bluuebunny/crossref_metadata_2025 huggingface dataset:
BRIDGING REGULATORY GAPS IN DIRECT-TO-CONSUMER HEALTH MONITORING TECHNOLOGIES FOR OLDER ADULTS
Authors: Ho Anita
Published: January 2025

This presentation explores unique ethical concerns that result from regulatory gaps in direct-to-consumer (DTC) AI health monitoring platforms, with a focus on the current landscape in the United States. Many older adults have multiple co-morbidities and are increasingly encouraged or even expected to continuously monitor their health, including by AI-powered predictive digital technologies. Some medically oriented AI-based algorithms can seek and receive regulatory approval as a medical device. Nonetheless, a much larger category of DTC AI health platforms includes wellness technologies that are not subjected to regulatory scrutiny or approval, even when many unregulated devices collect similar types of data as medical devices and vast amounts of health-related and personal information, blurring the line between medical and commercial data and products. Older adults are generally more risk averse and have limited digital, medical, and statistical literacy, and may also experience cognitive impairments. Enthusiasts often cite the potential of DTC health monitoring technologies to democratize health information and users’ well-being. However, the lack of governance for DTC applications raises unique and intersecting ethical concerns for the field of gerontology, particular around barriers for informed consent, lack of validation for product safety and clinical value, perpetuation of infantilization, non-transparent practices of data sharing, and potential impact of these technologies on familial care relationships and formal health care delivery. This presentation concludes with recommendations for regulatory considerations to uphold monitored older adults’ agency and well-being.
AI EXPLAINABILITY IN LONG-TERM CARE: A SOCIOLOGICAL INQUIRY
Authors: Gallistl Vera
Published: January 2025

Transparency, fairness, and explainability are integral components of contemporary discourses on AI governance, as evidenced by recent policies such as the AI Act by the European Commission. The concept of explainability reflects a growing recognition of the importance to understand AI systems’ operations and decisions, ultimately fostering trust in their utilization (Markus et al., 2021; Ghassemi et al., 2021). While AI explainability is commonly framed within technical parameters, focusing on tools within data science and informatics to elucidate the algorithms behind automated decision-making processes, this perspective tends to overlook the broader, contextual dimensions of AI explainability. In contrast, this paper adopts a sociological lens to explore the multifaceted nature of explainability (Borch & Min 2022) in the context of AI for long-term care settings (LTC). Drawing on insights from multiple-perspective case studies centered on two AI applications—fall detection and social robots— the study investigates how technology developers, care staff, and older adults conceptualize AI explainability. The paper uses data from 30 qualitative interviews and 50 hours of participant observations. The findings highlight the diverse and at times conflicting understandings of explainability that underpin the development and implementation of AI in LTC. They also illustrate how explainability needs of stakeholders in LTC go beyond technological aspects and instead focus on trust, transparency and meaning-making with AI. Finally, the findings underscore the need to broaden concepts around AI explainability to include the more nuanced explainability needs of older adults and avoid ageist tendencies in the AI explainability discourse.
IRVING S. WRIGHT AWARD AND TERRIE FOX WETLE AWARD LECTURES
Authors: Herman Hattie
Published: January 2025

The Irving S. Wright Award of Distinction Lecture will feature an address by the 2024 recipient Jeremy D. Walston, MD, FGSA, Johns Hopkins University. The Terrie Fox Wetle Award lecture will feature an address by the 2024 recipient Megan Huisingh-Scheetz, MD, MPH, AGSF, University of Chicago. The George M. Martin Lifetime Achievement in Mentoring Award will also be presented at this event to 2024 recipient Steven N. Austad, PhD, FGSA, University of Alabama at Birmingham. These awards are given by the American Federation for Aging Research, Inc.
HARNESSING HEALTH SERVICES RESEARCH TO FUEL FRAILTY IMPLEMENTATION AND INNOVATION
Authors: Huisingh-Scheetz Megan
Published: January 2025

Broad implementation of frailty assessment and management in clinical practice has been a core mission of geriatricians for decades, and now medical and surgical subspecialists have joined the effort. Dr. Terrie Fox Wetle has demonstrated the power of health services research paired with passion to foster change. In this presentation, I will pay tribute to Dr. Wetle, review the health services research and its application to frailty science, and reflect on the importance of passion to one’s career. I will share successes and remaining challenges of frailty implementation as exemplified in the Successful Aging and Frailty Evaluation clinic established in 2011. I will then discuss novel directions for frailty assessment and management using technology that may help overcome hurdles. Throughout the presentation, I will highlight mentors, collaborators and obstacles that have shaped my direction. I will end with a call for team science and policy change to advance frailty care.
ADVANCING DEMENTIA RESEARCH THROUGH AN EARLY CAREER SUMMER INSTITUTE
Authors: Fazio Sam
Published: January 2025

In 2020, the National Institutes on Aging (NIA) funded the five-year Alzheimer’s Association Interdisciplinary Summer Research Institute (AA-ISRI) focused on early career researchers interested in psychosocial and public health research related to dementia. This program is designed to equip researchers with the knowledge and tools to advance the field of dementia research. Specifically, the Institute aims to promote skill building and substantive knowledge of emerging leaders, better preparing them to develop the evidence to ultimately improve care and outcomes for persons living with dementia. During each of the first three years of the project, feedback from faculty and trainees underscored areas in which training is more and less beneficial and the importance of facilitating new and ongoing networks. During this symposium, we will 1) describe the inception and development of AA-ISRI; 2) provide insights from a psychosocial track alum on training and the impact AA-ISRI has had on their research and career; 3) provide insights from a public health track alum on training and the impact AA-ISRI has had on their research and career; and 4) detail lessons learned and steps that other organizations can take to develop similar programs, as well as suggestions for faculty working with individual mentees.
LESSONS LEARNED FROM THE SUMMER RESEARCH INSTITUTE/TRAINING NEEDS OF EARLY RESEARCHERS IN DEMENTIA
Authors: Zimmerman Sheryl , Fazio Sam
Published: January 2025

Across the first three years of the Alzheimer’s Association Interdisciplinary Summer Research Institute (AA-ISRI), 98% of respondents indicated they were satisfied with the program, 95% felt the program increased their understanding of Alzheimer’s, and 90% said the program improved their independent research skills. Alongside the positive reception of AA-ISRI, feedback from participants, faculty, and faculty leadership led to several adjustments and changes to the structure and content of the program. For example, breakout sessions meant to provide deeper exposure to issues targeted to either public health or psychosocial research were found to be of relevance to both tracks of trainees, informing overlapping needs despite the particular area of focus. This and other changes have refined the overall flow of the program, the relevance of information shared, and the recruitment and selection of appropriate participants. This presentation will review the key lessons learned that have helped to shape the AA-ISRI over the first three years, future improvements that have been discussed for subsequent years of the program, and ideas and considerations for organizations looking to implement similar programs for researchers, and mentors working with individual mentees.
INTERGENERATIONAL HEALING: GENERATIVITY AND EMOTIONAL WELL-BEING AMONG ALASKA NATIVE ELDERS
Authors: Lewis Jordan , Kim Steffi , Thompson Lena
Published: January 2025

The concept of generativity, defined as teaching and guiding the next generation, is an important stage of human development. Little research has been conducted with Alaska Natives on their understanding of generativity and its role and impact on their emotional health. This presentation is part of a parent study that consists of 162 qualitative interviews with AN Elders over the course of 16 years and were thematically analyzed to explore generativity and emotional health in successful aging. Across the lifespan, Alaska Native Elders engage in healthy and unhealthy behaviors which may or may not contribute to a healthy identity, or their ability to age successfully. This presentation will discuss four cultural factors, or indigenous cultural generative acts, used by Alaska Native Elders to improve their emotional wellbeing and fill the role of an Elder in their family and community. Throughout this study, Elders described ways that they “found balance” in their lives, including through family influence, being recognized as respected Elders in their communities, community and cultural engagement, and spirituality or living their Native ways of life. Elders felt that it was their responsibility and role to share their wisdom, knowledge, and experiences to help younger generations avoid some of the challenges they experienced and live healthy lives. This presentation will discuss how cultural factors can be used to guide development of culture-specific mental health treatment approaches, and more broadly, prevention strategies for all ages. Intergenerational healing can result in improved mental health for Indigenous Peoples of all ages.
THE JOYS OF GIVING: EXPLORING BIDIRECTIONAL RELATIONSHIPS BETWEEN ELDERS AND THEIR COMMUNITIES
Authors: Kim Steffi , Thompson Lena , Lewis Jordan
Published: January 2025

While Western community engagement with older adults research often focuses on topics such as community program involvement, volunteerism, and civic engagement, few studies have explored the role and impact of community engagement from an Alaska Native (AN) perspective. This presentation is part of a parent study consisting of 162 qualitative interviews with rural and 12 urban-based AN Elders over the course of 16 years and was analyzed using thematic analysis to explore the role of community in successful aging. AN Elders described bidirectional involvement in community engagement, in which they were involved as participants or as leaders. These engagements increased social connectivity and maintained cultural values. While few Elders described formal volunteer roles, they often supported one another through informal roles, like delivering food to others without access to traditional foods gathered from the land and the ocean. AN Elders also explained that the role of “Elder” is an important and respected community role, and often a title given based on their sharing of wisdom, experiences, and knowledge. A unique finding of this study is the bidirectional relationship between Elders and their communities. For example, Elders often expressed interest in participating in community activities, but communities also reach out to Elders to let them know they sought out their knowledge and experiences. Rural and urban based programs and services working to enhance engagement of Indigenous Elders in their community must consider expectations and desires communities may have of Elders and the desires of Elders to share their wisdom and experiences.
BEYOND PHYSICAL ACTIVITY: ALASKA NATIVE CONCEPTS OF PHYSICAL HEALTH, MOVEMENT, AND SUCCESSFUL AGING
Authors: Pedersen Maja , Kim Steffi , Thompson Lena , Lewis Jordan
Published: January 2025

Physical health is a key component of Western-centered models of successful aging. Physical movement in the form of exercise and functional activities are described in the literature as strategies to maintain health through reduced risk for falls, pain, and chronic disease, and to increase quality of life. However, physical health may not be consistently conceptualized across cultures, and few studies have explored this topic among Alaska Native (AN) older adults. We used thematic analysis to evaluate physical health in qualitative interviews with 162 AN Elders across the five regions of Alaska, collected over 16 years. Five overall themes were identified. (1) Elders described recognizing physical changes in their bodies, including gray hairs, or wrinkles. These changes were often seen as signs associated with wisdom. (2) Elders described that, despite physically slowing down, they adjusted tasks to do as much as possible, and found small ways to include daily movement. (3) Elders emphasized the importance of caring for oneself when young, including avoiding substance use. (4) Elders recommended addressing health challenges with a doctor, rather than ignoring them. (5) Elders described physical health as closely tied to living one’s Native ways, including physical activity through a subsistence lifestyle (e.g., gathering, hunting, fishing), relationship with the land, and benefits from eating Native foods. Overall, Elders found ways to preserve their physical health during challenging times and adjust to new norms. These findings can guide the development and tailoring of interventions designed to promote physical health among AN Elders for relevance and impact.
CHARACTERISTICS ASSOCIATED WITH PRIMARY CARE–BASED DEMENTIA SCREENING VISIT COMPLETION IN THE ERADAR STUDY
Authors: Karliner Leah , Dublin Sascha , Coley Yates , Hsu Clarissa , Barrett Tyler , Barnes Deborah
Published: January 2025

Nearly 7 million people in the U.S. are living with dementia, but approximately half are undiagnosed. We are performing a randomized, controlled trial in two healthcare systems (Kaiser Permanent Washington-KPWA, University of California San Francisco-UCSF) of targeted dementia screening. Among primary care patients ≥ age 65, high-risk individuals are identified using a predictive algorithm, eRADAR (electronic health record Risk of Alzheimer’s and Dementia Assessment Rule), and invited for a “brain health” screening visit (BHV). Among 1709 KPWA patients in the intervention group, 506 (30%) completed a BHV; ongoing UCSF recruitment is similar (N=68/221; 31%). Visit completion rates were lower for participants of color (Asian/Black/Latinx) at 18% (N=51/336) compared with non-Hispanic whites at 34% (N=446/1,313), adjusted OR 0.36, 95% CI 0.26-0.49. Completion rates were 33% (N=30/90) among people aged 65-74 vs. 16% (N=44/268) for those aged 90+, adjusted OR per decade 0.71, 95% CI 0.56-0.90. Prior diagnoses of memory problems/concerns or mild cognitive impairment (MCI) were associated with higher odds of completion (adjusted OR 1.49; CI 1.13-1.95), and so was lower comorbidity score (adjusted OR 1.01; CI 1.00-1.03). eRADAR score and gender were not associated with BHV completion. The eRADAR study participation rate is similar to other dementia screening studies. Younger, white patients and those who might be aware of their cognitive deficits–as demonstrated by prior diagnoses–appear more likely to participate. As disease-modifying treatments increasingly become available, further research with communities of color to understand facilitators and barriers to engagement in primary-care dementia assessment is vital to prevent care disparities.
EFFECTS OF ENVIRONMENTAL EXPOSURE ON DISPARITIES IN THE RISK OF ALZHEIMER’S DISEASE AND RELATED DEMENTIAS
Authors: Akushevich Igor , Yashkin Arseniy , Bona Vito Di , Kravchenko Julia
Published: January 2025

Chronic exposures to a range of environmental contaminants, in particular fine particulate matter (PM2.5), have been shown to be associated with an increased risk of Alzheimer’s disease and related dementia (AD/ADRD). However, causal relationships between the effects of ambient air pollutants (especially for low-to-moderate-level exposures) and PM2.5 constituents on AD/ADRD risk remain understudied in both the general population and vulnerable population groups in the U.S. The objective of this study is to evaluate the effects of exposures to PM2.5 and PM2.5 constituents (including black carbon, NH4, SO4, trace elements, and some others), test the causality of contaminant-outcome associations, and explain the epidemiological mechanisms of these causal pathways. To address this objective, we used Medicare-claims data and zip-code-level environmental data provided by the Socioeconomic Data and Applications Center (SEDAC) including daily and annual estimates of the concentrations of PM2.5 for 2000-2016, and trace elements including bromine, calcium, copper, aluminum, iron, lead, nickel, potassium, silicon, vanadium, and zinc. We reconstructed the concentration-response patterns of exposures to ambient contaminants on AD/ADRD risk and applied the parametric g-formula approach to test the causality of detected effects. We evaluated the concentration-response functions for all contaminants and found deviations from the linear dependence for concentrations above 10 µg/m3 (WHO standards) and for the Hispanic subpopulation. The highest risks were found for Native Americans, with a hazard ratio (HR) vs. White subpopulation exceeding HR>3 over the full range of average concentrations (5-12 µg/m3 for PM2.5). NH4, SO4 and lead demonstrated the highest effect among constituents of PM2.5.
“HOW WILL I EVER KNOW I DIDN’T BRING IT ON MYSELF?”: PERCEIVED PERSONAL RESPONSIBILITY IN DEMENTIA RISK
Authors: Peckham Allie , Maxfield Molly , James Dara
Published: January 2025

As public health messages increasingly emphasize the importance of “lifestyle interventions” to reduce dementia risk, our study aimed to explore how community dwelling middle-aged and older adults perceive this information. Here, our focus is on understanding how information around lifestyle interventions influences individuals’ perceptions of their control over health in relation to dementia risk. Our study further investigated how these health-promoting interventions might unintentionally contribute to ‘lifestyle stigma’ for individuals diagnosed with dementia. Through a secondary framework analysis of 50 semi-structured interviews, we found that participants showed a sense of personal responsibility towards engaging in lifestyle interventions to lower their chances of dementia. To interpret our findings, we relied on the concepts of locus of control and attribution theory. Of the 50 participants, we discovered that 23 participants discussed dementia risk, and 13 felt a degree of personal responsibility for their dementia risk. Four believed they had personal responsibility and control and actively engaged in lifestyle interventions. The remaining nine participants also engaged in lifestyle interventions, aiming to find comfort in the potential event of a dementia diagnosis. Recognizing the multifaceted nature of dementia risk, including environmental and external factors beyond individual control, is essential to communicating effectively and combating ‘lifestyle stigma’ that is becoming increasingly associated with the condition. By acknowledging the interplay between individual, social, and societal factors, we can develop more inclusive and effective public health strategies and messages to reduce dementia risk and promote overall well-being.
A MOSAIC OF RESILIENCE: INDIVIDUAL AND SOCIAL FACTORS FOR AGING WELL AMONG DIVERSE OLDER ADULTS
Authors: Cozad Aisha , Burton Cassandra Cantave , Farago Fanni
Published: January 2025

In the wake of the COVID-19 pandemic and continuing extreme weather events, the resilience of older adults in the areas of health and disaster management and preparedness are critical areas of study. As shown by AARP survey research, self-reported happiness and emotional well-being and resiliency is high among older adults, including across racial and ethnic groups. At the same time, these studies also demonstrate that many older adults have trouble bouncing back from hardships and feel concerned about the possibility of declining health and their ability to live independently. In related AARP research, survey data illuminates the crucial role that quality relationships and community features, including affordable and accessible housing, healthcare, and opportunities for social engagement, play in providing structural supports for older adults to age well in their homes and communities. Drawing on multiple AARP survey studies, this presentation will explore different aspects of resilience in aging among diverse communities of older adults, including those who identify as Black/African American, Hispanic/Latino, or LGBTQ.
SOCIAL AND ECONOMIC SUPPORT FOR PEOPLE LIVING WITH DEMENTIA IN MEXICO
Authors: Lopez-Ortega Mariana , Garcia-Chanes Rosa
Published: January 2025

Dementia is one of the most common causes of disability and dependence in the world and is a frequent reason that older people require supportive living situations. In Mexico, Alzheimer’s and other dementias represent the fifth main cause of DALYS (disability-adjusted life-years) and it is estimated that there were approximately 1 626 000 persons living with dementia. However, the health system is not prepared to adequately provide diagnosis, post-diagnosis care as well as care support at home for people living with dementia and their family caregivers. In addition, economic conditions of a large number of older persons is precarious given a life of informal work with no benefits or access to a contributory pension in old age and whose sole income is a small non-contributory pension and relying on children or other close relatives to provide financial and in-kind support, as well as all other health and personal care. The aim of this study is to characterise the support received by a sample of older adults in Mexico. We use the Mexican Health and Aging Study 2016 wave which for the first time included the Mex-Cog Wave 1 a detailed cognitive assessment. This allows for a detailed characterisation of support received by people living with dementia and to compare it with the support available and received by older adults with no impairment. The results allow for specific recommendations for further support programs and activities that focus on areas of need and currently not covered either by public or family supports.
INTERNET USE AMONG BRAZILIANS ADULTS IN LATE LIFE: DETERMINANTS OF USE AND IMPACTS ON COGNITIVE HEALTH
Authors: Chen Xiayu , Farina Mateo , Andrade Flávia , Wang Kun
Published: January 2025

Growing numbers of older adults use the Internet daily, suggesting its potential to improve general cognitive functioning, memory, and verbal fluency. Yet, a significant gap exists in understanding the association between Internet use and cognitive health within low- and middle-income countries. This study addresses this gap and evaluates the association between Internet use and cognitive health among Brazilian older adults using data from the second wave of the Brazilian Longitudinal Study of Aging(ELSI-Brazil). Multivariate linear regressions were employed to evaluate the association of Internet use with cognitive function, memory, and verbal fluency. Blinder-Oaxaca decomposition was conducted to estimate and decompose the cognitive health disparity between Internet users and non-users. Our finding suggested that about 17% of the older adults in the sample were Internet users, and 69% of them use the Internet on a daily basis. Internet use was positively associated with general cognitive functioning (β=0.14, 95% CI 0.07-0.20) and memory (β =0.19, 95% CI 0.10-0.28), accounting for demographic, social, geographical, and health factors. The daily Internet use was positively associated with general cognitive function (β=0.14, 95% CI 0.06-0.22) and memory (β=0.19, 95% CI 0.09-0.29). However, no statistically significant association was found between Internet use, use frequency and verbal fluency. Our study has also found that educational and health attainment significantly explains the cognitive health disparity between Internet users and non-users among Brazilian older adults. The findings underscore the need for targeted strategies to bridge the digital divide and enhance cognitive health, particularly among socioeconomically and health-disadvantaged groups in Brazil.
MAPPING 15-YEAR DEPRESSIVE SYMPTOM TRANSITIONS IN LATE LIFE: A POPULATION-BASED COHORT STUDY
Authors: Triolo Federico , Vetrano Davide Liborio , Trevisan Caterina , Sjöberg Linnea , Calderón-Larrañaga Amaia , Murri Martino Belvederi , Fratiglioni Laura , Dekhtyar Serhiy
Published: January 2025

As the longitudinal course of late-life depression remains unclear, we aimed to describe transitions along the depression continuum, and identify factors associated with specific transition patterns. We analysed 15-year longitudinal data on 2745 dementia-free persons aged 60+ from the Swedish National Study on Aging and Care in Kungsholmen. Depression (minor and major) was diagnosed according to DSM-IV-TR; subsyndromal depression (SSD) was operationalized as the presence of ≥2 symptoms without depression. Multistate survival models were used to map depression transitions, including death, and to examine the association of psychosocial (social network, connection, and support), lifestyle (smoking, alcohol consumption, and physical activity), and clinical (somatic disease count) factors with transition patterns. Over the follow-up, 19.1% had ≥1 transitions across depressive states, while 6.5% had ≥2. Each additional somatic disease was associated with a higher hazard of progression from no depression to SSD (HR 1.09; 1.07-1.10) and depression (HR 1.06; 1.04-1.08), but also with a lower recovery (HRSSD-NoDep 0.95; 0.93-0.97; HRDep-NoDep 0.96; 0.93-0.99). Physical activity was associated with an increased hazard of recovery to no depression from SSD (HR 1.49; 1.28-1.73) and depression (HR 1.20; 1.00-1.44), while richer social network was associated with both higher recovery (HRSSD-NoDep 1.44; 1.26-1.66; HRDep-NoDep 1.51; 1.34-1.71), and lower progression hazards (HRNoDep-SSD 0.81; 0.70-0.94; HRNoDep-Dep 0.58; 0.46-0.73; HRSSD-Dep 0.66; 0.44-0.98). Older people may present with heterogeneous depressive trajectories. Targeting the accumulation of somatic diseases and enhancing social interactions may be appropriate for both depression prevention and burden reduction, while promoting physical activity may benefit recovery from depressive disorders.
FINDING FORTITUDE: SOCIAL CONVOYS OVER THE LONG HAUL
Authors: Hu Rita , Ajrouch Kristine , Wethington Elaine
Published: January 2025

As populations globally face the opportunities and challenges of aging, social convoys across the lifespan are pivotal in navigating the complexities of later life. This symposium explores the dynamic interplay between social relations and aging, emphasizing the protective and predictive nature of social networks over the lifespan and in different cultural contexts. Becheroui and colleagues explore familial care in Lebanon across age groups, focusing on the balance between cultural expectations and the need for policy support. Antonucci and colleagues examine how socioeconomic status affects changes in health through social relations, particularly the influence of parent-child dynamics among men and women. Hu and colleagues also provide a longitudinal perspective, showing how social network trajectories over nearly three decades influence later-life cognitive health, emphasizing the enduring importance of weaker ties for cognitive health later in life. Webster and colleagues present evidence of how educational attainment within one’s social network at one point in time contributes to cognitive health later in life, pointing to the broader implications of social environments on cognitive well-being. Aimed at fostering a comprehensive understanding of social convoys in the aging process, this symposium invites a cross-disciplinary dialogue to enhance the support for aging individuals worldwide, embodying the symposium’s theme of finding fortitude through the power of social relationships.
CITY LIGHTS OR COUNTRYSIDE NIGHTS? RURALITY’S ROLE ON ANXIETY AND SLEEP IN MID- TO LATE-LIFE
Authors: Costa Amy , Halder Puja , McCrae Christina , Curtis Ashley
Published: January 2025

Anxiety and sleep health associations are well studied but contributing factors (e.g., level of rurality) to health disparities in this relationship are understudied, particularly in aging populations. The present study examined the moderating impact of rurality on associations between anxiety and aspects of sleep health in middle-aged and older adults living in the United States. Cognitively healthy middle-aged and older adults (N=251; Mage=64.7±7.9 years) completed an online survey measuring residence zip code, Pre-Sleep Arousal Scale, Pittsburgh Sleep Quality Index, and the Hospital Anxiety and Depression scale. Multiple regression and simple slope analyses examined whether rurality (rural vs. non-rural; coded by Delineating Core Based Statistical Areas) moderated associations between anxiety and sleep, controlling for age, sex, education, income, depression, medication usage, and nutritional status (Mini-Nutritional Assessment). Results revealed rurality moderated the association between anxiety and cognitive pre-sleep arousal (R2 change=.014, p=.01) and sleep disturbances (R2 change=.01, p=.04). Higher anxiety was associated with higher cognitive pre-sleep arousal, with an ~2x larger association for rural (B=.64, p<.0001) than non-rural (B=.35, p=.0002) participants. Similarly, higher anxiety was associated with more sleep disturbances for rural (B=.05, p<.001), than non-rural participants. In mid-to-late life, those living in rural areas may be more vulnerable to the impact of higher anxiety on worse sleep compared to those living in non-rural areas. Findings point to the need for a greater understanding of socioeconomic determinants of health and more tailored treatments, with potential emphasis on mitigating barriers impacting rural access to clinical treatments for anxiety and sleep health.
PREVALENCE AND THE ASSOCIATED FACTORS OF MULTIMORBIDITY AMONG OLDER NEPALIS IN WESTERN NEPAL
Authors: Tuladhar Lirisha , Sapkota Krishna , Kafle Bharat , Bhattarai Preeti , Bhattarai Pratik , Shrestha Aman
Published: January 2025

Multimorbidity, the concurrent presence of multiple chronic diseases, is a global public health issue, with higher prevalence rates observed among older age groups and individuals of lower socioeconomic status. This study aims to determine the prevalence of morbidity levels and the associated factors across all three ecological regions of Western Nepal. Utilizing a community-based cross-sectional design, 612 participants were interviewed face-to-face. Levels of morbidity were grouped as “no morbidity,” “single disease,” and “multiple diseases.” Ordinal logistic regression examined the association between levels of morbidities and various sociodemographic, economic, and health behavior factors. Probabilities models were cumulated over the higher-ordered levels of morbidity. Among sociodemographic variables, participants of urban residents (OR=1.68, CI: 1.16—2.44), of age 70 years and above (OR=1.55, CI: 1.10—2.17), females (OR=2.43, CI:1.61—3.66) and with disability (OR=1.58, CI:1.14—2.18) were associated with increased odds of being in a higher category (increasing morbidity) rather than lower category than their respective counterparts after adjusting for the covariates. Economic factors did not establish significant relationships with morbidity levels. Among health behavior factors, those who consumed alcohol had 41% decreased odds of higher morbidity compared to non-consumers (OR=0.59 CI:0.37—0.92). This study identified significant associations between multimorbidity and specific demographic groups in urban areas, notably older females and individuals with disabilities. It highlights the necessity of providing tailored behavior change information and implementing screening programs to reduce the prevalence of health issues in these populations.
THE ROLE OF HETEROGENEITY IN NEUROCOGNITIVE AGING
Authors: Moreno Sylvain
Published: January 2025

Neurocognitive aging research has predominantly adopted a linear approach, categorizing aging populations homogeneously. Researchers like Salthouse argue that this perspective perceives cognitive decline as almost linear from early adulthood. However, emerging findings challenge this view, highlighting significant variability in cognitive aging and proposing different subtyping methods to study the neurocognitive aging population. Our talk will propose a novel subtyping framework inspired by the Orchid and Dandelion theory from Boyce (2005). This new framework introduces a nuanced understanding of cognitive aging, categorizing individuals based on genetic and phenotypic characteristics to better capture the heterogeneity of cognitive abilities as people age. Using extensive datasets such as the UK Biobank and machine learning analytical techniques, our research investigates the impact of environmental factors on distinct cognitive aging subtypes. This approach diverges from the traditional linear models, revealing that lifestyle factors have varying impacts on different cognitive aging subtypes, underscoring the theory’s premise that some individuals (orchids) are more environmentally sensitive, affecting their cognitive aging process. In contrast, others (dandelions) show resilience. This paradigm shift towards recognizing cognitive aging’s inherent heterogeneity offers a more accurate and personalized understanding of aging, emphasizing the importance of subtyping in developing targeted interventions. Our findings advocate for a move beyond the “linear” methodology found in the literature, highlighting the need for a framework that accommodates the heterogeneity of cognitive aging.
JOURNAL OF GERONTOLOGY SOCIAL SCIENCES: FEATURED 2023 EDITOR’S CHOICE ARTICLES
Authors: Kelley Jessica
Published: January 2025

Social science inquiry on age, aging, and the life course spans many topics and methodologies. This symposium highlights papers that were selected as Editor’s Choice articles in the Journal of Gerontology Social Sciences in 2023. These papers highlight methodological innovations, important advancements in our state of knowledge in an area, or emerging issues in the study of aging and older adults. Wright et al. compare differences in income pooling between remarried and cohabiting older adults. Taylor et al. present a qualitative study of the ways that kinless older adults navigate a dementia onset. Stokes et al. utilize novel dyadic analysis to explore the interrelationship of loneliness and cognition among married couples over time. Latham Minus et al. document mental and physical health among older adults who are formerly incarcerated, showing differences by gender and race. Al-Rousan et al. examine the relationship between migration history and cognitive functioning among older Arab Americans and refugees.
KINLESS OLDER ADULTS WITH DEMENTIA: QUALITATIVE ANALYSIS OF DATA FROM THE ADULT CHANGES IN THOUGHT STUDY
Authors: Taylor Janelle , Gray Marlaine Figueroa , Freitag Callie , Kariya Hitomi , Crane Paul , Vig Elizabeth , Berridge Clara , Larson Eric
Published: January 2025

Objectives

To examine the circumstances and needs of older adults who were “kinless,” defined as having no living spouse or children, when they developed dementia.

Methods

We conducted a secondary analysis of information from the Adult Changes in Thought study. Among 848 participants diagnosed with dementia between 1994 and 2016, we identified 64 who had no living spouse or child at dementia onset. We then conducted a qualitative analysis of administrative documents pertaining to these participants: handwritten comments recorded after each study visit, and medical history documents containing clinical chart notes from participants’ medical records.

Results

In this community-dwelling cohort of older adults diagnosed with dementia, 8.4% were kinless at dementia onset. Participants in this sample had an average age of 87 years old, half lived alone, and one third lived with unrelated persons. Through inductive content analysis, we identified 4 themes that describe their circumstances and needs: (1) life trajectories, (2) caregiving resources, (3) care needs and gaps, and (4) turning points in caregiving arrangements.

Discussion

Our qualitative analysis reveals that the life trajectories that led members of the analytic cohort to be kinless at dementia onset were quite varied. This research highlights the importance of nonfamily caregivers and participants’ own roles as caregivers. Our findings suggest that clinicians and health systems may need to work with other parties to directly provide dementia caregiving support rather than rely on family, and address factors such as neighborhood affordability that particularly affect older adults who have limited family support.
LET’S GET PHYSICAL: ACTIVITY, FUNCTION, AND FITNESS AS KEY COMPONENTS OF AGING AND HEALTH
Authors: Schrack Jennifer , Wanigatunga Amal , Spira Adam
Published: January 2025

Physical activity, physical function, and physical fitness (“activity, function and fitness”) are established predictors of health and longevity. Yet, many aspects of how and why measures of activity, function, and fitness are so strongly linked with physical and cognitive health in older adults remain under-addressed. This is further complicated by the multidimensional aspects of activity, function, and fitness, allowing them to function as both predictors and outcomes of health. This symposium will focus on quantifying and defining measures of activity, function, and fitness and their associations with various features of physical and cognitive health across several large U.S. cohort studies. Dr. Davoudi will present the prevalence of impairments in motor function (gait speed, chair stands, standing balance, grip strength) in the National Health and Aging Trends Study (NHATS). Dr. Wanigatunga will describe new methodology to assess the combined contribution of sensory and motor functioning to cognitive health in the Baltimore Longitudinal Study of Aging (BLSA) and the Atherosclerosis Risk in Communities (ARIC) study. Dr. Dougherty will present the association of physical activity with Alzheimer’s biomarkers (amyloid, total tau, phosphorylated tau) and cognitive functioning in the Biomarkers of Cognitive Decline Among Normal Individuals (BIOCARD) study. Dr. Twardzik will describe trends in public transit use and associations with physical activity in NHATS. Finally, Dr. Yue will present the association of sleep quality and quantity with measures of fitness and energetic efficiency in the BLSA. Collectively, these presentations will highlight novel pathways through which activity, function, and fitness contribute to healthy aging.
LINKS OF SLEEP WITH CHANGES IN CARDIORESPIRATORY FITNESS AND ENERGETIC EFFICIENCY IN MIDDLE-AGED AND OLDER ADULTS
Authors: Yue Yiwei , Callow Daniel , Diallo Idiatou , Rabinowitz Jill , Wanigatunga Sarah , Simonsick Eleanor , Schrack Jennifer , Spira Adam
Published: January 2025

Sleep disturbances are linked to cardiovascular disease in middle-aged and older adults, but little is known about the associations of poor sleep with cardiovascular fitness and energetic measures in this population. We investigated cross-sectional and longitudinal associations of actigraphic sleep parameters with cardiorespiratory fitness, walking energetics, and resting metabolic rate among 263 participants (mean age=72.7±10.1 years, 53.6% women) in the Baltimore Longitudinal Study of Aging. Additionally, we assessed modifying roles of sex, race, and age in these associations. Primary predictors included actigraphic total sleep time (TST), sleep efficiency (SE; % of time in bed spent asleep), sleep onset latency (SOL), wake after sleep onset (WASO), and average wake bout length (WBL). Outcomes included maximal oxygen consumption (VO2max), energetic cost of walking (ECW), and resting metabolic rate (RMR). Adjusting for demographics, comorbidities, self-reported physical activity, time, and interactions of time with covariates, longer WBL was cross-sectionally associated with lower VO2max (B=-1.24, p<0.01) and higher RMR (B=62.65, p<0.01); lower SE with lower VO2max (B=1.18, p<0.01); and shorter TST with higher RMR (B=-16.03, p<0.05). Women had stronger associations between longer TST and higher VO2max and greater WBL with slower decline in VO2max than men. Middle-aged adults showed stronger connections of higher SE and lower WASO with lower RMR than older adults (interaction p-values<0.05). In summary, shorter TST, longer WBL, and lower SE are linked with poorer cardiorespiratory fitness and energetic efficiency among middle-aged and older adults. Studies are needed to determine whether enhancing sleep can improve fitness and energetic efficiency, and vice-versa.
C-REACTIVE PROTEIN LEVELS AMONG LGB OLDER ADULTS: INTERSECTIONAL ASSOCIATIONS OF RACE, ETHNICITY, AND EDUCATION
Authors: Alberth Andrew , Prasad Anyah , Collins Amanda , Rataj Alison , Farmer Heather , Stokes Jeffrey
Published: January 2025

Objectives

This paper assesses the intersection between sexual orientation, race, and ethnicity as they relate to CRP levels among middle-aged and older adults in the Health and Retirement Study (HRS). It will also explore how educational attainment, a commonly used demographic correlate with socioeconomic status, may differently benefit racially, ethnically, and sexually diverse middle-age and older adults.

Methods

This study uses data from the 2016 Health and Retirement study. C-reactive protein levels, sexual orientation, race and ethnicity, educational attainment, and covariate variables were collected using serum samples and survey responses from 1,426 older adults enrolled in the study. Individuals were included if they had reported measures for key independent and dependent variables. Multiple imputation was used to address missing values across control variables. Associations and moderators were assessed using ordinary least squares (OLS) regression.

Results

This study found lesbian, gay, and bisexual (LGB) respondents had lower CRP levels when they had higher educational attainment compared to similarly educated straight respondents. Additionally, Black LGB respondents had less inflammation than Black and straight or White and LGB respondents.

Discussion

This study’s findings indicate educational attainment may differently benefit LGB older adults compared to straight older adults, and respondents who are Black and LGB experience greater protection from elevated CRP levels compared to only Black or LGB respondents. These findings suggest educational attainment may be differently used to protect against systemic inflammation among sexual minority populations. Furthermore, these results suggest additional nuance is necessary to understand how CRP levels impact diverse populations.
SECOND CLASS CARE: PATTERNS OF LGBTQ+ PATIENT EXPERIENCES AND RECEIPT OF PREVENTIVE CARE IN MIDLIFE AND OLDER AGE
Authors: Tran Nathaniel , McKay Tara , Gonzales Gilbert , Fry Carrie , Dusetzina Stacie
Published: January 2025

The objectives of this study were to (1) Identify latent classes of LGBTQ+ patient experiences using seven indicators of clinical and cultural competence, (2) Identify sociodemographic characteristics associated with class membership, and (3) Estimate the association between class of patient experiences and receipt of preventive care. The sample included 954 LGBTQ+ adults aged 50-76 from the Vanderbilt University Social Networks, Aging, and Policy Study. Respondents reported on seven indicators of their clinician’s LGBTQ+ clinical and cultural competency. Latent class analysis was conducted to identify patterns of LGBTQ+ patient experiences. We estimated marginal effects of class membership on preventive care using logistic regression. Three latent classes emerged: 34% assigned to the Affirming class, 60% to the Neutral class, and 6% to the Discriminatory class. Gender identity, sexual orientation, race/ethnicity, state of residency, and HIV status significantly predicted class membership (all p< 0.01), but not education, income, health insurance, or chronic conditions. Compared to those the Affirming class, individuals in the Neutral class were 12.4pp less likely to have ever been tested for HIV and 17.1pp less likely to have been recently tested for HIV, both p< 0.001; those in the Discriminatory class were 12.2pp less likely to have recently received an influenza vaccination and 14.8pp less likely to have recently completed a colorectal cancer screening, both p< 0.05. In the absence of explicitly affirming healthcare experiences, LGBTQ+ patients are less likely to receive timely preventive services. Increasing the capacity of health systems to provide LGBTQ+ affirming healthcare may advance health equity.
RISK AND RESILIENCE RELATED TO SELF-PERCEPTIONS OF AGING AMONG LESBIAN AND GAY OLDER ADULTS
Authors: Guest M Aaron , Giasson Hannah , Koffer Rachel
Published: January 2025

Lesbian and gay individuals may face unique experiences and expectations associated with growing older. In part, this may result from the perception of an overemphasis on youth in the LGBTQ+ community. The present study aimed to provide a preliminary model of how lesbian and gay adults view their aging and identify psychosocial risk and resilience factors specific to this community. Data are from a pilot study of social perceptions of aging in lesbian and gay adults, in which 45 gay and 46 lesbian adult participants (ages = 55-87, 70% white) completed questionnaires on their health, perceptions of aging, community engagement, identity congruence, and stressful experiences. Self-perceptions of aging were measured with an 8-item scale ranging from 1 to 6, where higher scores indicate greater agreement with positive perceptions of aging. In a regression model accounting for age, self-rated health, subjective socioeconomic status, and race/ethnicity, lesbian women reported better self-perceptions of aging than gay men (b = 0.50, SE = 0.16, p <.01). Further, greater outness was associated with better self-perceptions of aging (b = 0.04, SE = 0.01, p =.01), LGBTQ+ community engagement did not relate to self-perceptions of aging (b = -0.11, SE = 0.12, p =.38). More stressful experiences in daily life were associated with worse self-perceptions of aging (b = -0.14, SE = 0.05, p <.01). Results will be discussed in the context of a model of risk and resilience for “accelerated social aging” among Lesbian and Gay populations.