bluuebunny/crossref_metadata_2025 huggingface dataset:
Policy Series: ESPO/ Social Research, Policy, and Practice Section Symposium: Connecting Aging Research to Policy: Insights and Strategies for Early-Career Researchers
Authors: Pendergrast Claire , May Jennifer
Published: December 2020

A wide range of policy issues, from healthcare to transportation to social insurance, influence health and wellbeing for older adults. Gerontologists have the opportunity to get involved with policy at any scale, from the organizational or community level to local, state, or federal policy. This symposium brings together a diverse panel of emerging and established academics to discuss strategies for early career researchers to understand and participate in aging policy activities. Panelists will discuss opportunities for researchers to contribute their expertise to policy discussions, and will share their own experiences and perspectives on participating in the policy process. Specific topics covered will include aging policy internship opportunities for graduate students, academic involvement with advocacy efforts to promote healthcare access to older adults, strategies for designing and conducting impactful and policy research, approaches to collaboration with diverse stakeholders to connect research to policy, and strategies for communicating policy-relevant research findings to general public and policy audiences. This symposium will reflect the SRPP’s strong commitment to connecting research to policy and practice, and will provide early career scholars with strategies to connect their own research to policy in order to inform decision-making and improve health and quality of life for older adults.
Engaging and Educating Older Adults and Caregivers in Age-Friendly Healthcare
Authors: Emery-Tiburcio Erin , Snyder Rani
Published: December 2020

As the Age-Friendly Health System initiative moves across the US and around the world, not only do health system staff require education about the 4Ms, but older adults, caregivers, and families need education. Engaging and empowering the community about the 4Ms can improve communication, clarify and improve adherence to treatment plans, and improve patient satisfaction. Many methods for engaging the community in age-friendly care are currently in development. Initiated by Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Programs (GWEPs), Community Catalyst is leading the co-design of Age-Friendly Health System materials with older adults and caregivers. Testing these materials across the country in diverse populations of older adults and caregivers will yield open-source documents for local adaptation. Rush University Medical Center is testing a method for identifying, engaging, educating, and providing health services for family caregivers of older adults. This unique program integrates with the Age-Friendly Health System efforts in addressing all 4Ms for caregivers. The Bronx Health Corps (BHC) was created by the New York University Hartford Institute of Geriatric Nursing to educate older adults in the community about health and health behaviors. BHC developed a method for engaging and educating older adults that is replicable in other communities. Baylor College of Medicine adapted and tested the Patient Priorities Care model to educate primary care providers about how to engage older adults in conversations about What Matters to them. Central to the Age-Friendly movement, John A. Hartford Foundation leadership will discuss the implications of this important work.
Embedding Patient Priorities Care in an Age-Friendly Health System
Authors: Naik Aanand , Kiefer Lea , Catic Angela , Dindo Lillian
Published: December 2020

Background: Patient Priorities Care (PPC) is an innovative approach to improving care for older adults with multiple morbidities. We developed a PPC training program for healthcare professionals and describe preliminary results. Methods: We implemented PPC in a geriatrics clinic. 20 staff and trainees participated on 1) how to identify patient priorities, 2) documentation in the electronic health record (EHR), and 3) strategies to align care with priorities; and received case-based audit and feedback. Results: 250 patients participated in PPC encounters. The EHR template was subsequently integrated within an Age Friendly Health System (AFHS) note. Clinicians have integrated this AFHS template for all encounters. Conclusion: PPC is a feasible approach to the care of older adults with multiple morbidities following a structured clinician training program. PPC can be effectively incorporated into the “Matter Most” component of AFHS.
Housing, Affordability, and Community-Based Aging
Authors: Scheckler Samara
Published: December 2020

The house acts as both an environment of care and a vehicle to financially potentiate long-term community-based support. While housing can empower a diverse set of options for a person-centered aging process, inadequate housing can also impede healthy aging in the community. This symposium teases out the nodes where housing acts to benefit or limit safe community-based aging. The first paper in this symposium, Homeownership Among Older Adults, describes typologies of older adult homeownership and sensitively highlights trends, disparities and important considerations of homeownership in later life. The next two papers take these older adults and explores situations where their housing acts as an asset or as a burden. Identifying Cost Burdened Older Adults acknowledges that housing cost burdens look different for older adults than younger cohorts. A more precise definition of older adult housing cost burden is proposed to help researchers and policymakers better synthesize the complex relationships between older adult housing and their long-term care decisions. The Long-Term Care Financing Challenge then explores the role of home equity in expanding the community-based long-term care choice set for older adults. This paper demonstrates benefits (both realized and unrealized) in home equity and suggests policy implications moving forward. Finally, Cardiometabolic Risk Among Older Renters and Homeowners disentangles the relationship between housing and health by demonstrating health disparities that are associated with housing tenure, conditions and affordability. Taken together, this symposium explores the complex and multidirectional relationships between housing, long-term care and older adult health.
The Long-Term Care Financing Challenge: What Role for Home Equity?
Authors: Tavares Jane , Cohen Marc , Popham Lauren
Published: December 2020

With increasing longevity comes the need for support in activities of daily living. This growing demand for long-term services and supports (LTSS) threatens older adult financial security. About 25 million adults aged 65 and older will have a significant LTSS need that will cost up to $140,000 out-of-pocket plus an estimated $120,000 from public payers like Medicaid; the total public and private costs of care exceeding $250,000. Home equity, the most valuable financial asset owned by Americans, offers one solution to this financing challenge. While seniors boast $7 trillion in collective home equity, opportunities to annuitize this asset vary and the distributions of home ownership and value are highly skewed. Using the 2016 wave of the HRS, this paper explores the relationship between socio-demographic/health characteristics and the annuitized home value. We determine which individuals with LTSS needs might benefit from the annuitization of home equity and to what extent.
Creating Stories Using TimeSlips With People Living With Dementia
Authors: Ihara Emily , Barrett Kendall , Tompkins Catherine , Inoue Megumi , Hanson Kari
Published: December 2020

TimeSlips is an award-winning, non-pharmacologic, creative storytelling intervention designed specifically for individuals living with dementia by Anne Basting. As part of the NextGen pilot program, George Mason University implemented TimeSlips at a dementia-specific adult day health care center with undergraduate and graduate students trained as facilitators. They worked with two different populations living with ADRD – an early-stage group and a moderate- to late-stage group. Students who participated reflected upon their experiences and noted that they learned so much about the importance of open-ended questions and accepting even one-word answers. One student stated: “This makes so much sense, as I have noticed participants take these open-ended questions and deliver beautifully unexpected and clever responses.” The implementation was different for these two groups, and our analysis of the content and process indicate that consistency and person-centeredness are key to participants’ expression of pride and joy in their accomplishments.
Disaster Literacy
Authors: Brown Lisa , Peterson Lindsay
Published: December 2020

People who plan ahead typically fare better during the response and recovery phases of a disaster. However, problems arise when the needs, wants, abilities, and resources of vulnerable people are not adequately considered. The lack of alignment between the literacy demands of existing materials and the literacy skills of many vulnerable subgroups limits their ability to understand and effectively use potentially life-saving information. Existing health literacy models that have demonstrated effectiveness in changing health behaviors and improving outcomes is a first step to reducing disaster-related morbidity and mortality in low resource and low literacy areas. This presentation will 1) describe how interdisciplinary collaborations can be used to address this public health issue, 2) explain how health literacy techniques can be applied when developing disaster materials, and 3) present research data on a social marketing campaign to improved disaster preparedness of older adults. Part of a symposium sponsored by Disasters and Older Adults Interest Group.
Interprofessional Collaboration to Address Elder Abuse, Neglect, and Exploitation With Adult Protective Services
Authors: Liu Pi-Ju , Penhale Bridget
Published: December 2020

Adult Protective Services (APS) is responsible for investigating reports of abuse, exploitation, and neglect among vulnerable adults. Additionally, APS also refers or provides needed services to victims. Though APS also takes the lead position in investigation and service planning, determining harm and designing person-centered remedies often require other professionals to be prepared to address these elder justice issues with APS. Afterall, adult safeguarding is everybody’s business. This symposium includes four presentations on researchers’ findings working with APS and other professionals. Dr. Burnes will compare outcomes on usual APS care (APS only) versus enhanced APS care (APS plus advocate who are case managers). Dr. Pi-Ju (Marian) Liu will examine nurses’ role in working in and with APS, focusing on how their job responsibilities are different from other nurses and APS social workers. Dr. Jason Burnett will present an innovative referral portal linking banks and other financial firms directly to APS. Lastly, Dr. Zachary Gassoumis will appraise the multidisciplinary teams across the country, including professionals involved, and provide input on what makes a team work well together. Following the four presentations, Dr. Bridget Penhale will open up the discussion regarding protective agencies’ operations and collaboration with other agencies, focusing on the comparison between protective agencies in the United States and European countries. Abuse, Neglect and Exploitation of Elderly People Interest Group Sponsored Symposium.
Home Health Registered Nurses’ Experiences With Financial Exploitation of Older Women With Cognitive Impairment
Authors: Rogers Carol , DeSpain Lisa , Wilson Janet
Published: December 2020

Older adults diagnosed with cognitive impairment (CI) who live at home are at high risk for FE due to dependence on caregivers and diminishing cognitive and financial capacities. Health care providers are mandated reporters for elder abuse, that includes financial exploitation (FE), one of the seven types of older adult maltreatments. Twenty Home Health Care Nurses (HHRN) of older adults in Oklahoma were interviewed to discover their understanding and experiences with FE. Transcripts were analyzed by conventional content analysis. Line-by-line codes were generated inductively and codes were grouped into categories and themes until data saturation was reached. Five themes emerged: Red Flags, Familiar Offenders, Dire Consequences, Barriers/Facilitators, Doing Better. Conclusions: HHRNs are an untapped resource to provide suggestions for improvements of FE detection/reporting of older adults with CI and to help formulate policies, procedures, strategies to improve coordination and communication among healthcare, law enforcement, and social service systems.
Person-Centered Health Care: An Approach That Integrates Acute and Long-Term Care
Authors: Young Yuchi , Resnick Barbara
Published: December 2020

The world population is aging. The proportion of the population over 60 will nearly double from 12% in 2015 to 22% in 2050. Global life expectancy has more than doubled from 31 years in 1900 to 72.6 years in 2019. The need for long-term care (LTC) services is expanding with the same rapidity. A comprehensive response is needed to address the needs of older adults. Learning from health systems in other countries enables health systems to incorporate best long-term care practices to fit each country and its culture.

This symposium aims to compare long-term care policies and services in Taiwan, Singapore, and the USA where significant growth in aging populations is evidenced. In 2025, the aging population will be 20% in Taiwan, 20% in Singapore and 18 % in the USA. In the case of Taiwan, it has moved from aging society status to aged society, and to super-aged society in 27 years. Such accelerated rate of aging in Taiwan is unparalleled when compared to European countries and the United States. In response to this dramatic change, Taiwan has passed long-term care legislation that expands services to care for older adults, and developed person-centered health care that integrates acute and long-term care services. Some preliminary results related to access, care and patterns of utilization will be shared in the symposium. International Comparisons of Healthy Aging Interest Group Sponsored Symposium.
Off-Label Antipsychotic Prescribing for Persons With Dementia in Assisted Living
Authors: Wretman Christopher , Zimmerman Sheryl , Sloane Philip , Preisser John
Published: December 2020

Off-label antipsychotic use is contra-indicated for persons with dementia due to lack of efficacy and FDA black box warnings. Yet, residents in assisted living (AL), including those with dementia, are frequently prescribed such medications. If distinct typologies of AL communities exist based on prescribing rates, it might be possible to reduce use. Toward that end, data from 247 AL communities in seven states were analyzed to discern potential unobserved latent classes that differentiate prescribing levels. Results using finite mixture modeling determined a 5-class solution best fit the data, with class-level prescribing rates ranging from 16.9% of residents with dementia to 27.4% (Mean = 18.9%). Bivariate tests found differences across classes by variables related to community structure, medication processes, and resident-case mix (e.g., frequent formal pharmacy review was more likely in communities with higher prescribing). Typologies are useful to identify differences and care and may be useful for quality improvement.
Advancing the Concept of Resilience for Older People Who Are Experiencing Homelessness
Authors: Wada Mineko , Canham Sarah , Fang Mei Lan
Published: December 2020

Current conceptualizations of resilience have overlooked the lived expertise of older people experiencing homelessness (OPEH) – individuals who have much insight to offer in terms of progressing notions on how people ‘stand up’ to adversity and ‘bounce back’ to a state of physical and psychological homeostasis across the life course. Drawing from extant literature and data from a community-engaged research project, which interviewed 40 participants and examined the health supports needed for individuals experiencing homelessness upon hospital discharge, we provide a comparison of resilience among homeless individuals generally and resilience among OPEH. Based on narratives of significant adversity experienced by OPEH in Vancouver, Canada, we offer a critical analysis of ‘resilience in ecological context’ that identifies unique characteristics of resilience at micro, meso, exo, and macro system levels. We discuss how our conceptual model of resilience pertinent to OPEH can be used to shape research, policy, and practice. Part of a symposium sponsored by the Environmental Gerontology Interest Group.
Can the Nation’s Housing Support a Population Seeking to Age in Place?
Authors: Molinsky Jennifer
Published: December 2020

While surveys report that most older adults wish to “age in place,” the nation’s current housing and neighborhoods fall short on several dimensions needed to support independence and health in later life. Drawing from national data (including the American Housing Survey, American Community Survey, Health and Retirement Survey, and Survey of Consumer Finances), we describe the current housing and living situations of older adults and key challenges they face in securing affordable, accessible housing while also securing supportive services. We identify three challenges: the unaffordability of housing, which causes budgetary tradeoffs in healthcare spending; a lack of accessibility features in homes and neighborhoods, which can limit independence and safety, and the low-density location of much of the US housing stock (including that inhabited by older adults), where service delivery is difficult and the potential for isolation is high. We conclude with an overview of the policy implications of these challenges.
Older Women Causing a Ruckus: Gentrification, Displacement, and Tenant Advocacy
Authors: Versey H Shellae
Published: December 2020

Gentrification is a process through which lower-income neighborhoods experience large-scale investments and an influx of wealthier residents, often displacing lower-income residents. The restructuring of neighborhoods for newer, wealthier residents can compromise belonging, place attachment, and security for existing residents. This study explores resistance to displacement through tenant advocacy and organizing in New York City. This research specifically focuses on the efforts of older, lower-income, African American women, who are most at risk for eviction and housing stability, and yet are at the center of advocacy efforts to preserve affordable, low-income housing. In three case studies, we interview key stakeholders invested in anti-displacement housing preservation, eviction resistance, and public housing organizing to highlight the often invisible work taking place from within socially vulnerable communities. Implications for policy and future directions for applied research are discussed.
Social Exclusion and Material Disadvantage: Housing, Poverty, and Living Standards Impacts
Authors: Waldegrave Charles , Phillipson Chris
Published: December 2020

SRPP 2020 Ollie Randall Symposium Award Winner. Many of the detrimental effects of material disadvantage on the lives of citizens have been well understood by public health and social scientists, and post-World War II social protection polices were designed to mitigate the negative impacts of them. As the numbers of older people increase proportionally to the rest of the population in most countries, less is known about the exclusionary impacts of material disadvantage and the roles housing, poverty and living standards play on the health, well-being and social connections of their lives. This symposium draws together research emanating out of four countries Norway, Poland, Ireland and New Zealand that are part of the European COST Action 15122 Reducing Old-Age Social Exclusion: Collaborations in Research and Policy (ROSEnet). The papers present contemporary results of specific health well-being and social impacts of material disadvantage in the four quite different countries and assesses them through the lens of social exclusion. As the growing international evidence during the last decade has highlighted the negative health and well-being impacts of loneliness and social disconnection (Holt-Lunstad et. al. 2015), the role of housing, poverty and living standards has in creating social exclusion is less well known. This research analyses the subjective and objective experiences of material disadvantage and quantifies their exclusionary impacts on well-being (e.g. quality of life, loneliness), health functioning (mental and physical) and their challenges to macro-structures (e.g. government policies, social protection).
Exclusion From Social Relations and Loneliness: Individual and Country-Level Changes
Authors: Aartsen Marja , Morgan Deborah , Dahlberg Lena , Waldegrave Charles , Mikulionienė Sarmitė , Rapolienė Gražina , Lamura Giovanni
Published: December 2020

Social isolation and loneliness have profound implications for quality of life and health and welfare budgets, but interventions to reduce loneliness are limited effective. The aim of this study is to examine the often-ignored impact of macro-level drivers of loneliness, in addition to micro-level drivers by adopting a cross-national perspective. We use longitudinal data from 2013 and 2015 from the Survey of Health, Aging, and Retirement in Europe (SHARE), combined with macro-level data from additional sources. Our study confirms that key micro-level drivers of loneliness are gender, health and partnership status, frequency of contact with children and changes therein. Macro level drivers are level of safety in the neighbourhood, and poverty and social deprivation of a society. In order to understand and reduce loneliness we require not just a focus on individual risk factors, behaviours and expectations, but also on macro-level factors that are associated with exclusion from social relations.
Title VI: Modernizing Allotments for Vulnerable Elder Rights Protection Activities and Other Programs
Authors: Duhaney Taneika
Published: December 2020

Of the many changes to the OAA, the Modernizing Allotments for Vulnerable Elder Rights Protection Activities and Other Programs section included notable changes. This bill specifies that Title VII programs will receive a 7% increase in 2020 and a 6% increase in the following four fiscal years. It extends the Supporting Grandparents Raising Grandchildren Act for an additional year. The reauthorization ensures that ombudsman representatives can be reimbursed for costs incurred through their services. The Act requires that the Government Accountability Office study federal programs for home modification assistance for older adults and individuals with disabilities. The Act directs the Administrator of the Administration for Community Living to continue the 2017 requirement of disseminating and soliciting feedback on the Principles for Person-directed Services and Supports during Serious Illness. This reauthorization updates home and community-based best practices; and elder justice activities, including community outreach and education to bolster community partnerships.
Policy Series: The Elder Justice Act, Nursing Home Reform, and Funding Legislation
Authors: Lindberg Brian
Published: December 2020

This session will provide updates on major federal efforts to address elder abuse, neglect, and exploitation, including strategies for prevention, intervention, services, and prosecution. Congress has been working on both reauthorizing the Elder Justice Act and policies to address poor long-term care facility quality issues, and this panel will provide an update on those efforts and what lies ahead in2021. The panel will include elder justice and nursing home advocates and congressional staff.
Factors Associated With Health Care Utilization Among Working Caregivers
Authors: Washington Tiffany , Kim Eunhye , Mois George , Smith Matthew
Published: December 2020

This study examined factors associated with health care utilization among working family caregivers using data from the 2013 Regional Healthcare Partnership – Region 17 Health Assessment survey. Anderson’s Behavioral Model of Health Services Use guided the selection of variables. Chi-square or t-test were computed to compare statistically significant differences between caregivers who did and did not utilize health care, and logistic regression was employed to identify factors associated with health care utilization. Of the 220 working caregivers, 41.8% put off their health care primarily because they could not miss work. Age, days pain limited activity, and days not having enough rest or sleep were associated with health care utilization. Paid family leave could mitigate the challenge of simultaneously managing employment responsibilities, caregiving tasks, and health needs of working family caregivers.
The Impact of Intersectional Identities on Older People With HIV
Authors: Brennan-Ing Mark , Emlet Charles
Published: December 2020

Kimberlé Crenshaw introduced the term “intersectionality” in the late 1980s to highlight the experience discrimination and marginalization of Black and African-American women originating from the confluence of their racial/ethnic and gender identities. Since that time the focus on intersectionality has broadened to consider other communities and individuals who may have multiple stigmatized and discredited identities, including older people with HIV (PWH). For example, Porter and Brennan-Ing described the “Five Corners” model as the intersection of ageism, racism, classism, sexism, and HIV stigma for older transgender and gender non-conforming PWH. HIV disproportionately affects marginalized communities (e.g., racial/ethnic and sexual minorities). Thus, for older PWH it is important to consider how HIV stigma may intersect with other marginalized identities and impact physical and psychological well-being. The first paper in this session examines how the intersection of HIV serostatus, gay identity, and age complicates identity disclosure, leading to social isolation and interference with care planning. The second paper describes how intersectional identities among older PWH interfere with access to mental health services in a population that is disproportionately affected by depression and PTSD. Our third paper examines the role of race, education, and behavioral health in neurocognitive functioning among a diverse sample of older HIV+ gay and bisexual men. Our last paper examines neurocognitive functioning among older Latinx PWH, finding that sexual and gender minorities were at greater risk for impairment. Implications of these findings for research and programming that accounts for the effects of intersectionality among older PWH will be discussed.
The IN-CARE Project: Socioeconomic Inequalities in Care Use and Provision Across Countries and Over Time
Authors: van Groenou Marjolein Broese
Published: December 2020

Ageing societies and recent reforms to long-term care (LTC) in many European countries are likely to make informal care by kin and nonkin increasingly critical for fulfilling the care needs of older people. To date, it is unknown whether informal care falls disproportionately on disadvantaged populations. The IN-CARE project (a collaboration of Dutch, UK and German research teams; http://in-care.fk12.tu-dortmund.de/) examines if and how LTC reforms exacerbate existing social disparities in care use and provision in older age. To this end, this project compares the socioeconomic status (SES) gradient in formal and informal care across Europe and over time. A particular effort is made to include macro-level indicators of LTC systems in cross-level analyses across countries. The first paper presented in this symposium by the UK team studied SES-inequality in care receipt across European nations with different care systems; the second paper presented by the German team studied the same question but now among caregivers, the third paper provides the analyses for caregivers in Japan, and the fourth paper by the Dutch team studies SES-inequalities in care use within the Netherlands over time (1995-2015). The symposium will start off with a short description of the IN-CARE project (2019-2022). Tine Rostgaard agreed to be our discussant.
Advancing States Through the OAA Reauthorization
Authors: Terzaghi Damon
Published: December 2020

States are major policymakers and funders of community-based services for older Americans and ADvancing States played a significant role in supporting the OAA authorization this year. This presentation will provide the states' perspective regarding funding, services, research and demonstrations, and more.
Older Latinx and African Americans’ Experiences of Civic Participation
Authors: Reyes Laurent
Published: December 2020

By 2030 Latinx and African Americans are expected to be the largest non-White groups of older adults. In the past 20 years, older adults’ civic participation has received considerable attention. However, until now most scholarship has focused on formal volunteerism and voting, activities that remain inaccessible to many marginalized groups. As a consequence, other civic activities are going unrecognized. The aim of this study is to understand how civic participation is experienced throughout the lives of 24 African American and Latinx adults 60+ living in New Jersey. Because civic participation is a concept that has many names and meanings depending on culture, language, and history I employ photo-elicitation techniques followed by in-depth interviews to understand civic participation through participants’ lens. Findings from this study can serve to improve conceptualizations and measurements of civic participation for future studies and inform efforts to strengthen civic participation among these populations. Part of a symposium sponsored by the Qualitative Research Interest Group.
Research Engagement With Persons Living With Dementia: Putting Lessons Learned Into Practice
Authors: Frank Lori
Published: December 2020

In the US few research initiatives actively engage persons living with dementia (PLWD) as partners in the research. The 2017 Summit actively engaged multiple types of stakeholder groups, including one for Persons Living with Dementia (PLWD), and was the first large-scale US research meeting to actively engage PLWD in planning and conduct of the meeting. The PLWD conducted a self-evaluation of their work that yielded best practices, meeting the need for guidelines for engaging with PLWD. The 2020 Summit presented the opportunity to test best practices. Some were implemented by the group conveners, like use of video-enabled meetings. Others were implemented with the PLWD, including decisions about governance structure for the group. The use of learnings from the first Summit in engaging with PLWD in the following Summit supported refinement of some engagement practices, yielding a list of recommendations for future work.
Empowering Partnerships Among Researchers, Persons Living With Dementia, and Caregivers
Authors: Gil Heidi , Shivers Stephani , Savage Bob , Taylor Geri , Taylor Jim , DeFrancesco Erica , O’Connell Maria , Lepore Michael
Published: December 2020

Conducting research collaboratively with persons living with dementia (PLWD) requires preparation. To enhance the capacity of PLWD to be engaged in research, we collaboratively developed and deployed a replicable two-day training workshop for PLWD, care partners, and professional/academic researchers. An assessment of strengths, values and experiences, and an introductory education session, served as experiential warmup activities for PLWD prior to the two-day workshop. Twelve PLWD, nine care partners, and 14 professional/academic researchers participated in the workshop. Participants identified 16 topics as highly important for research and prioritized four topics for immediate study design. Studies addressing these topics were collaboratively designed by PLWD, care partners, and professional researchers during day two of the workshop. Lessons learned from the workshop, including key preparation steps for collaboration—such as securing minimally distracting collaboration environments—are summarized, and access to a free toolkit that supports workshop replication is provided.
Transforming Primary Care Practice Into Age-Friendly Health Systems
Authors: Berg-Weger Marla , Emery-Tiburcio Erin , Tumosa Nina
Published: December 2020

Transforming primary care practice to improve the health of older adults is a major focus of the Geriatric Workforce Enhancement Program (GWEP). Using the 4Ms of an Age-Friendly Health System (What Matters, Mentation, Medication, and Mobility) as a framework, presenters will describe their GWEP’s ongoing development, training, and evaluation initiatives aimed at increasing providers’ knowledge and practice skills, and improving older adult’s health outcomes. These initiatives are creating increased professional competencies in geriatric care that will: 1) help older adults maximize their health and wellbeing, and 2) better support caregivers and families. In this symposium, presenters from three GWEPs, Pennsylvania State University, Rush University Medical Center, and Saint Louis University will describe AFHS initiatives with rural and urban primary care partner sites. Educational and programmatic initiatives and strategies that map onto the 4Ms that will be discussed including geriatric assessment, dementia-focused interventions, falls prevention, opioid assessment, and caregiver well-being and support. Outcomes in older adult’s health and functional status will be discussed. Presenters will highlight the importance of building AFHS in primary care and strategies to bridge this framework into the community.
Improving the Driving of Community-Dwelling Older Canadians: A Randomized Controlled Trial
Authors: Vrkljan Brenda , Sangrar Ruheena , Griffith Lauren , Letts Lori , Porter Michelle
Published: December 2020

Older Canadians, similar to aging drivers in many other countries, want to drive, need to drive, and live in communities where driving is both valued and necessary for out-of-home participation. Many community-dwelling seniors are medically fit-to-drive, yet their collision risk remains higher than most other age groups, which some have attributed to their propensity to drive shorter distances in high-traffic areas (Antin et al., 2017). In this randomized controlled trial, the effect of a customized video-based older driver training program on behind-the-wheel performance was captured using the latest technology for an on-road evaluation. Results indicated the mean reduction in number of driving errors [mean (95% CI)=-12.0(-16.5, -7.6),p<0.001] favoured the intervention group where their change between baseline and 4-week follow-up was statistically significant [mean(95% CI)=-10.3(-13.8, -6.8),p<0.001], but not for the control group [mean (95% CI)=1.7(-0.08, 4.2), p>0.05]. Our novel, video-based approach that provided individualized feedback improved driving performance for older drivers. Part of a symposium sponsored by Transportation and Aging Interest Group.
Using Implementation Research to Promote the Expansion and Sustainability of Intergenerational Programs
Authors: Hasche Leslie
Published: December 2020

Implementation studies provide guidance on how to reduce the gap between empirically-supported interventions and routine care. For intergenerational programs that bring older adults and other generations together to promote social connection, improve health and well being, and to reduce ageism, the role of implementation science is rarely studied. Intergenerational programs have a long-standing role in social service and housing contexts, yet the quality of the evidence and sustainability of these programs is often in question. This symposium aims to demonstrate how implementation studies can identify available evidence and influential contextual factors to examine issues of adoption, fidelity, and sustainability of intergenerational programs. First, a scoping review of the available evidence on best practices of intergenerational programs will help highlight fidelity issues. Second, an environmental scan for intergenerational housing will highlight how contextual factors may impact the adoption and spread of intergenerational programs. Third, a pre-implementation study delivering multi-modal best practices training to local community sites will share indicators of the feasibility of training staff to implement evidence-based intergenerational practices. Finally, an evaluation of a community collaborative of organizations implementing intergenerational programs will highlight the process by which organizations develop and sustain partnerships. The chair will summarize how the studies’ methodological approaches incorporate implementation science and outcomes. Implications for both future research on organizational context, funding, and implementation strategies, as well as for practice settings will be named. The discussion will identify implementation gaps that will need to be overcome to expand and sustain intergenerational programs.
A Process Evaluation on the Implementation of Cross-Organizational Intergenerational Partnerships
Authors: De Fries Carson , Steward Andrew , Fix Rachel , Hasche Leslie
Published: December 2020

A collaborative group of organizations in the rocky mountain region of the U.S. implemented sixteen intergenerational programs with varying themes (i.e. mentorship, music and art therapy, baking, life stories, etc.). This two-year study used survey data and a focus group to understand successful approaches and challenges to implementing cross-organizational partnerships between adult-serving and youth-serving organizations. We utilized qualitative data through open-ended comments on program evaluations and a focus group discussion with leaders of seven community organizations. Questions in the focus group prompted participants to describe the process of initiating, developing, and sustaining partnerships. The three main themes were: the benefits of shared organizational values, outlining programmatic roles and expectations, and an ability to cope with negative partnership experiences. Insights about successful approaches to implementing cross-organizational partnerships, as well as the challenges of developing and sustaining such partnerships may be beneficial in similar settings.
Experiences of Assisted Living Communities Affected by Hurricane Irma: Leadership, Lessons Learned
Authors: Hyer Kathryn , Peterson Lindsay , Dosa David , June Joseph , Dobbs Debra
Published: December 2020

Little is known about the effects of disasters on assisted living community (ALC) residents. This is a concern given the growth of the AL industry and the increasing numbers of AL residents with functional limitations and chronic health conditions. This research examined the experiences of AL administrative staff to better understand the impact of Hurricane Irma. Qualitative interviews were conducted with representatives of ALCs across Florida (N=70), and transcripts were analyzed using Atlas.ti version 8. Research team members met regularly to reach consensus on codes, identifying five major themes across the interviews, 1) planning and preparation, 2) leadership, including plan execution and managing the unexpected, 3) effects/consequences of the storm, including effect on residents and staff, 4) lessons learned, and 5) electrical power. Results provide a broad view of ALC preparedness, how it varies across different types of ALCs and implications for resident wellbeing and future emergency planning.
The Effects of INDY on Fly Metabolism
Authors: Rogina Blanka , Kannan Kavitha , Mishra Dushyant , Macro Jacob , Lesperance Danielle , Broderick Nichole , Padhi Shivani , Rosenbloom-Snow Aaron
Published: December 2020

The Indy (I’m not dead yet) gene encodes a plasma membrane citrate transporter in Drosophila. INDY reduction affects metabolism and extends longevity of flies and worms. In flies, INDY is predominantly expressed in the midgut, fat body and oenocytes, tissues with a key role in metabolism. We hypothesize that INDY reduction in the midgut regulates citrate levels leading to metabolic changes that preserve intestinal stem cell (ISC) homeostasis and slows aging by modifying Insulin/Insulin-like signaling (IIS), which is a key nutrient sensing pathway. Our second goal was to examine the role of JAK/STAT signaling pathway, which activates epithelial renewal in the gut, in response to aging-related stressors. We hypothesize that Indy reduction has effects on the microbiome, preventing bacterial overgrowth and altering community diversity, leading to extended longevity in a JAK/STAT-mediated fashion. Our data suggest that effects of Indy reduction is mediated by reduced IIS and JAK/STAT pathways
Role of Reduced Protein Intake in Metabolic and Healthspan Benefits of Plant-Based Diets
Authors: Mitchell James , MacArthur Michael , Mitchell Sarah
Published: December 2020

Plant-based nutrition consisting of vegetarian/vegan dietary patterns are positively associated with metabolic fitness and inversely associated with risk of cardiovascular disease, diabetes and all-cause mortality. The nutritional and molecular basis of such benefits remains unclear. Here we considered the potential contribution of protein quality (amino acid profiles) and quantity to plant-based nutritional benefits. To this end, we investigated whether individuals adhering to plant-based diets consume a different AA profile, and used isocaloric diets in controlled rodent studies with modulation of both AA composition and total protein amount using crystalline AA vs. naturally-sourced protein ingredients. We found surprisingly few differences between AA profiles of vegans vs. omnivores, but large effects of total protein independent of source in rodent studies, strongly suggesting a major effect of total protein rather than AA composition in health benefits of plant-based diets. Mechanistically, we discuss the role of reduced protein intake on glucose and lipid homeostasis.
Longitudinal Fasting Blood Glucose Trends and Mortality Risk in Mice Differs From That of Non-Human Primates and Humans
Authors: de Cabo Rafael , Palliyaguru Dushani , Shiroma Eric , Nam John ,   SLAM Investigators, Ferrucci Luigi
Published: December 2020

Longitudinal studies in humans have led to the development of strong predictors of outcomes of health, disease and mortality. Translation from model organisms to human has been faced with species-specific regulation of metabolic function and challenged by the lack of longitudinal studies addressing trajectories of change that can be used, as in humans to predict outcomes. Here we compare longitudinal predictors of health and mortality of three major metabolic indices among mice, non-human primates and humans. Longitudinal fasting blood glucose, body weight and body composition over the lifespan were compared across species, mice, Rhesus monkeys and humans. Survival analysis was conducted to calculate the risk of death for subjects with highest and lowest quartiles of fasting blood glucose. We will present data highlighting species-specific mechanisms of glucose homeostasis over the lifespan and its association with mortality.
Inter-Species Interactions in the Fly Gut Microbiome Shape Aging
Authors: Ludington William
Published: December 2020

Gut bacteria affect key aspects of host fitness, including fecundity and lifespan. However, it is unclear to what extent individual species versus complex interactions drive host fitness. We dissected the natural microbiome of Drosophila melanogaster and revealed that interactions between bacteria shape host fitness through life history tradeoffs. Empirically, we made germ-free flies and colonized them with each possible combination of the five core species of bacteria. We measured the microbiome and fly fitness traits including reproduction and lifespan. Notably, flies that reproduced more died sooner. Removing bacteria after reproduction extended lifespan in most cases, suggesting an indirect tradeoff. However, in certain cases, antibiotics did not extend lifespan, indicating a metabolic memory of the microbiome. Overall, complex interactions within the microbiome had significant effects on host fitness. We suggest that model systems with reduced complexity will be instrumental in elucidating mechanisms of microbiome-host interactions.
Circadian Regulation of Mitochondrial Uncoupling and Lifespan
Authors: Ulgherait Matthew
Published: December 2020

Because old age is associated with defects in circadian rhythm, loss of circadian regulation is thought to be pathogenic and contribute to mortality. We show instead that loss of specific circadian clock components Period (Per) and Timeless (Tim) in male Drosophila significantly extends lifespan. This lifespan extension is not mediated by canonical diet-restriction longevity pathways, but is due to altered cellular respiration via increased mitochondrial uncoupling. Lifespan extension of per mutants depends on mitochondrial uncoupling in the intestine. Moreover, up-regulated uncoupling protein UCP4C in intestinal stem cells and enteroblasts is sufficient to extend lifespan and preserve proliferative homeostasis in the gut with age. Consistent with inducing a metabolic state that prevents over-proliferation, mitochondrial uncoupling drugs also extend lifespan and inhibit intestinal stem cell overproliferation due to aging or even tumorigenesis. These results demonstrate that circadian-regulated intestinal mitochondrial uncoupling controls longevity in Drosophila and suggest a new potential anti-aging therapeutic target.
Uncovering the Molecular Underpinnings of Oxidative Stress-Induced Senescence
Authors: Carpenter Melissa , Pomatto Laura Corrales-Diaz , Kato Jonathan , Wong Sarah , Bosompra Oye , Bernier Michel , de Cabo Rafael
Published: December 2020

The aging process is sexually dimorphic, with males having higher occurrence rates of cancer and facing a greater risk of mortality. Sexual dimorphism in the response to cellular damage may account for distinct phenotypic changes with age as they relate to the accumulation of cellular damage leading to cancer. Cellular senescence triggers permanent cell cycle arrest in order to protect against malignant growth. However, organismal senescence increases with age and is associated with the release of pro-inflammatory signals (cytokines, chemokines, and proteases) known as the ‘senescence-associated-secretory-phenotype’ (SASP) that, if unchecked, accelerates tissue damage and creates a microenvironment ripe for cancer development. In this study, we hypothesized that sexual disparities in mortality and cancer prevalence stems from differences in the rate of accumulation of senescent cells in mice. Male and female C57BL/6J mice were fed ad libitum or subjected to 30% calorie restriction, a nutritional intervention known to delay the onset of various cancers and prevent senescent cell accumulation. Primary skin fibroblasts were collected longitudinally to allow measurement of cell proliferation, wound healing and the release of SASP factors. The results indicate that when compared to males, fibroblasts of CR-fed females showed significant improvements in cell growth rate, wound healing and SASP markers vs. AL controls. Work is underway to determine how sex influences cellular protective pathways. Thus, like other cell processes, cellular senescence is unequal between males and females and CR delays the emergence of the senescence phenotype.