bluuebunny/crossref_metadata_2025 huggingface dataset:
POLYGENIC RISK SCORE FOR DIABETES PREDICTS POSTOPERATIVE ACUTE KIDNEY INJURY
Authors: Leis Aleda , Mathis Michael , Smith Jennifer , Mukherjee Bhramar , Karvonen-Gutierrez Carrie
Published: January 2025

Large genetic studies often lack detailed phenotyping of complex conditions because doing so requires substantial resources and intensive testing. Given the high prevalence of these conditions, particularly among older adults, omission of such information may lead to biased results. This analysis examined the utility of a polygenic risk score for type 2 diabetes (PRST2DM) versus phenotypic diabetes status in predicting postoperative acute kidney injury (AKI). Data from 14,824 Michigan Genomics Initiative patients age ≥18 years who underwent non-cardiac, non-renal, non-urologic, and non-liver transplant surgical procedures were included. PRST2DM was generated using previously published weights (Mars 2020; pgscatalog.org); values were binned into deciles. AKI was defined using modified Kidney Disease–Improving Global Outcomes (KDIGO) criteria. Logistic regression models of phenotypic T2DM status and the PRST2DM were evaluated; both models were adjusted for a common set of preoperative and intraoperative factors. AKI prevalence was 5.0% (n=737). The odds of AKI were 52% higher among those with phenotypic T2DM versus those without T2DM. Similarly, those in the highest PRST2DM decile had 43% higher odds of AKI compared to those in the lowest decile. Model area under the curve values were largely consistent between the phenotype and PRS models. These findings support the utility of the PRST2DM to serve as a suitable proxy for phenotypic T2DM when a granular phenotype is not available, is subject to information bias, or may not yet have occurred. Such a use is novel and may allow for more dynamic analyses of outcomes in genetic cohorts with limited phenotyping.
AFFORDABLE, ACCESSIBLE HEARING CARE AMONG INDIVIDUALS WITH COGNITIVE IMPAIRMENT: LESSONS FROM THE HEARS RCT
Authors: Nieman Carrie , Betz Joshua , Suen Jonathan , Trumbo Jami , Han Hae-Ra , Marrone Nicole , Lin Frank , Oh Esther
Published: January 2025

Hearing loss is highly prevalent and associated with adverse health outcomes but undertreated among individuals with cognitive impairment, particularly African Americans. The incorporation of community health worker (CHW)-partnered models may increase access and reduce disparities. The HEARS intervention is a hearing care intervention delivered by CHWs that provides a low-cost amplification device. This pre-specified subgroup analysis based within the HEARS randomized controlled trial (RCT) aims to assess whether cognitive impairment modified the effect of the HEARS intervention among community-dwelling older adults. The analysis was stratified by cognitive status using the total Montreal Cognitive Assessment (MoCA) score (□25: cognitive impairment; post hoc sensitivity analysis using □22). Among 149 randomized participants with MoCA data, 100 individuals were cognitively impaired (Mean adjusted MoCA: 21(SD 3.5; 52% African American; 70% low-income). At 3-months post-intervention, communication function significantly improved among individuals with cognitive impairment compared with control, with an estimated average treatment effect of -13.92 HHIE-S change (95% CI:-16.84,-10.86), comparable to those without cognitive impairment (-11.47; 95% CI:-18.04,-4.17). Post hoc sensitivity analysis using a □22 MoCA cut-off for cognitive impairment yielded similar findings. Among individuals with cognitive impairment, the HEARS intervention, compared with waitlist control, significantly improved communication function. The improvements were comparable to participants without cognitive impairment and similar in magnitude to improvements documented for older adults who received conventional hearing care. To the authors’ knowledge, this trial was the largest trial to date of a hearing care intervention in the U.S. of African American older adults and low-income older adults with cognitive impairment.
AGELESS HORIZONS: IMPACT OF AI, CLIMATE CHANGE, AND EPIGENETICS ON GERONTOLOGICAL SYNDROMES
Authors: Manini Todd , Kaufmann Christopher
Published: January 2025

This interdisciplinary symposium will provide the audience an eclectic, contemporary view of gerontology syndromes. It brings together researchers in epidemiology, built environment to natural hazards, new epigenetic age measures, climate events, artificial intelligence (AI) and gerontological syndromes. In this symposium, the audience will learn about how the literature is using AI to study the 5 M’s of Geriatrics — Mind, Mobility, Medications, what Matters most and Multicomplexity. This topic is complemented by using new AI methods with Latent Dirichlet Allocation to analyze clinical notes to better estimate the frailty syndrome. Results from older adults undergoing Transcatheter Aortic Valve Replacement suggest a substantial improvement in identifying frail older adults compared to an electronic record approach only. Next, new hallmark measures of biological aging using epigenetic age are studied as a potential mechanism by which biopsychosocial factors could influencing pain and mobility in older adults. Lastly, there are significant adverse health outcomes due to environmental shocks of extreme weather and climate events. Older adults are known to have a greater health susceptibility to these events. However, the impact on health can happen in even deeper ways by modifying mobility after the acute effects have ceased. Mobility resilience signifies a capacity to adapt and maintain community interactions following environmental shocks. Results from hurricane Ian in 2022 suggest that neighborhoods with a higher density of older adults are less mobility resilient. Today’s advances in AI and access to unique data sources are on the horizon and will open new approaches to studying gerontological syndromes.
FUNCTIONING OUTCOMES AT OLDER WORKING AGES BY INCOME GROUPS: COMPARING THE US WITH 11 EUROPEAN COUNTRIES
Authors: Choi HwaJung , Jivraj Stephen , Fors Stefan
Published: January 2025

This study extends prior research by examining physical and cognitive function for low vs. high-income working-age adults (55-64 years) in the U.S. by comparing to 11 European countries. Using a pooled cross-sectional analysis, the study estimated differences in comparably measured outcomes of activities of daily living (ADLs), instrumental activities of daily living (IADLs), and word recall assessment, with adjustment for survey design aspects and sociodemographic characteristics. Income groups were determined based on the distribution within each country, year, and age. Overall, older working-age adults from the U.S. were significantly more likely to have difficulty with ADLs and IADLs compared to all European countries examined in the study, with the exception of having a similar outcome with England for having difficulty with ADLs. In particular, the adjusted prevalence of ADL limitation from the lowest income group (bottom 20%) was 30% in the U.S. vs. 4%-13% in 10 European countries. Those from the highest income group (top 20%) in the U.S. had a similar risk of having difficulty with ADLs to most countries examined in the study but had a greater risk of having difficulty with IADLs compared to the majority of the countries in the study. Word recall scores from the lowest income group were poorer in the U.S. compared to many European countries, while those from the highest income group performed better in the U.S. Targeting the poorest in the U.S. at risk of disability through intervention should be a priority.
ADHD GENETIC BURDEN ASSOCIATES WITH COGNITIVE DECLINE AND ALZHEIMER DISEASE MARKERS IN OLDER ADULTS
Authors: Arpawong Thalida Em , Kim Jung Ki , Crimmins Eileen
Published: January 2025

Attention deficit hyperactivity disorder (ADHD) is associated with greater risk for Alzheimer disease and related dementias (ADRD). Genetic liability for ADHD, via a well-characterized polygenic score, has shown associations with cognitive decline and AD neurodegenerative markers, but these associations have not been tested in large and diverse samples of older adults. Using data from a population-based Health and Retirement Study, we used linear mixed-effects regression to test associations between an ADHD polygenic score (ADHD-PGS) and longitudinal trajectories of cognitive decline over 12 years among 12,090 White and 3,100 Black adults aged 51 and over. We used linear regression to test the associations between the ADHD-PGS and AD markers, p-tau181 and Abeta 42:40 ratio, among a subset who provided a blood sample (2,361 White and 537 Black older adults). All models were run separately by ethnicity, and controlled for age, sex, APOE4 carrier status, and ancestry principal components. The ADHD-PGS was associated with cognitive decline among White (p< 2e-16) and Black (p=.008) older adults. The ADHD-PGS was associated with p-tau181 (p=0.045) and the Abeta ratio (p=0.039) among White, but not Black older adults (p’s=ns). The ADHD-PGS, which represents the continuum of genetic liability for ADHD-related traits in the population, shows associations with faster cognitive decline over 12 years among a diverse set of older adults. The ADHD-PGS shows statistically significant associations with two neurodegenerative markers among White older adults, but not among a smaller sample of Black older adults, although effect sizes for p-tau were similar across groups.
THE POWER OF ARTS-BASED ACTIVITIES: APPLICATIONS OF AN INTERGENERATIONAL HAIKU-MAKING ACTIVITY
Authors: Matsumoto Yoshiko , Maeda Harumi
Published: January 2025

The power of arts- and humanities-based activities for enhancing the well-being and quality of life of older adults is well documented in the existing literature (e.g., Fraser et al., 2015; Letrondo et al., 2023; Young et al., 2016). An intergenerational haiku-making activity designed and implemented by the authors et. al. (2021, 2024) is one such activity. In this activity, 2-3 older adults living with mild cognitive impairment (MCI) interact with 2-3 university students to create haiku poems based on seasonal photos of their choice, followed by short one-on-one feedback interviews. Analysis of the recorded activity sessions demonstrates how the activity created meaningful outcomes for both older and younger participants, including increased emotional well-being, intergenerational understanding, and self-expression. This presentation discusses two applications of the intergenerational haiku-making activity in two different settings. First, we designed and taught a community-engaged learning course in which undergraduate and graduate students learned first-hand how humanities-based intergenerational activities enhance intergenerational communication and mutual understanding. Second, the activity was re-designed to target older Japanese immigrants living with cognitive impairment by incorporating elements that encourage them to draw upon their Japanese language heritage. The bilingual version will be implemented in a local Japan-focused adult day services program. This presentation highlights the effectiveness of arts- and humanities-based activities by showing the ways in which one particular activity can be expanded and applied in different settings to offer tailored benefits to people of varying ages and cognitive conditions.
AGE-FRIENDLY HEALTH SYSTEMS 4MS IMPLEMENTATION: THE NEED FOR BOOSTER STRATEGIES
Authors: Pohnert Anne , Schiltz Nicholas , Dolansky Mary
Published: January 2025

This study describes the implementation of the Age-Friendly Health System (AFHS) 4Ms Framework within the largest convenient care health system in the U.S. Implementation and improvement science methods were used to facilitate adoption of the 4Ms into ~1,100 MinuteClinics located in 35 states and DC, and to educate the ~3,300 providers working at these locations. Modifications to the electronic health record enabled the comprehensive documentation of assessments and actions related to the AFHS 4Ms. Formative evaluation utilized Tableau dashboards for provider and manager reporting. In the initial year, the project employed a quality improvement design. Only 22% delivery of the 4Ms was achieved after the first year indicating that “booster” strategies were needed. Following 18 months of implementing additional booster strategies to enhance 4Ms uptake, the system received IHI Regional Committed to Care Excellence recognition, achieving significant improvements across all 4Ms. As of 2024 Q1, 38.0% of eligible patients visits receive all 4Ms, while XX% receive at least one of the 4Ms. While improvement and implementation science methods facilitated initial implementation, further understanding and enhancement strategies are essential for scaling up and widespread adoption.
AN IMPLEMENTATION BOOSTER TO EMPOWER THE PATIENT AND CAREGIVER: 4MS ADVOCACY TIP SHEET
Authors: Napoleon Betty , Zonsius Mary , Zimmerman Elizabeth , Foradori Megan , Dolansky Mary
Published: January 2025

Consumer driven reminders are another way to increase the uptake of evidence-based practices. With that in mind, our patient advocacy council engaged in the development of an Age-Friendly Advocacy Tip Sheet. Patients shared that they were unaware as to how to ensure that they received AFHS 4Ms care. Patients’ views enhance insights into booster strategies for implementation of the 4Ms. It is not only essential for providers to have access to resources to deliver the 4Ms of care, but it is equally important for consumers to have tools to boost 4Ms care. Through multiple iterations, feedback sessions, and on-going qualitative analysis, we supported our Patient Advisory Council to create an Age-Friendly Health Systems Advocacy Tip Sheet to empower older adults to prioritize the 4Ms of care during appointments. This Tip Sheet includes self-advocacy suggestions, information on the 4Ms of care, and a work-sheet style space to list questions and concerns before the visit. There is also a space for note taking during the visit, along with next steps for acting on what matters. A scannable QR Code on the back of the Tip Sheet provides access to additional resources and information on Age-Friendly Health Systems. Feedback from both providers, patients, and other older adults has been overall positive, with remarks such as it is helpful, user-friendly, colorful, easy to understand, and applicable to pre-appointment preparation.
THE EFFECT OF ETHNIC ENCLAVE ON COGNITION AND EVERYDAY FUNCTIONING DIFFERS ACROSS NEIGHBORHOOD DISADVANTAGE
Authors: Clark Alexandra , Morriss Emily , Grant Jeremy , Esiaka Darlingtina , Ajrouch Kristine , Tarraf Wassim
Published: January 2025

Ethnic enclaves represent concentrated geographic areas where Hispanic community members reside in close proximity to same group peers. Previous research has revealed evidence of a “barrio advantage” where living in an ethnic enclave is associated with better health outcomes. However, there is some evidence to suggest (1) the protective effects of enclave may be moderated by neighborhood-level socioeconomic factors and (2) the impact of ethnic enclave on cognitive and functional outcomes remain poorly understood. The present study leveraged data from the Hispanic Established Populations for the Epidemiological Study of the Elderly to examine the effects of ethnic enclaves on cognitive and functional outcomes. We examined associations between tract-level segregation (Hispanic-Specific Getis-Ord Gi*) and baseline cognitive and functional outcomes, as well as change over time. Analyses included cluster adjusted linear regression models sequentially adjusted for neighborhood and individual level sociodemographic measures. Findings showed a positive association between enclave residence and baseline cognitive status, controlling for neighborhood and individual level socioeconomic disadvantage. The enclave effects did not extend to baseline functional status. Despite positive enclave effects at baseline, enclave residence was associated with faster rates of cognitive and functional decline. Markers of socioeconomic disadvantage were not consistent modifiers of associations between the enclave effect and cognitive and functional outcomes. Results will be discussed within the ecological system theory to emphasize environmental contexts are important for late life cognitive and functional outcomes, and further highlight potential points of intervention that may promote equitable aging outcomes in Hispanic older adults.
IMPROVING ASSISTED LIVING RESIDENTS QUALITY OF LIFE: RESULTS FROM AN MN ASSISTED LIVING REPORT CARD
Authors: Shippee Tetyana , Woodhouse Mark , Skarphol Tricia , Moeller Kelly , Glass Lauren , Shands Rachel
Published: January 2025

In 2019, Minnesota enacted new legislation resulting in creation of an online Assisted Living Report Card. As part of this work, two surveys, the Resident Quality of Life Survey and Family Satisfaction Survey, were developed to assess AL residents’ quality of life (QOL) and family satisfaction. Our study presents the development and analysis of these surveys in Minnesota AL communities from 2020-2023. Resident respondents (N=12,091) were predominantly female (68.6%) and White (81.4%), with mean age 82.8 years; family satisfaction survey respondents (N=11,935) were mostly female (64.2%) and White (91.1%), with a mean age 63 years. Respondents rated various survey items with scores from 0 (lowest) to 2 (highest) for resident QOL, and 0 (lowest) to 3 (highest) for family satisfaction, with mean scores calculated for each of the domains. Overall, resident quality of life and family satisfaction scores were high, yet “overall satisfaction” (1.22), “engagement” (1.48), and “food” (1.53) domains had the lowest scores, while “environment” (1.88), “finances” (1.85), and “security” (1.82), had the highest mean scores among residents. Among family members, having one’s “personal needs met” (2.12) and “finances” (2.13) had the lowest mean scores, while “choice” (2.36), “housekeeping” (2.38), and “environment” (2.39) had the highest mean scores. Insights from our study highlight areas for improvement to enhance well-being and satisfaction among AL residents and their families.
MINNESOTA’S ASSISTED LIVING LICENSE: ENGAGEMENT OF SMALL ASSISTED LIVING PROVIDERS
Authors: Moone Rajean , Shippee Tetyana , Hakanson Megan
Published: January 2025

When Minnesota passed State Statute 144G in 2019 it fundamentally changed the licensure of assisted living communities in the state. This new regulatory framework was developed by a group of stakeholders representing consumer advocates, provider advocates, and state government. However, assisted living providers who served culturally specific persons in small communities were largely absent from the development of this new license. As a result, several unintended consequences and challenges have emerged in implementation in these settings. We interviewed a sample of 14 licensed assisted living directors operating small, culturally specific communities to understand their experiences with the regulatory framework. After a qualitative analysis four main themes emerged: (1) lack of participation in the initial license development, (2) challenges to implementation of license requirements, (3) inconsistency in and preparation for survey inspections, and (4) inadequate reimbursement and funding. To address these concerns, several recommendations were identified which ranged from ensuring all stakeholders are engaged in policy development to developing a new rate setting methodology for Medicaid waivers. Although these recommendations are specific to Minnesota, they do have implications for other states and agencies that are developing similar regulations.
OFFERING ACCREDITATION TO ASSISTED LIVING COMMUNITIES IN NORTH CAROLINA
Authors: Efird-Green Lea , Zimmerman Sheryl , Sloane Philip , Reed David , Tian Yuke , Davis Scott , Preisser John
Published: January 2025

In 2021, the North Carolina Legislature approved and funded the Adult Care Home [Assisted Living] Accreditation Pilot Program. Across the state, the program’s goal is to evaluate the effectiveness of accreditation through quality outcome measures to determine whether accreditation achieves compliance with licensure requirements and improves or maintains quality of care compared to a control group. Assisted living communities were selected using stratified random sampling that accounted for geographic region and state-assigned quality rating. A total of 146 communities originally agreed to participate. Of the 73 communities randomly assigned to the accreditation arm, to date 39 (53%) either withdrew or chose to not go through the process of accreditation; 4 (5%) withdrew after beginning the accreditation process; 24 (33%) achieved accredited status; and 6 (8%) are delayed in completing the process or not likely to do so. The key reason for withdrawal from the accreditation process is the time and effort required in the context of staffing shortages, which has implications for long-range implementation even if accreditation is found to be beneficial. This session will present the aims and methods of the evaluation; the accreditation process itself (including benefits, potential administrative burden, and types of deficiencies found during surveys); the feasibility of becoming accredited for diverse participating communities; and potential strategies to bolster capacity for accreditation. (Additional contributors to this and the outcome presentation include Teresa Hoosier [ACHC], Jeff Horton [NCSLA], Frances Messer [NCALA], Barbara Sylvester [ACHC], and London Grantham, Aja Johnson, Danielle Owens, Toni Parker, and Katrice Perry [UNC].)
THE BRIDGE CARE MODEL: TRANSITIONAL CARE FOR PERSONS EXPERIENCING HOUSELESSNESS
Authors: Leutwyler Heather , Cuffaro Taylor
Published: January 2025

Introduction

Persons experiencing houselessness (PEH) are well-understood to prematurely age, experiencing higher rates of geriatric conditions at a younger age, considered “older” by age 50. Based on the rigorously-tested Transitional Care Model for older adults, UCSF Street Nursing provides low barrier care to PEH during transitions from emergency departments (ED) and in-patient admissions. Our practice focuses on: nurse-led early assessment and engagement; continuity and coordination of care; the patient-clinician relationship; holistic focus on individual patient’s needs; education and promotion of self-management; active engagement of patients and their support network; and patient-driven evidence-based care planning to address health problems and risk factors that contribute to frequent ED visits and hospital readmissions among PEH.

Methods

UCSF Street Nursing meets patients in the ED or in-patient prior to discharge and follows them for 6-12 months, supporting integration into community outpatient care. Clinical activities include: medication administration, wound care, street-based syphilis and STI treatment, complex care coordination, complex medication management, health education focused on self-management, and co-attending primary and specialty care visits both virtually and in-person. Outcomes: The average age of the 58 patients referred to our practice was 52 (sd=12.5). Given the premature mortality and accelerated aging of PEH, our sample represents an older adult population. Our practice produced a greater than 50% reduction in ED visits in the first 6 months following discharge.

Conclusion

UCSF Street Nursing is a promising nurse-led novel approach to care for unhoused older adults with potential to reduce hospitalization and improve health for an overlooked population.
DISTRIBUTION AND DETERMINANTS OF LONG-ACTING INJECTABLE ANTIPSYCHOTIC MEDICATION USE AMONG OLDER ADULTS
Authors: Lohman Matthew , Verma Mansi , Jones Paige , Scott Victoria , Fields Eve
Published: January 2025

While long-acting injectable antipsychotic medications (LAIs) are important components in the management of schizophrenia and related disorders, little is known about LAI use among older adults in real-world settings. We analyzed electronic health records from the South Carolina Department of Mental Health comprising 41,401 patients (n=8,481 aged > 60) who received ambulatory psychiatric services at one of 16 regional mental health centers in 2022. We compared use of eight types of first- and second-generation LAIs by demographic (age, race/ethnicity, gender, zip code, insurance source) and clinical characteristics (primary and secondary diagnoses, oral antipsychotic use). Logistic regression models were used to estimate associations between individual characteristics and likelihood of using LAI medications. In total, 1,400 adults age > 60 used LAIs in 2022, including 1,231 with schizophrenia or another psychotic disorder. Compared to younger adults, older adults were less likely to use LAIs but more likely to use first vs. second-generation LAIs (OR=2.19, p<.001). Controlling for diagnosis, insurance provider, and total services, older adults were significantly more likely to use LAIs if they were male (OR=1.40, p=.002), Black (OR=2.46, p<.001), Asian (OR=9.79, p=.001), and living in a suburban area (OR=1.33, p=.009). There were no significant demographic differences in oral antipsychotic use. Results suggest that LAI use among older adults differs substantially by sociodemographic characteristics while oral antipsychotic use does not. Understanding reasons for differences is important to determine and promote equitable access to and use of LAIs across racial/ethnic, geographic, and other sociodemographic groups of older adults.
BIOLOGICAL SEX MODERATES THE EFFECT OF EXERCISE ON COGNITIVE FUNCTION IN ADULTS WITH CHRONIC STROKE
Authors: Gamboa Rebeca Hernández , Falck Ryan , Dao Elizabeth , Liu-Ambrose Teresa
Published: January 2025

Exercise (EX) and cognitive/social enrichment (ENRICH) are promising strategies for promoting cognitive function post-stroke. The effects of these interventions on cognitive function may vary by biological sex, i.e. males (M) vs females (F). We conducted a secondary analysis of a three-arm, six-month, assessor-blinded, randomized clinical trial among 120 community-dwelling adults aged 55+ years with chronic stroke (i.e., ≥12 months since stroke), to examine if biological sex moderates the effects of EX or ENRICH on cognitive function. Participants were randomly assigned to 2x/week EX (N=34, M=21, F=13), 2x/week ENRICH (N=34, M=23, F=11), or 2x/week balance and tone control (BAT, M=30, F=22). Our primary outcome of cognitive function was the Alzheimer’s Disease Assessment Scale Cognitive Subscale Plus (ADAS-COG-Plus) at baseline, end of intervention (6 months), and follow-up (12 months). Using linear mixed models, we examined if biological sex moderated the effects of EX or ENRICH on cognitive function using planned contrasts. Baseline ADAS-Cog-Plus and Mini Mental State Exam score were included as fixed-effect covariates. Biological sex moderated the effect of EX, but not ENRICH, on ADAS-Cog-Plus (F = 5.75, p< 0.01). The effects of EX compared to BAT were significantly larger for females than males (estimated mean difference: -0.394, 95% CI: -0.778, -0.011, p< 0.05). EX females had better ADAS-COG-PLUS performance at end of the intervention (estimated mean difference: -0.463, 95% CI: -0.758, -0.168, p< 0.005) compared with females in the BAT group. Findings suggest that exercise may be a key strategy to promote cognitive function among older females living with stroke.
EXPLORING NOVEL DETERMINANTS OF EXERCISE BEHAVIOR: A LAGGED EXPOSURE-WIDE APPROACH
Authors: Lee Harold , Kim Eric , Conroy David , VanderWeele Tyler
Published: January 2025

Many middle-aged to older adults do not engage in regular exercise at all, despite its importance for healthy aging. Extensive research grounded in behavioral and social science theories has identified numerous determinants of exercise. However, few studies used an exposure-wide approach, a data-driven exploratory method that is particularly useful for identifying determinants. We used data from 13,771 participants in the Health and Retirement Study (HRS), a diverse, national panel study of adults aged >50 in the United States, to evaluate 62 candidate predictors of exercise participation. Candidate predictors were drawn from the following domains: health behaviors, physical health, psychological well-being, psychological distress, social factors, and work. We used Poisson regression with robust error variance to individually regress exercise in the outcome wave (t2:2014/2016) on baseline candidate predictors (at t1;2010/2012) controlling for all covariates in the previous wave (t0;2006/2008). Some health behaviors (e.g., ever exercising), physical health conditions (e.g., physical functioning limitations and lung disease), psychological factors (e.g., health mastery, purpose in life, and positive affect), and social factors (e.g., helping others, religious service attendance, and volunteering) were robustly associated with increased subsequent exercise. Among factors related to psychological distress, perceived constraints stood out as a factor in reducing exercise. To conclude, we identified potentially novel exercise determinants, such as purpose in life and helping others, that have not been captured using a theory-driven approach. Future studies validating these findings in older adults are needed.
A CRITICAL CARE PATHWAY BASED ON ICOPE TO PROMOTE HEALTHY AGING OF OLDER ADULTS
Authors: Yu Doris Sau Fung , Tang Yiting , Chen Shuangzhou , Chen Feng
Published: January 2025

The United Nations Decade of Healthy Aging 2021-2030 calls for proactive and collaborative strategies to optimize the functional capacity of older adults. Aligning with the World Health Organization advocacy of optimizing the functional capacity of older adults through increasing the compatibility of their intrinsic capacity (IC) of older adults and the environment, the research team has developed the 12-week Pathway to Healthy Aging to translate the ICOPE care model to the Chinese community. The 12-week Pathway to Healthy Aging is a health-social collaborative model that adopts the WHO-ICOPE approach, together with the concepts of clinical critical care pathway, case management, empowerment-based behavioral modification and health-oriented peer coaching to promote healthy aging to the older adults with signs of accelerated aging. From September 2022 to June 2023, the care model was provided to 806 targeted clients recruited from a territory-wide region in Hong Kong. The speaker will share experiences and challenges of translating the WHO ICOPE care model in a Chinese community. More specifically, she will share the insights on: i) how to integrate the ICOPE assessment data to identify the health care priority of older adults, ii) method to develop the critical care pathway to promote person-center care and longer-term behavioral change for healthy aging promotion, iii) strategies to optimize effective collaboration between the nurses and health-oriented peer coach in case management. The presentation will conclude with remarks to inform future initiatives aimed at preparing society for an aging population.
IMPACT OF THE CRITICAL CARE PATHWAY ON INTRINSIC CAPACITY ON HEALTHY AGING PROMOTION
Authors: Zhai Xiangyu , Tang Yiting , Chen Shuangzhou , Chen Feng , Yu Doris Sau Fung
Published: January 2025

The United Nations Decade of Healthy Aging prompted the implementation of the “Pathway to Healthy Aging”, a 12-week health-social collaborative care program. This program, based on the Integrated Care for Older People (ICOPE) care pathway by the World Health Organization, incorporated clinical critical pathways, empowerment-based behavior modification, and health-oriented peer support. Intrinsic capacities of older adults were used as health indicators for effectiveness evaluation. From January 2023 to January 2024, 1024 older adults (female = 868; Mage = 75.5, SD = 7.52) participated, with 493 completing a six-month follow-up. Outcome-based evaluations demonstrated significant improvements across three time-points in locomotor capacity based on Timed Up and Go Test (χ²(6)=73.49, p<0.001, Cramér’s V=0.16) and Short Physical Performance Battery (χ²(4)=31.83, p<0.001, Cramér’s V=0.12), cognitive capacity (measured by Montreal Cognitive Assessment 5-minute protocol; F(2, 984)=52.93, p<0.001, partial η²=0.11), and psychological capacity (measured by 15-item Geriatric Depression Scale; F(2, 984)=11.31, p<0.001, partial η²=0.09). No significant change in hand grip strength (χ²(4)=6.15, p=0.188). Vitality capacity, based on Mini Nutritional Assessment, improved immediately after the program (χ²(4)=7.45, p=0.047, Cramér’s V=0.09) but showed no significant further change at the six-month follow-up, based on pairwise comparison analyses (Bonferroni’s correction). Insomnia (The Insomnia Severity Index) also significantly improved (χ²(6)=77.42, p<0.001; Cramér’s V=0.16). This program demonstrates the effectiveness of the ICOPE care model in promoting healthy aging in real-world settings, emphasizing the potential of collaborative care models to enhance the elderly population’s intrinsic capacities. These findings have critical implications for stakeholders working towards the United Nations’ goal of fostering healthy aging.
EXAMINING THE DYNAMIC PROCESS LINKING PERSONALITY, HEALTH BEHAVIORS AND STRESS, AND HEALTH OUTCOMES
Authors: Luo Jing , Zhang Bo , Yoneda Tomiko , Graham Eileen , Mroczek Daniel
Published: January 2025

Personality has been found to contribute to individual differences in health and aging. In search of the underlying mechanisms, health behavior and stress have been shown to play roles in the personality-health association. However, given the evidence that personality traits are dynamic within individuals, it remains unclear how the dynamic intraindividual connections between personality and health behavior engagement and stress experiences contribute to interindividual differences in health and health change over time. Using 10-wave data from the Longitudinal Internet Studies for the Social Sciences (N = 3,421), the current study examined the effects of the intraindividual interplays between changes in personality and changes in health behaviors and stress on individual differences in different health outcomes and changes in health outcomes. Adopting multilevel structural equation modeling, the results suggested that after controlling personality at the interindividual level, the dynamic intraindividual interplays between extraversion, openness and smoking at each time point still displayed significant effects on interindividual differences in smoking, which in turn significantly contributed to interindividual differences in self-rated health and symptom complains in the last wave and changes in general disease level and cardiovascular diseases over time. Meanwhile, the dynamic intraindividual interplays between extraversion, conscientiousness and perceived stress were significantly related interindividual differences in perceived stress, which were significantly linked to interindividual differences in the levels of and changes in all health outcomes. The current findings enhance our understanding of how the dynamic intraindividual connections between personality and people’s behaviors and experiences may inform interindividual differences in health during aging.
LIFE SATISFACTION MODERATES LIFESPAN DECLINES IN STRESS REACTIVITY
Authors: Chopik William
Published: January 2025

Positive psychological well-being is often conceptualized as a protective factor for maintaining health across the lifespan. But why does psychological well-being confer such benefits? One potential possibility is that it shapes how we respond to stressors on a daily basis. However, much of existing research on this topic will examine these associations in the context of short-term experience sampling studies. Although useful in linking well-being to how we perceive and experience stress, this research can be limited in that it rarely tests prospective effects of well-being on stress reactivity over longer intervals. In the current study, I examined changes in stress reactivity across three waves of the National Study of Daily Experiences from approximately 1996 to 2017 (N = 1,500; Mage = 46.74; 54.1% women; 91.7% white) as a function of life satisfaction at wave 1. Employing three-level multi-level models, I reproduced recent research showing stress reactivity declines across life (b = -.02, p <.001); life satisfaction predicts lower stress reactivity both overall (b = -.04, p <.001) and in the context of a higher number of average (b = -.04, p <.001) and daily stressors (b = -.02, p <.001). Integrating repeated measures of life satisfaction and stress reactivity in the context of a random-intercept cross-lagged panel model suggested that reduced stress reactivity might lead to increases in life satisfaction across life. The results will be discussed in the context of how daily processes might “trickle up” to cultivate variation in global reports of well-being.
DAILY AND TECHNOLOGICAL CHALLENGES AND NEEDS IN OLDER AGES: A MIXED METHODS STUDY
Authors: Cruz Michelle , Chu Li , Gonzalez Laura Paola Gomezjurado , Zhang Ruohan , Wu Jiajun , Fei-Fei Li , Carstensen Laura
Published: January 2025

Modern societies face two trends that are seemingly unrelated yet concurrently impacting our lives: population aging and technological advancements. Both trends are happening rapidly in today’s society, and in combination raise an important question: How can we guide future technologies and their deliveries to better suit older adults’ needs so older adults are not “left behind” in the fast-changing cultural shifts due to technological advancements? A growing body of literature captures technological needs and problems among older adults. Yet, many of these studies used relatively small sample sizes consisting of relatively young older adults who are homogeneous in terms of race and ethnicity to represent all older adults. The present study utilizes a mixed methods design to ensure qualitative findings are generalizable. We recruited a racially diverse sample of Asian, Black/African, Hispanic, and White community-dwelling older adults over the age of 75 from the San Francisco Bay Area to form eight focus groups. Participants freely discussed their daily challenges and needs, and how technology may meet these needs. With manual coding and natural language processing techniques, we identified close to 30 areas where technologies may contribute to daily life. Findings from the qualitative sessions and a follow-up survey will be presented. Our findings have the potential to inform service providers, government, technologists, and entrepreneurs how they can better support older adults who are independent living but have started to observe difficulties.
CAN INTERMITTENT FASTING SLOW PRIMARY AND SECONDARY AGING IN HUMANS?
Authors: Peterson Courtney
Published: January 2025

Calorie restriction slows primary and secondary aging and increases lifespan in multiple animal species. However, recent evidence suggests that calorie restriction extends lifespan largely via extended fasting periods rather than energy restriction per se. The practice of periodically extending the fasting period is known as intermittent fasting. Dozens of studies in animals suggest that intermittent fasting decreases body weight; reduces the incidence of and/or progression of several chronic diseases; and extends lifespan. In humans, there are a wide range of intermittent fasting approaches, including alternate-day fasting, alternate-day modified fasting, the 5:2 diet, the fasting-mimicking diet, and time-restricted eating (TRE). In this presentation, I will briefly review evidence showing that intermittent fasting extends lifespan in animals. I will then define and discuss the various forms of intermittent fasting studied in humans. I will cover what is known about the feasibility of different types of intermittent fasting and their effects on primary and secondary aging in humans. I will conclude with a deeper dive into the most popular form of intermittent fasting, TRE. I will discuss its effects on weight loss, cardiometabolic health, and primary and secondary aging in humans.
CAPABLE CARE PARTNER
Authors: Paone Deborah , Schuller Jeanne , Szanton Sarah
Published: January 2025

We created and tested a prototype of CAPABLE Care Partner as an enhancement to CAPABLE. We developed this through a three-phased approach over three years and incorporated care partners, older adults, clinicians, and administrators to design and test this enhancement using human-centered design principles. We created this to recognize the role and supportive actions of care partners and to provide some support for their needs as well as those of the older adult participant. We conducted a pilot in 2023 in three U.S. implementation sites--programs that had successfully offered CAPABLE for at least one year. Results from post-pilot assessments and 360 degree qualitative interviews showed positive effect on care partners, and provided real-world insights on how to incorporate a social support specialist into the program, so that the care partner and the older adult dyad connect to social support/community resources, attend to self-care, and are better positioned to address current and future needs to age in community.
SOCIAL INTEGRATION OF OLDER MEN AND WOMEN ACROSS EUROPEAN WELFARE STATES: ESTABLISHING A NEW COMPARATIVE INDEX
Authors: Brandt Martina , Levinsky Michal , Wagner Melanie
Published: January 2025

Social integration is a crucial factor for health and mortality in old age. However, despite the increasing attention in aging populations, there is currently no instrument available for comparing social integration of older adults across Europe. In this study, we aim to investigate a social integration index established by Berkman and colleagues across welfare regimes and gender in Europe, with a focus on family policy and gender roles. We utilize data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) and conduct multivariate regression analysis to examine the interactions between gender and welfare regimes on social integration based on this index. Our findings suggest that women are less socially integrated than men, and that older adults in more ‘familialistic’ regimes tend to be less socially integrated. Moreover, care regimes are important for the gender gap in social integration. Women tend to be less integrated in family-oriented welfare systems, presumably due to their role as primary caregivers, which can limit their opportunities for social integration activities outside the home. This study contributes to the literature on social integration and highlights the importance of developing policies that promote social integration among individuals, particularly women, in different welfare systems.
STUDY DESIGN OF THE AGING AND COGNITIVE HEALTH EVALUATION IN ELDERS (ACHIEVE) TRIAL
Authors: Huang Alison
Published: January 2025

This presentation describes the design, interventions, participants, and primary and exploratory outcomes of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study. The ACHIEVE study is a multicenter, randomized controlled trial designed to test the effect of a best-practice hearing intervention vs. health education control on cognitive decline (primary outcome) and other exploratory health outcomes, such as physical activity and function, over 3 years. Participants were 977 community-dwelling adults aged 70-84 years with untreated hearing loss and without substantial cognitive impairment. The ACHIEVE study was partially nested within the Atherosclerosis Risk in Communities [ARIC] study; participants were recruited from the ARIC study (n=238) and de novo (n=739) from the surrounding communities of four U.S. sites. Participants were randomized 1:1 to hearing intervention or health education control and followed for 3 years. The study’s primary outcome was cognitive decline; measures of physical activity (accelerometry-based and self-reported physical activity), fatigue, and physical function were collected as exploratory outcomes. Participants were median age 76.4 years, 53.5% female, 87.8% White, and 53.3% held a Bachelor’s degree or higher. Compared to the ARIC cohort, participants recruited de novo were younger, had fewer chronic conditions, higher cognitive function, and worse self-reported hearing-related quality of life at baseline. Differences in participant characteristics by recruitment source are important considerations in the interpretation of intervention effect. This presentation provides important background for contextualization of ACHIEVE study findings on physical activity and function presented in this symposium.
LIVING ALONE AND LIKELIHOOD OF HAVING HIGH DEPRESSIVE SYMPTOMS AMONG OLDER ADULTS
Authors: Chang (Gudjonsson) Milan , Eymundsdottir Hrafnhildur , Sigurdardottir Sigurveig , Launer Lenore , Gudnason Vilmundur , Jonsson Palmi
Published: January 2025

Background

Depression significantly impacts the overall well-being and quality of life in older adults, leading to reduced engagement in social and physical activities and an increased vulnerability to disability. Older individuals living alone may be more prone to have depressive feelings than those residing with a spouse or family members. This study aimed to investigate the association between living status and high depressive symptoms among Icelandic older adults.

Methods

The analytical sample comprised 4,492 participants with a mean age of 76.3 years, of which 2,564 were women (57.1%), drawn from the Age, Gene/Environment Susceptibility-Reykjavik Study. Participants with diagnosed dementia and clinical depression were excluded from the analysis. Living arrangements were categorized as living alone (n=1,650, 36.7%) or with others. High depressive symptomatology (HDS) was defined as a Geriatric Depression Scale-15 score of 6 or higher (n=236, 5.3%). Logistic regression analysis was performed, adjusting for age, gender, education, body size, diabetes, hypertension, cholesterol, physical activity, and leisure activity.

Results

After full adjustment, individuals living alone showed a significantly higher likelihood of experiencing HDS compared to those living with others (Beta = 1.46, 95% CI: 1.10 ~ 1.94, P <= 0.01).

Conclusion

These findings emphasize the critical need to recognize potential mental health implications for older adults living alone, underscoring the imperative for targeted interventions and supportive healthcare systems. Addressing the unique challenges faced by solitary older adults is crucial for enhancing their mental well-being and overall quality of life.