadak et al). We then introduce a technology-enabled pilot intervention to strengthen care partners’ self-care behaviors (Ishado et al.) and a physical activity intervention to promote maintenance of function (Li et al.). We conclude with a panel discussion of cross-cutting implications of these approaches for future research, clinical care, and policy.
A QUALITATIVE STUDY EXPLORING OLDER ADULTS’ PERCEPTIONS, FACILITATORS, AND BARRIERS IN PLANNING FOR AGING AND FRAILTY
Authors: Frechman Erica , Maxwell Cathy , Dietrich Mary , Buck Harleah , Rhoten Bethany , Davis Amanda
Published: December 2022

Aging in place is often a desired aspect of the aging trajectory but too often older adults and society in general, do not consider the factors involved in planning to make this a reality. Planning for aging and frailty entails a comprehensive life course approach to planning for one’s aging process in five unique domains: communication/socialization, environmental, financial, physical care, and cognitive status. In order to promote upstream planning, there is a need to explore the lived experiences of older adults through understanding their viewpoints on planning, and what may promote or hinder this process. The purpose of this study was to explore how people perceive the concept of planning for aging and frailty and to identify facilitators and barriers involved in planning efforts. Using semi-structured questions, 20 community-dwelling older adults (aged 50-80) were interviewed. In-vivo coding and descriptive content analysis was utilized and revealed 17 codes within categories, including six codes and three categories in the perception domain (internal, external, future-oriented), seven codes and three categories in the facilitators domain (internal, external, systems), and four codes and two categories in the barriers domain (internal, systems). The depth of older adults’ personal identities, life experiences, and the impact of societal influences emerged within the categories. Planning for aging and frailty is an unique concept that promotes planning through awareness and acceptance of the normal aging process. Future research through intervention development is needed to educate and empower older adults, optimize planning, and navigate barriers to planning.
EXPLORING THE POTENTIAL OF WEARABLE DEVICES FOR HEALTH MONITORING: A FOCUS ON BLACK OLDER ADULTS
Authors: Harris Maurita , Kapoor Shaunik , Rogers Wendy
Published: December 2022

Chronic diseases are some of the top conditions leading to death in the United States. Management of these chronic diseases could benefit from monitoring risk factors, such as physical activity. Wearable devices (e.g., Fitbit) have the capability to track and give information to allow the individual to take control of their health. However, wearables are typically advertised to young, physically active, and individuals who belong to racial groups with the highest population. As such, the purpose of this study was to understand Black adults’ opinions and attitudes towards wearable design to support usage, focusing on both users and non-users. Participants were interviewed to explore their wants and needs towards wearables to support usage (e.g., aesthetics) and to overcome barriers (e.g., usability concerns). The findings from the thematic analysis will be presented to illustrate these facilitators and barriers identified by Black adults. These insights can guide future inclusive design.
ENGAGING LOW-INCOME SENIORS IN PARTICIPATORY DESIGN OF SMART SPEAKER APPLICATIONS FOR WELLNESS
Authors: Chung Jane , Winship Jodi , Gendron Tracey , Wood Rachel , Mansion Natalie , Demiris George
Published: December 2022

Low-income senior housing (LISH) residents are at a high risk of unmanaged health conditions, loneliness, and limited healthcare access. Smart speakers have the potential to improve wellness in LISH settings. We conducted a user-centered process with primarily African American, LISH residents (N=25) to develop prototypes of smart speaker applications for wellness and social connections. Five focus groups were conducted to elicit feedback about challenges with maintaining wellness and attitudes towards smart speakers. Participants expressed their desires for using the technology for safety and health. Through design workshops, they identified several smart speaker functionalities perceived as necessary for improving wellness and social connectedness. Then, seven low-fidelity prototypes and scenarios were developed in the following categories: wellness check-ins, befriending the virtual agent, community involvement, and mood detection. We demonstrate how smart speakers can provide a tool for their wellness and increase access to applications that provide a virtual space for social engagement.
WHAT MAKES A BEAUTIFUL DAY IN THE NEIGHBORHOOD? PLACE AS A CONTRIBUTOR TO FUNCTION IN LATER LIFE
Authors: Rosso Andrea
Published: December 2022

Neighborhood environments are increasingly recognized as an important determinant of health and function in older adults. Environmental supports such as density of intersections and available community resources can promote activity and participation which in turn promotes physiological health. In contrast, barriers such as disorder and high traffic can limit activity and participation, particularly for those at high risk for mobility limitations and falls. Here, we present five papers exploring these relations. First, Kate Duchowny presents work assessing relations of the built and social environment with muscle strength in the Health and Retirement Study. Two papers utilizing walkability assessments using Google Street View in a physical activity intervention trial are presented; Kyle Moored demonstrates relations of neighborhood walkability with Global Positioning System (GPS)-derived time out of home and Anisha Suri assesses how the relation between actigraphy-derived gait quality and daily step counts differs by walkability. Next, Philippa Clarke presents data on the association of neighborhood environment with diabetes risk in those with low visual function in an administrative claims database. Finally, Pam Dunlap describes results of a systematic review of outdoor environmental risk factors for falls and fear of falling. Together, these papers will demonstrate the breadth of ways in which neighborhood environments and function relate to determine health outcomes for older adults.
NEIGHBORHOOD WALKABILITY IS ASSOCIATED WITH GPS-DERIVED LIFE-SPACE MOBILITY OF OLDER ADULTS
Authors: Moored Kyle , Crane Breanna , Dunlap Pamela , Carlson Michelle , Rosso Andrea
Published: December 2022

For community-dwelling older adults, living in a more walkable neighborhood may encourage greater travel outdoors (i.e., life-space mobility). We assessed associations between neighborhood walkability and objective, GPS-derived life-space mobility. Participants were 149 adults (Age: M=77.1±6.5, 67% women) from a randomized trial to improve walking in older individuals. Participants carried a GPS at baseline that passively collected real-time location data for 5-7 days. Life-space mobility was quantified using median percentage time spent outside of home (pTOH). Neighborhood walkability was assessed using a modified Active Neighborhood Checklist and Google Street View, and a composite factor score was derived (M=-0.13±0.90, greater score=less slopes, more mixed residential/commercial land use). Each 1-point higher walkability score was associated with 2.5% greater pTOH (95%CI: 0.21-4.69, β=.23, p=.032), after adjusting for age, sex, race, device, season, and clustering on Census tract. Future work will examine how neighborhood walkability and functional status may interact to influence life-space mobility.
NEIGHBORHOOD WALKABILITY INFLUENCES ASSOCIATIONS BETWEEN PHYSICAL ACTIVITY AND GAIT MEASURES IN OLDER ADULTS
Authors: Suri Anisha , Zhu Xiaonan , Acharya Geeta , Harding Alyson , VanSwearingen Jessie , Redfern Mark , Sejdic Ervin , Rosso Andrea
Published: December 2022

Neighborhood walkability can influence physical activity and of older adults. Residential neighborhoods of participants (N=186, 77±6 years, 70% females) were audited for walkability using Google Street View. Factor analysis categorized neighborhood walkability as high, medium, and low. Gait quality was derived from a 4-m instrumented walkway (pace, variability, walk-ratio) and accelerometry signals at the lower back during a 6-minute walk test (adaptability, similarity, and smoothness). Activity was step-count from seven-day actigraphy. We studied associations between gait variables and step-count across high, medium, and low walkability neighborhoods using linear regression (age and sex as covariates). Pace(m/s) [High(β=0.46, p<.05), Medium(β=0.43, p<.05), Low(β=0.25, p>.05)], adaptability(m/s2) [High(β=0.47, p<.05), Medium(β=0.24, p<.05), Low(β=0.37, p<.05)], and similarity [High(β=0.39, p<.05), Medium(β=0.28, p<.05), and Low(β=0.18, p>.05)] were associated with step-count, stronger associations for high walkability neighborhoods (p for interactions <0.01). No associations with variability, walk-ratio, and smoothness were found. Associations between gait and activity differed by neighborhood walkability.
DO MORE EMPATHIC OLDER ADULTS RUMINATE MORE? EMOTION REGULATION MATTERS
Authors: Huo Meng , Leger Kate , Birditt Kira , Fingerman Karen
Published: December 2022

Older adults differ in their responses to distress, and those who tend to ruminate report poor health. We sought to examine whether trait empathy, the tendency to share and understand others’ distress, underlies rumination, and whether this association varies by emotion regulation. Participants included 289 adults aged 65+ in the Daily Experiences and Well-being Study. They reported demographics, empathy, general preferences for emotion regulation strategies, and affect throughout the day as well as daily rumination. Empathy was associated with greater rumination, which was particularly evident in older adults who preferred avoidant strategies. We also found that the link between empathy and rumination was attenuated on days when older adults had lower negative affect variability. This study identifies empathy as a key factor that underlies individual differences in rumination, a key precursor of psychopathologies, and also suggests emotion regulation as a promising target of interventions that can promote older adults’ health.
DO FRIENDS GET UNDER THE SKIN? DAILY INTERACTIONS AND CARDIOVASCULAR FUNCTIONING AMONG BLACK AND WHITE AMERICANS
Authors: Ng Yee To , Han Sae Hwang , Fingerman Karen , Birditt Kira
Published: December 2022

Scarce research has examined racial differences in cardiovascular health in the context of social interactions. This study investigated whether (a) friend interactions were associated with better cardiovascular functioning, and (b) such associations vary among Black and White adults. This study employed dual assessment techniques—ecological momentary assessments (EMA) and ambulatory physiological assessments—to examine the co-occurrence of social interactions and cardiovascular functioning. Multilevel models revealed no racial differences in ambulatory HRV and frequency of friend interactions throughout the day. Findings revealed a between-person link of friend interactions and better HRV in the overall sample. Race-stratified models found a within-person link between friendship interaction and worse HRV and a between-person link between friendship interaction and better HRV for Blacks but not for Whites. Findings suggest friend interactions are more salient for Blacks’ cardiovascular health and may serve as a modifiable factor for preventing cardiovascular diseases.
LATINX GRANDPARENTS RAISING GRANDCHILDREN: THE INFLUENCE OF CULTURAL NORMS
Authors: Mendoza Nancy , Park Cherrie
Published: December 2022

Few studies have focused on the experiences of Latinx grandparents. Using a grounded theory approach, nine Latinx grandparent caregivers were interviewed in an effort to understand how the Latinx culture influences their experiences. Major themes that emerged during data analysis were related to reasons for caring. These included cultural norms of caring and reasons for the non-usage of services. Findings suggest Latinx grandparents tend to care for their grandchildren because they view it as part of their role as a grandparent. Thus, the biggest “barrier” to acquiring services could be that they do not view themselves as primary caregivers. These findings emphasize the need to understand the experiences of these grandparents and the importance of tailoring education and resources to this subgroup. This study provides professionals with a new way of looking at services for Latinx grandparents and opens the door to a new set of implications for practice.
EXPERIENCES OF KOREAN GRANDFAMILIES: DIFFERENCES BETWEEN MATERNAL AND PATERNAL GRANDPARENTS
Authors: Lee Youjung
Published: December 2022

Grandparent-headed families in South Korea have been growing prominent in the country’s cultural landscape. Approximately 153,000 Korean grandparent-headed households existed in 2015; this number is expected to double by 2035. This qualitative study explored Korean custodial grandparents’ experiences of raising grandchildren and the cultural significance of multigenerational caregiving in Korea. Using a phenomenological approach, semistructured interviews with 22 custodial grandparents were conducted. Significant functions of patrilineality and stigma surrounding divorce for Korean grandparent-headed families were found. Considering the complicated cultural factors, social/family service programs must pay attention to the unique needs of grandparent-headed families and consider the circumstances related to grandparents’ positions in the family (i.e., paternal vs. maternal grandparent caregivers). Korean government programs and policies could better help marginalized grandparent-headed families with an empowerment approach to help marginalized grandparent-headed families gain positive attitudes toward their caregiving situation.
ENGAGING A COMMUNITY ADVISORY BOARD TO VALIDATE A CULTURALLY TAILORED INTERVENTION MODEL
Authors: Cotton Quinton , Green-Harris Gina , Chang Juliet , Block Laura , Gilmore-Bykovskyi Andrea
Published: December 2022

National dementia research priorities call for interventional studies addressing the needs of vulnerable populations experiencing disparities and for greater inclusion of dementia care recipients and their family caregivers in research. While studies document disparities, high needs and experiences of African American dementia caregivers, there is limited translation of this knowledge into the development, implementation, and dissemination of dementia-specific culturally tailored interventions. Research methods that facilitate engagement capable of strengthening data collection and culturally congruent interpretation of caregiving perspectives are needed to inform intervention development. Drawing on a qualitative study utilizing Grounded Dimensional Analysis, we employed a longitudinal engagement method with a Community Advisory Board (CAB) to validate a culturally tailored crisis intervention model for African American dementia caregivers. We identified lessons learned through a review of transcripts, memos and research team discussions. CAB members identified language, family structure, cultural history, knowledge, and respect as important features for cultural tailoring.
TALKING ABOUT AT-RISK DRINKING WITH OLDER ADULTS AGING WITH HIV
Authors: del Pino Homero
Published: December 2022

Older adults living with HIV (OALWH) may have health conditions that amplify the negative health effects of alcohol use. Traditional alcohol screening tools do not consider comorbidities or age. We adapted the Comorbidity Alcohol Risk Evaluation Tool screening tool for at-risk drinking to reflect HIV-related conditions and medications. We tested a brief intervention with Black OALWH and collected usability data. Participants, n=27, 53.2 average age in years, 21 average years living with HIV. Three themes: (1) Expectations of doctors (“Doctors better ask me questions about my alcohol use...”); (2) It’s how you say it (“[Doctors] talk down to me like I don’t know my freaking disease …”); and (3) Effects of surviving HIV (“I am fully aware of the effects of alcohol…. I’m probably better informed than most people…”). We identified strategies to address at-risk drinking with OALWH.
THE DYNAMIC GENOME-CHALLENGES AND OPPORTUNITIES FOR HEALTHY AGING
Authors: Adams Peter
Published: December 2022

Chromatin is a key determinant of cell phenotype and function. Therefore, chromatin stability over the lifespan is presumably a pre-requisite for maintenance of cell and tissue phenotype and function, and hence healthy aging and longevity. However, chromatin is not a static fixed structure, but is a dynamic and plastic “breathing” assembly. This dynamic chromatin likely represents a challenge for a cell to achieve phenotypic stability, healthy aging and longevity. As a dynamic and plastic entity, chromatin is prone to change or drift, a process likely exacerbated by intrinsic cellular processes and extrinsic/environmental influences. We have proposed that cells possess mechanisms of chromatin homeostasis, or chromostasis, that preserve chromatin integrity, suppress phenotypic instability and so slow the pace of aging. Implications of dynamic chromatin for healthy aging and longevity will be discussed.
“WE WANT TO PAY AND WE WANT TO STAY”: OLDER ADULTS MANAGING PROPERTY TAX BURDEN IN A GROWING URBAN COUNTY
Authors: Traver Anthony , White Katie , Sheldon Marisa , Dabelko-Schoeny Holly , Sanders Bethany
Published: December 2022

Aging in place is a goal for many older adults. As many older adults own their homes, strategies designed to promote aging in place must account for threats to the financial sustainability of ownership and occupancy later in life. One such threat is property taxes, which have risen substantially in many metropolitan areas over the last decade as home values soar. Property tax relief programs offered by state and local governments are designed to ease the housing cost burden of older adults. Yet, recent research indicates that such programs do little to ensure affordability for low-income homeowners. This study reviewed local property tax relief programs and interviewed local older adult homeowners and housing professionals to understand the circumstances of older adult homeowners in one growing U.S. County. Four major themes emerged from the interviews: housing market dynamics, personal finances, local housing resources, and wellbeing. Results indicate that unaffordability is a growing concern among older adult homeowners and services providers alike. Current property tax relief programs are thought to do little to reduce the cost burden posed by property taxes. Implications for social policy include expanding eligibility criteria and indexing the benefit to a local economic metric so that the relief remains relevant in areas with dynamic markets. Implications for practitioners include understanding the property tax relief programs in one’s area and referring clients when appropriate.
RECESSION EVENTS AND SLEEP PROBLEMS IN MIDLIFE AND AGING ADULTS
Authors: Bhat Aarti , Diaz Jose , Almeida David
Published: December 2022

Adverse economic events can negatively impact aspects of health, including sleep quality. Poor sleep can increase risk of developing or exacerbating health conditions such as cardiovascular and metabolic disease, cancer, and suicidal ideation. It is critical to examine how economic hardships may amplify health disparities in midlife and aging, a rapidly growing demographic in the U.S. This study examines the effect of recession hardships on sleep issues in midlife and aging adults using waves 2 and 3 of the Midlife in the United States study (MIDUS; N = 2602; M age = 63.47; 56.99% women; 15.76% Black). Participants reported chronic sleep problems experienced in the past year, alongside frequency of experiencing sleep disruptions (trouble with onset, maintenance, feeling unrested). Participants also reported economic impacts (financial, housing, and job-related) experienced in the aftermath of the recession; with 75.56% reporting at least one adverse recession event. Regression indicated that recession events were significantly associated with higher odds of chronic sleep problems and high frequency sleep disruptions in wave 3, even when controlling for sleep problems in wave 2. When examining race and age as moderators, Black participants who experienced adverse events were more vulnerable to chronic sleep problems than white participants, whereas age showed no significant interactions. Results indicate that adverse economic events can impact sleep quality for midlife and aging adults, and that policy mitigating economic effects on sleep may especially benefit Black adults. Subsequent analyses will examine the effect of recession events on daily sleep patterns.
IMPLEMENTATION RESEARCH: INTERGENERATIONAL PROGRAMS ACROSS UNIVERSITY SETTINGS
Authors: Juris Jill , Leedahl Skye , Douglas Natalie
Published: December 2022

Implementing intergenerational programs within university settings has been associated with benefits for all generations involved, which often includes young children, university students, and older adults. However, from conceptualization to pilot testing to evaluation, challenges and opportunities present themselves. This symposium will highlight implementation realities for intergenerational programs within higher education settings. This symposium will specifically address dimensions of: geography (rural versus urban), modality (such as in-person, virtual, or a mix), community/university partnerships, and scholarship for faculty balancing instruction and research demands. Addressing stages of implementation, the papers reflect a continuum from pre-planning to pilot to more advanced stages of implementation. First, Lisa Borrero will highlight challenges and opportunities of conceptualizing fully online intergenerational programming, including the pre-implementation planning, execution, and evaluation stages.The second paper from Ladan Ghazi Saidi will describe pre-implementation tasks completed to establish interest in intergenerational programming in a rural setting, as well as challenges stemming from the pandemic. Third, Jill Juris and colleagues will highlight an online intergenerational technology program offered from a rural Western North Carolina university that began implementation during the pandemic.Fourth, Rachel Scrivano and colleagues will describe a community-based participatory research method that bridged the gap between expectations and reality of implementing a 5-year intergenerational program focused on healthy food access. The fifth paper from Skye Leedahl and colleagues will discuss the implementation experiences of an intergenerational, reverse mentoring, technology program that has evolved for seven years at a Rhode Island public university and utilizes community partners from across the state.
EPIGENETIC MECHANISMS OF TISSUE AGING
Authors: Sen Payel , Yang Na , Occean James , Melters Daniel , Shi Changyou , Wang Lin , Sidoli Simone , Dalal Yamini
Published: December 2022

Epigenetic alterations are one of the key hallmarks of aging. How epigenetic changes broadly affect euchromatin-heterochromatin balance, three-dimensional chromatin conformation, histone composition and global transcriptome in aging have not been addressed. Using murine liver as a model organ and an integrated multi-omics approach, we find that aged cells assume a repressed chromatin state characterized by condensed chromatin, broad heterochromatinization, global suppression of the transcriptome, and inability to self-interact over long distances. Our findings reveal that global chromatin alterations pose a barrier and promote a cellular state that is refractory to injury sensing and repair.
MAKING THE CASE FOR AGE INCLUSIVITY IN HIGHER EDUCATION
Authors: Bowen Lauren , Montepare Joann , Silverstein Nina , Whitbourne Susan , Beaulieu Celeste
Published: December 2022

Often viewed as institutions primarily servings 18-to-24-year-old student populations, U.S. colleges and universities are age-diverse. In our recent national study of AFU institutions, 21 campuses maintaining age data reported that 12,718 faculty (39.24% of faculty) and 20,361 staff (42.31% of staff) were ages 50+. Additionally, 22 campuses reported 7,080 students (1.58%) ages 50+. Despite higher education’s attention to diversity, equity, and inclusion (DEI), age is often overlooked; therefore, universities may need strategies for improving age inclusivity. Across 2,447 open-ended survey responses from our study, faculty, staff, and students describe experiences with age inclusivity (e.g., feeling valued) and exclusion (e.g., feeling unwelcome), and many call for greater sensitivity to aging in existing DEI efforts, such as more age-inclusive language in classrooms and attention to age bias in hiring and promotions. In addition, this presentation will examine responses that raise important considerations for integrating age inclusivity with other higher education DEI efforts.
AGE-FRIENDLY MESSAGES AND IMAGES: A VIEW FROM HEALTH PROFESSIONS EDUCATION
Authors: Gugliucci Marilyn
Published: December 2022

The World Health Organization (WHO) report published March 2021 emphasizes that older adults are often subjected to a variety of negative stereotypes including helplessness, frailty, and child-like qualities. Ageism has both real mental and physical health consequences, including a decreased will to live, less desire to live a healthy lifestyle, an impaired recovery from illness, increased stress, and a shortened life span. Health professions education has a responsibility to prepare future providers in more than mindful physical care of older adults, it must address ageism that has proliferated negative personal biases that have triggered reduced overall health and quality of life. Preparation of lectures and learning materials in health professions education requires mindfulness of diversity as well as the implicit bias faculty may portray regarding age. This presentation will bring these nuances to light for consideration and as a reference to instill change.
FACTORS ASSOCIATED WITH EATING PERFORMANCE IN NURSING HOME RESIDENTS WITH DEMENTIA AND MULTIPLE COMORBIDITIES
Authors: Liu Wen , Galik Elizabeth , Resnick Barbara
Published: December 2022

Eating performance is the functional ability to get food and drink into the mouth. Nursing home residents with dementia commonly experience compromised eating performance and subsequent nutritional consequences. Resident characteristics including cognition, physical capacity, and functional ability are associated with eating performance. This study aimed to test the association between functional ability, behavioral symptoms, psychotropic medication use, and comorbidities and eating performance. This was a secondary analysis using baseline data from two randomized controlled trials testing the impact of Function Focused Care on function and behavioral symptoms between 2014-2020. A total of 889 residents with moderate-to-severe dementia (mean age 86.58 years, 72% female, 70% white, 69.5% severe dementia) from 67 nursing homes in two states were recruited. Eating performance (dependent variable) was measured using the single self-feeding item on the Barthel Index. Independent variables included functional ability (Barthel Index total score excluding self-feeding item score), behavioral symptoms (agitation, depression, resistiveness to care), and psychotropic medication use (anti-depression, sedative, anti-psychotics, anti-seizure, anti-anxiety), and comorbidities. Residents had on average 5 documented comorbidities (SD=3.06, range=0-12) and were on approximately 1 psychotropic medication (range=0-5, SD=1.24). Thirty-eight percent of residents were dependent in eating performance. Functional ability (OR=1.052, 95% CI=1.043,1.061, p<.001), depression(OR=.931, 95% CI=.887,.978, p=.004), and anti-anxiety medication use(OR=.632, 95% CI=.409, .978, p=.039) were associated with eating performance. Findings supported better functional ability, lower depression, and less anti-anxiety medication use were associated with better eating performance. Targeted efforts including maintaining functional ability, minimizing anti-anxiety medication use, and managing depression are encouraged to support eating performance.
A TECHNOLOGY-BASED BODY-MIND INTERVENTION FOR LOW-INCOME AMERICAN OLDER ADULTS
Authors: Thiamwong Ladda , Xie Rui , Park Joon-Hyuk , Lighthall Nichole , Loerzel Victoria , Stout Jeffrey
Published: December 2022

Research is limited on the use of technology to help individuals who have a mismatch between physiological fall risk (Body) and perceived fall risk (Mind) and are unable to access traditional fall interventions. We examined the feasibility and acceptability of a technology-based body-mind intervention in low-income older adults during the COVID-19 pandemic and explored barriers to access and adopting the technology. Data were collected using a survey, balance test, accelerometer-based physical activity (PA), and semi-structured interviews with twenty participants who engaged in an 8-week intervention at a low-income setting in Florida. We found that: 1) the technology-based intervention is feasible, 2) participants tend to accept technology to alter their perceptions of fall risk and balance capacity, 3) tailored activities to each component are not a one-size-fits-all approach. There were no statistically significant changes in sedentary time, light PA, and moderate to vigorous PA between pre and post-intervention.
A MULTISITE INVESTIGATION OF FACTORS INFLUENCING QUALITY OF LIFE IN THAI OLD ADULTS DURING THE COVID-19 PANDEMIC
Authors: Roopsawang Inthira , Aree-Ue Suparb , Chintapanyakun Teepatad , Saraboon Yuwadee , Intharakasem Sirirat
Published: December 2022

Coronavirus-19 outbreak situation is a significant problem affecting the older population globally. The aim of this study was to investigate the association among physical activity, physical frailty, social frailty, life-space mobility, and depressive symptoms on quality of life in Thai older persons with non-communicable diseases prior to the COVID-19 pandemic. A path analysis was used for data analysis with the Mplus program. A total of 2,000 participants aged rang 60 – 89 years with a mean age of 65.13 years (SD = 4.62 years) participated in the study. Path analysis indicated that physical frailty was the strongest direct power on quality of life followed by depressive symptoms, and life-space mobility, respectively at the time of COVID-19's first outbreak. Monitoring and managing changes in physical frailty, depressive symptoms, and life-space mobility are suggested to promote active aging and maintain a good quality of life in this population, specifically age-friendly living areas.
MULTIDISCIPLINARY PERSPECTIVES ON LATER-LIFE DEPRESSION: THE ROLE OF BRAIN HEALTH
Authors: Steffen Ann , Moye Jennifer
Published: December 2022

Bi-directional associations between depression and cognitive functioning are magnified among aging individuals, challenging behavioral health providers who treat older adults experiencing clinical and subsyndromal depression. This symposium contributes to the science and practice of assessing and treating later-life depression while also attending to issues in professional training. The first paper presents pre-treatment data from the multi-site Optimum Study of older adults experiencing treatment-resistant depression (n = 529). The relevance of positive psychological constructs is supported with analyses showing important relationships among cognitive functioning, social participation, and psychological well-being. The second paper describes the development of an updated measure to assess behavioral health providers’ knowledge of later life depression, including brain health concerns. Psychometric data for the measure were generated from a random pool of licensed social workers (N=900) who were mailed the survey packet. The third presentation features an experimental study demonstrating that foundational information about aging, including debunking misconceptions about cognitive aging, influenced continuing education preferences of generalist Licensed Professional Counselors (LPCs). Among the randomly generated pool of LPCs (N = 120), participants who received aging-specific information were more likely to later choose an aging-specific continuing education option. The fourth paper highlights recommendations for mental health practitioners working in primary care and general medical settings with older adults who have co-existing depressive symptoms and cognitive concerns. The fifth and final presentation describes cognitive behavioral clinical tools to address brain health concerns in the context of later-life depression, using the new Brain Health module of a published client workbook.
PSYCHOLOGICAL WELL-BEING IN OLDER ADULTS WITH TREATMENT-RESISTANT DEPRESSION
Authors: Kallmi Selmi , Steffen Ann , Lenze Eric
Published: December 2022

Geriatric psychiatry research has documented the importance of psychological well-being to older adults diagnosed with depression (Lenze et al., 2016). This presentation utilizes pre-treatment data from the Optimum Study of treatment-resistant depression in older adults recruited from five USA and Canadian metropolitan areas (N = 529). Social participation was measured with the PROMIS scale: Ability to Participate in Social Roles and Activities (Hahn et al., 2014). Positive affect and life satisfaction were assessed using scales from the Psychological Well-Being subdomain (Salsman et al., 2013) of the NIH Toolbox for Assessment of Neurological and Behavioral Function - Emotion Battery (NIHTB-EB). Along with associations between social participation and positive affect (r = .38, p < .01) and between social participation and life satisfaction (r = .26, p < .01), path analyses explored social participation as a mediator of the relationship between cognitive functioning (NIHTB-CB; Weintraub et al., 2013) and psychological well-being.
THE IMPACT OF SOCIAL INEQUALITIES ON DIGITAL ENGAGEMENT OF OLDER ADULTS DURING THE COVID-19 PANDEMIC
Authors: Petrovčič Andraž , Grošelj Darja , Žádník Štěpán , Prevodnik Katja , Reisdorf Bianca C
Published: December 2022

The COVID-19 pandemic has had profound implications on how older adults engage with the digital world. While there is converging evidence that during the pandemic the number of online newcomers has increased the most among older adults, digital inequalities have become even more condensed among the socially disadvantaged groups in this period. Importantly, such patters of age-related digital exclusion were not observed only in terms of self-reliant internet use but also in older adults’ ability to access internet resources indirectly by asking others to act on their behalf – a practice known as use-by-proxy. Drawing on the van Dijk’s resources and appropriation theory, we aim to understand which categorical and resource inequalities determine the direct and indirect forms of internet use among older adults during the pandemic. Therefore, in November 2021 a telephone survey (N = 701) was carried out among individuals aged 65+ in Slovenia. Three logistic regression models were fitted to explore the association between socio-demographic characteristics of respondents and their access to material and social resources with internet use as well as with availability and activation of use-by-proxy. The results suggested that both categorical and resource inequalities are predictors of internet use. Conversely, availability of use-by-proxy is strongly associated only with social resources, while use-by-proxy activation depends on material resources and household composition. Overall, we argue that social inequalities affect also the indirect forms of internet use in later life which means that the ability to compensate by help for digital inequalities is also stratified unevenly.
SOCIAL SUPPORT, SOCIAL STRAIN, AND DENTAL CARE UTILIZATION AMONG OLDER CHINESE AMERICANS
Authors: Mao Weiyu , Wu Bei , Chi Iris , Yang Wei , Dong XinQi
Published: December 2022

Regular dental care utilization is instrumental to good oral health. This study aimed to examine how positive and negative aspects of social relationships jointly exert influences towards dental care use among foreign-born older Chinese Americans. Data came from the Population Study of Chinese Elderly in Chicago collected between 2017 and 2019 (n = 3,000). Dental care utilization was dichotomized into “no dental visit” versus “any dental visit” in the past two years (including dental visit overseas). Social support and strain were measured by the Health and Retirement Study’s scale from spouse, other family members, and friends (1= having any support/no strain). In stepwise logistic regression, accounting for chronic conditions, oral health problems, and sociodemographics, spousal support remained to be significantly associated with a lower likelihood of having any dental visit. Findings illustrate the importance of understanding how different aspects of social relationships might play a role in dental care use.
EFFICACY OF THE STROLL SAFE OUTDOOR FALLS PREVENTION PROGRAM
Authors: Chippendale Tracy , Albert Steven
Published: December 2022

Informed by the Ecological and Health Belief models, the manualized Stroll Safe program addresses the unmet need of a targeted outdoors falls prevention program. We examined the efficacy of the program in partnership with eight Naturally Occurring Retirement Community program sites in one U.S city (N=86). Participants age 60 and older with a history of falls or a fear of falling were recruited. Community sites were randomly assigned to the treatment or wait list control group. Results of independent samples t-tests reveal a statistically significant improvement in knowledge of outdoor fall risks and safe community mobility strategy use for the treatment group as compared to the wait list control group on the Outdoor Falls Questionnaire (OFQ) and Falls Behavioral Scale for the Older Person (FaB) (ps<.001, Cohen’s d=1.9 & 1.2). Improvements were retained at 6-week follow up. Implementation strategies are being developed to facilitate program adoption by other occupational therapists.
PLACE, TIME, AND STRUCTURAL RACISM: GLOBAL PERSPECTIVES FOR REIMAGINING AGING
Authors: Muramatsu Naoko
Published: December 2022

Racism is embedded throughout society, producing enduring health inequities. Structural racism is pervasive across racial or ethnic groups and at the intersection of racism, ageism, and sexism. However, only the tip of the iceberg is visible in the literature or media. This presentation highlights aging and long-term care experiences of racial and ethnic groups that are often invisible in structural racism discussions (e.g., Asians). It also features direct care workers, many of whom are minorities or immigrants. I present a conceptual model of how structural racism (institutionalized, personally mediated, internalized) impacts well-being (mental, physical, cognitive, social). The model integrates the concepts of “place” (where we live, work, play, learn), “time” (effects of history, cohort, age), and invisibility. Global perspectives of structural racism will help engage gerontologists, policy makers, practitioners, and the public to maximize everyone’s opportunities to live meaningful lives.
PAIN, PLACE, AND POSITIONALITY: SYSTEMIC APPROACHES TO IMPROVING EQUITABLE HEALTH OUTCOMES FOR OLDER ADULTS
Authors: Robinson-Lane Sheria
Published: December 2022

Racism and other “isms” are systemic problems that operate across multiple domains and affect access to care and services, available treatments, and long-term health outcomes for older adults. As such, changing these systems requires diverse methodological approaches that can identify and examine the contextual factors that influence these outcomes, along with continued strong advocacy that will result in related policy change. This presentation will highlight challenges in care delivery and outcomes for Black older adults in pain management, COVID care, and long term care placement and examine how mixed methodological approaches and implementation of the Culturally and Linguistically Appropriate Services (CLAS) Standards as outlined by the U.S. Department of Health and Human Services can make a difference.
EXPERT CONSENSUS PANEL RECOMMENDATIONS FOR MEDICAL AND MENTAL HEALTH CARE IN ASSISTED LIVING
Authors: Zimmerman Sheryl , Sloane Philip , Wretman Christopher , Cao Kevin , Silbersack Johanna , Carder Paula , Thomas Kali , Meeks Suzanne
Published: December 2022

Assisted living (AL) is now the largest residential provider of long-term care in the U.S., and the acuity of AL residents has been rising. However, AL is not a health care setting, and concern has grown about the medical and mental health care needs of AL residents. Because there is no guidance to inform this care, a Delphi consensus panel of 19 experts was convened, and their recommendations were compared to actual practice. Panelists rated 200 discrete items, 43 of which met standard recommendation cut points (rated as important by at least 75% of panelists) and reflected four critical components of AL: the tenets of AL, the role AL plays in providing long-term care for persons with dementia, the need for pragmatism in response to the diversity of AL, and workforce needs. Next steps regarding implementation of the recommendations will be discussed.
THE FACE OF ELDER ABUSE IN AFRICA: THE NIGERIAN PERSPECTIVE
Authors: Cadmus Eniola
Published: December 2022

Elder abuse is increasingly recognized as a serious problem in many African societies, including Nigeria. Contributing factors include a high level of poverty, unemployment, diminished availability, willingness, and ability of primary caregivers to provide for their older persons. Traditionally, elder abuse is considered taboo, and high secrecy surrounding its occurrence further contributes to challenges reporting and addressing the problem. Additionally, the patriarchal nature of the Nigerian society accounts for the gender-based differences in forms of abuse experienced with increased vulnerability among older women. This paper presents case studies that typify the experience of abuse among male and female older persons. The prevalence rates of abuse are drawn from community surveys across the six geopolitical zones. Although the methodologies vary, the total prevalence of any form of abuse experienced ranged from 30-81.1%. However, most studies relied on self-reports with no attempts at verification or data and records for triangulation of information.
THE MANY VOICES OF CARE PARTNERS ACROSS THE CONTINUUM OF CARE
Authors: Fox Aimee , Latimer Abigail , Waldrop Deborah
Published: December 2022

Caregiving and care-sharing is a dynamic, stressful, and physically demanding responsibility, often leading to adverse psychological and physical outcomes. Caregiving for chronic illness and disease involves increasing complexity and scope of responsibilities and expectations. Utilizing strengths-based approaches and a variety of qualitative methods, this symposium highlights the many voices of care partners across the continuum of care; pre-, during and post-caregiving. First, Latimer and colleagues will present a case study of an older adult with multiple chronic illnesses, offering insight into anticipating care needs and coping with daily stressors of multi-morbidity in late life. Second, Morgan and colleagues will present findings from interviews with care partners on supporting the inner strength of those recently diagnosed with mild cognitive impairment. Third, Fox and colleagues share results from a dyadic, multi-modal intervention for pain management. Care partners who both experience persistent pain discuss changes in their relationship as a result of participating in the intervention together. Fourth, Wladkowski discusses caregiver’s perspectives on live discharge and re-enrollment into hospice care. Her findings demonstrate how the anticipated “end” isn’t always the end for ADRD caregivers. Fifth, Buck and colleagues will share caregivers’ responses to a psychotherapy intervention for the treatment of complicated grief post-death of the care partner. Discussant Deborah Waldrop will contextualize these findings and offer suggestions for future research and interventions to enhance care partners’ well-being across the continuum of chronic illness and care.