bluuebunny/crossref_metadata_2025 huggingface dataset:
EXPLORING OPPORTUNITIES TO FOSTER GERONTOLOGY EDUCATION AND GLOBAL ENGAGEMENT
Authors: Gautam Ramraj , Hollis Linda , Mendez Jennifer
Published: January 2025

The Academy for Gerontology in Higher Education (AGHE) helps advance gerontology, geriatrics, and age-friendly instruction through the development of curriculum, educational, and training materials. Much of this work is done in the context of the United States. GSA/AGHE being an international organization there remains a further need to bring global gerontology educators and experts together. Using the UN Decade of Healthy Aging framework, the purpose of this study was a) to learn more about international gerontology education programs in order to collaborate and share materials, and b) to explore opportunities in increasing international aging programs. The study protocol was IRB-approved. International gerontology educators were recruited through announcements in aging newsletters, GSA Connect, interest groups, AGHExchange, and through GSA 2023 international presenters’ listserv. Twenty-six participants representing academic institutions from ten different countries responded to the Qualtrics survey. Several strategies were suggested for sharing gerontology education resources: curricula and syllabi sharing through cloud servers, inviting international guest lectures, involving students in international and intergenerational projects, and collaborations with international educators. Among the four World Health Organization decades of healthy aging 2022-23 focus areas, participants ranked Age-Friendly Environments as number one, followed by combating ageism, long-term care, and integrated care. 61.5% of respondents were not a member of AGHE – GSA and 85.7% of participants showed interest in joining. Plans to incorporate the suggested strategies and future collaboration international gerontology educator opportunities will be discussed.
THE ACHIEVE TRIAL: EFFECT OF HEARING LOSS INTERVENTION ON WHITE MATTER INTEGRITY
Authors: Deal Jennifer
Published: January 2025

Hearing treatment delays cognitive decline in at-risk older adults. Pathways linking hearing loss to cognitive decline are unknown but may include central effects on brain structure/function. The ACHIEVE randomized controlled trial tested hearing intervention (amplification and rehabilitation) versus health education control on cognitive decline in 977 adults aged 70-84 years. Here we describe the effect of treatment on the pre-specified outcomes of white matter hyperintensity (WMH) volume and microstructural integrity in 445 participants who underwent 3T brain magnetic resonance imaging scans at baseline and Year 3. Fractional anisotropy (FA) and mean diffusivity (MD) were derived from diffusion tensor imaging. Participants were 76.4±4.0 years, 50% female and 12% self-reported Black race. Control (vs. hearing intervention) participants were older and had lower baseline memory scores, but otherwise treatment groups were balanced on measured characteristics. Among 303 participants who completed both MRI scans (n=141 treatment, n=162 control), using linear mixed effects models in an intention-to-treat analysis adjusted for baseline hearing loss severity, recruitment source, study site, age, sex, education, interaction terms between each covariate and time, and time-varying total intracranial volume, hearing treatment slowed rates of WMH volumetric change in whole brain (difference in 3-year change comparing intervention to control: -0.077 cm3, 95% confidence interval [CI]: -0.152, -0.002), with the strongest lobar effect in the occipital lobe (-0.151, 95% CI: -0.284, -0.017). No consistent associations were observed for FA and MD. Follow-up of ACHIEVE participants is ongoing to determine if intervention effects on white matter integrity require longer follow-up time.
EFFECT OF HEARING INTERVENTION ON OLDER ADULTS AT RISK OF COGNITIVE DECLINE: ACHIEVE RANDOMIZED TRIAL
Authors: Pike James
Published: January 2025

The Aging and Cognitive Health Evaluation in Elders (ACHIEVE, Clinicaltrials.gov Identifier: NCT03243422) randomized trial investigated the effect of a hearing intervention versus a health education control on 3-year cognitive change among dementia-free older adults with untreated hearing loss. Participants were recruited from the Atherosclerosis Risk in Communities (ARIC) study (n=238) or de novo from the community (n=739). The hearing intervention slowed cognitive decline by 48% in ARIC participants, but not in healthy de novo volunteers. A possible explanation for this difference is that the cognitive benefits of the hearing intervention could be observed only for individuals at increased risk for cognitive decline. To evaluate whether risk of cognitive decline moderated the effect of the hearing intervention, we used a sample of dementia-free ARIC participants (N=2,692) who did not participate in ACHIEVE to develop a model that explained 80.7% of the variance in cognitive decline over a 6-year period. The model was applied to baseline measures of ACHIEVE participants (N=977) to calculate their predicted risk of cognitive decline. The covariate-adjusted, intention-to-treat effect of the hearing intervention on 3-year cognitive change was examined in a mixed effects model that included a three-way interaction between time, randomization, and predicted risk of cognitive decline. Among participants in the top quartile of risk, cognitive decline in the hearing intervention group was 58.1% (95% CI 31.4%-90.9%) slower than the control group. The results suggest the effect of a hearing intervention on 3-year cognitive change was greatest among individuals at higher risk of cognitive decline.
ENHANCING SUPPORT SYSTEMS FOR OLDER ADULTS’ HEALTH AND WELL-BEING: A HEALTH EQUITY APPROACH
Authors: Nguyen Ann , Ellis Katrina
Published: January 2025

This symposium examines psychosocial factors that shape the health and well-being of older adults using a health equity lens. The first paper examines the interplay between racial discrimination, social relationships and cellular aging among older African Americans. The findings from latent class analysis demonstrate significant heterogeneity in experiences of discrimination, social relationships, and susceptibility to molecular stress among African Americans. The second paper investigates protective factors and adverse outcomes associated with elder abuse among persons living with dementia (PLWD) using a systematic review methodology. The results identify several caregiver-related factors that protected against elder abuse and adverse outcomes related to medical conditions and medication adherence. The third paper reports the findings for the effect of urbanicity of residence on the health of caregivers of PLWD using data from the 2020-2022 Behavioral Risk Factor Surveillance Systems surveys. This analysis indicates that caregivers who lived in rural areas were more likely to self-report poor physical health than caregivers who lived in urban areas. The fourth paper examines barriers for caregivers to engage in fall risk management from the perspective of health professionals who work with PLWD and their caregivers using semi-structured, qualitative interview data. Thematic analysis identifies the several themes related to barriers. Overall, these papers will provide important insights into modifiable psychosocial factors that influence health and well-being. Modifiable psychosocial factors have broad translational importance in promoting health equity. The findings will be discussed with attention to important socio-cultural and contextual factors and highlight implications for gerontological practice and research.
DISCRIMINATION, SOCIAL RELATIONSHIPS, AND ACCELERATED AGING AMONG MIDDLE-AGED AND OLDER AFRICAN AMERICANS
Authors: Lincoln Karen , Gaines Bryan , Mariko Hawa , Golithadka Kaushik , Cole Steve
Published: January 2025

This study addresses the limited exploration of the interplay between racial discrimination, social relationships and cellular aging among African Americans. Utilizing latent class analysis, distinct risk and protective profiles were defined by perceptions of discrimination, social support, and negative interactions among middle-aged and older African Americans. Findings revealed four distinct profiles, demonstrating significant heterogeneity in experiences of discrimination, social relationships, and susceptibility to molecular stress among African Americans. The largest profile (32.09%) was characterized by high everyday and major discrimination, low family and friend support, and minimal strain. The second profile (25.37%) had wide variation, including moderate everyday discrimination, high major discrimination, very low family support, moderate friend support, moderate family and high friend strain. The smallest profile (19.4%) was characterized by high everyday and major discrimination, high family support, moderate friend support, and high strain from family and friends. Respondents in this profile had significantly elevated molecular stress compared to the reference profile (23.13%), which was characterized by low discrimination, high support, and high strain from family and friends. Regression analysis revealed that African Americans with more health conditions were more likely to belong to the high-risk profile than the reference profile. This study identified a subgroup of African Americans with an elevated risk of accelerated aging, marked by substantial racial discrimination and ambivalent social relationships. Findings provide insights into health disparities by identifying genes activated in response to discrimination and the potential influence of social factors in mitigating or exacerbating the effects of racial discrimination on cellular aging.
GERIATRIC WORKFORCE TRAINING TO ADVANCE AGE-FRIENDLY CARE IN RURAL COMMUNITIES
Authors: Severance Jennifer , Murphy Sara
Published: January 2025

Texas has one of the highest rates of rural hospital closures and a scarcity of healthcare professionals, including primary care physicians and registered nurses, with 82% of Texas counties designated as primary care shortage areas. Critical workforce shortages require innovative training models. To address challenges in rural communities across Texas and the surrounding region, a HRSA-funded Geriatrics Workforce Enhancement Program (GWEP) leveraged partnerships with academic, primary care, long-term care, and community-based organizations and expertise in geriatric clinical care. This symposium explores innovative approaches to geriatrics training by sharing critical resources, responding to community needs, and applying technology to transform clinical training environments for medical students, primary care residents, practicing health care teams, and older adults and caregivers in rural communities; expand organizational capacity to provide quality geriatrics care; and replicate evidence-based practices to impact older adults at the individual, community, and population levels. First, presenters will provide an overview of the overall strategy involving collaborators as key connections and subject matter experts for the unique needs and opportunities in rural communities. This is followed by individual projects engaging medical students, residents, practitioners, and older adults and caregivers as learners and change agents for Age-Friendly care. This symposium presents cross-sector recruitment strategies using technology and partnerships as well as methods of adapting these models to a local context while expanding training opportunities for rural areas and underserved populations.
INTEGRATING AGE-FRIENDLY QUALITY IMPROVEMENT INTO RURAL CLINICAL ROTATION FOR MEDICAL STUDENTS
Authors: Christensen Keri , Severance Jennifer , Hadley Lesca
Published: January 2025

Early learning experiences in quality improvement (QI) prepare medical students for practice in complex health systems and for improving processes of care for older adult patients. We developed a curriculum using the Institute for Healthcare Improvement (IHI) Age-Friendly Health Systems 4Ms framework to train third-year medical students (n=75) in geriatrics-focused QI during a twelve-week family medicine clinical rotation in rural communities. Prior to the rotation, students completed asynchronous online training introducing QI models, Plan-Do-Study-Act (PDSA) cycles, and the Age-Friendly 4Ms framework. During the rotation, students met with their preceptor to identify a goal and conduct project activities to enhance Age-Friendly care for older adults within their practice setting. Students also collected information about the local community and patient outcome data related to CMS quality measures. Geriatrics faculty conducted weekly virtual meetings with students to discuss projects and challenges. A final written assignment summarizing their project results, clinical implications and next steps for the primary care setting in a standard abstract format that can be used for a poster presentation at a professional conference. Students (n=71) completed evaluation surveys to rate the usefulness of training and to self-assess knowledge and skills using five-point Likert-type items. Students (n=50) reported increased knowledge and skills in conducting QI activities and improved understanding of the importance of improving processes and patient care. Integrating the Age-Friendly Health Systems framework into QI training can support competency development in system-based practice while disseminating Age-Friendly practices and resources within a health care setting.
POLICY SERIES: INEQUITABLE IMPACTS OF POLICY AND PAYMENT CHANGES ON CARE USE AND OUTCOMES FOR OLDER ADULTS WITH HIGH CARE NEEDS
Authors: Falvey Jason , Kumar Amit
Published: January 2025

Over the past decade, the CMS has introduced numerous value-based policy initiatives. While these changes aim to reduce cost of care, they often have disparate effects on patient care and clinical outcomes particularly among minority communities and older adults with high-needs. The first presentation explores the disproportionate impacts of Medicare Advantage (MA) penetration among skilled nursing facility (SNF) users across various racial and ethnic identities, shedding light on the disparities perpetuated within the healthcare system. Another will then examine the ramifications of the Patient-Driven Groupings Model (PDGM) on older adults with dementia receiving home care, scrutinizing the changes in care and potential impacts on outcomes associated with this shift. Following this, the discussion shifts to the inequitable access to adult day services in urban areas, particularly highlighting the barriers faced by many older adults seeking non-institutional long-term care options that are growing in number around the country. Last, the symposium will discuss findings from qualitative work exploring how neighborhood disadvantage affects community mobility and successful aging in place among older adults recovering from lower extremity surgery, and the structural inequities experienced by this population with changes to home health care benefits. We will specifically highlight factors such as community cohesion and exposures to violent crime as key deterrents for recovery among older adults living with new mobility disability. Overall, this symposium will stimulate current debate on merits and demerits of various federal policies and growth of MA plans for older adults with high-needs.
GEOGRAPHIC PATTERNS IN THE LOCATIONS OF ADULT DAY CENTERS AND NURSING HOMES IN TEXAS
Authors: Downer Brian
Published: January 2025

Most older adults want to live at home in a community setting and avoid moving to a nursing home. Adult day centers (ADCs) are a valuable resource that can help older adults live at home. However, a concern is older adults may not have access to ADCs to benefit from their services. This analysis describes geographic patterns in the locations of ADCs and nursing homes in Texas. We used data from the Texas Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) to identify all licensed ADCs and CMS certified nursing homes, respectively, in Texas. Data for county characteristics (population, % aged >65) came from the US Census. Texas has 425 ADCs and 1,195 nursing homes. Among the 254 Texas counties, 48 (18.9%) have at least one ADC and 217 (85.4%) have at least one nursing home. Of the 37 counties with no nursing home, 1 county had an ADC while 170 of the 206 counties without an ADC had at least one nursing home. Approximately 6% (n=73) of nursing homes and 54.8% of ADCs (n=233) were in the thirteen counties boarding Mexico, with Hidalgo County (total population n=855,175; 11.5% aged >65) having nearly one-third of all ADCs (n=132). Conversely, the five most populous counties in Texas (total population n=12,482,916; 12.0% aged >65) had 26.1% of ADCs (n=111) and 30.0% of nursing homes (n=354). These findings suggest that older adults living in large metropolitan areas of Texas may have inadequate access to ADCs.
RISK PERCEPTIONS OF DIRECT CARE NURSING HOME STAFF ASSOCIATED WITH RESTRICTED SOCIAL ACTIVITIES
Authors: Akter Nahida , McClean Melissa , Kowalchik Kalei , Mogle Jacqueline , Carpenter Joan , Behrens LIza
Published: January 2025

Recognized globally, social activities support better quality of life in older adulthood. The COVID-19 pandemic presented unprecedented challenges for nursing homes (NHs) in balancing infection prevention control (IPC) measures with honoring resident preferences for social activities. The purpose of this study was to explore NH staff’s risk perceptions around facilitating resident preferences amidst pandemic restrictions. Guided by the Preference-Based Person-Centered Risk Engagement Model, this study used mixed methods to achieve an in-depth understanding NH staff risk perception. Quantitative data included demographics and risk perceptions using the Risk Propensity Scale. Participants (N=24) were 39 years on average (range: 18-62), mostly female (88%) and white (79%). Purposive sampling reflected a range of roles within the NH context: certified nursing assistants (29%), activities directors (25%), social workers (25%), and nurses (21%). Average risk perceptions scores were in the risk avoider range at 3.53 (SD = 1.43; range: 1.00-7.14) and most participants (58%) self-identified as risk avoiders. Those who identified as risk seekers were significantly more likely to be male (chi-sq(2)=17.14, p<.01) and African American (chi-sq(4)=20.42, p<.01). Qualitatively, semi-structured individual interviews collected staff perceptions of risk related to residents’ social activities. Guided content analysis revealed two main themes supported by six sub-themes: Factors of decision-making (family influence, organizational, staff and resident characteristics) and Direct care staff influencing preference-based care (cognitive skills and technical skills). Findings will be discussed considering implications for how best to support direct-care staff with varied perceptions of risk (risk seekers/risk avoiders) to encourage social activities when IPC measures are indicated.
NURSING HOME LEADER PERSPECTIVES OF DELIVERING QUALITY CARE AT TRANSITION TO ENDEMIC PHASE OF COVID-19
Authors: Behrens LIza , VanHaitsma Kimberly , Boltz Marie , Calo William , Van Scov Lauren , Kraschnewski Jennifer
Published: January 2025

Nursing Home (NH) leaders are challenged to deliver quality person-centered care (PCC), despite the COVID-19 transition to an endemic phase. This study aimed to describe NH leadership perspectives on preparing and maintaining quality care during the transition point between the COVID-19 pandemic and endemic to identify how best to support NHs in balancing infection risks with PCC. Fifteen (n=15) NH leaders enrolled in the Project Extension for Community Health Outcomes (ECHO) study participated in semi-structured interviews between March and April of 2022. Interviews lasted approximately 60 minutes, were recorded, transcribed verbatim, and verified for accuracy. Multiple coders used constant comparative method to code remaining transcripts (final kappa was.76). Final descriptive themes and subthemes were created via group consensus. NH Leaders reported an average of 18.2 years of experience and held various roles as leaders including Administrator (n=7), Director of Clinical/Health Services (n=3), Director of Nursing (n=2), Director of Infection Prevention and Control (n=1), and Staff Development Director/Coordinator (n=2). Leaders described their perspectives in six themes: Facilitators to operations during COVID-19, Barriers to operations during COVID-19, Resources, Infection control and vaccine uptake, Handling residents’ preferences during COVID-19, and ECHO participation. Results confirmed continued challenges in delivering quality PCC impacted by enforcement issues with vaccination processes and uptake for staff, supply gaps, and lack of knowledge in how to handle residents’ preferences for social activities. Results demonstrate the need for more resources to support staff delivery of quality PCC while balancing risks related to managing the COVID-19 endemic.
USE OF AND EXPERIENCES WITH ALTERNATIVE SITES FOR HEALTH CARE BY US ADULTS AGES 50–80
Authors: Keenan Teresa , Komisar Harriet , Dean Olivia , Solway Erica , Lampkin Cheryl
Published: January 2025

In recent years, “alternative” sites for health care – such as urgent care and retail health clinics – have expanded to meet the growing demand for more convenient and accessible care. In August 2023, the University of Michigan National Poll on Healthy Aging asked a national sample of 2,687 adults ages 50-80 (completion rate: 50%) about their use of and opinions about alternative sites of care. In all, 60% of adults ages 50-80 reported using an alternative site in the past two years: urgent care clinic (47%), retail clinic (28%), worksite clinic (9%), and mobile health clinic (5%). Use of these alternative sites was more common among those ages 50-64, women, and those with higher incomes. Among older adults who visited an alternative care site in the past two years, 91% reported having a primary care provider (PCP). Of those with a PCP, 71% contacted their PCP about their visit to an alternative site. The most common reasons reported for visiting an alternative site were to avoid the hospital emergency department (44%) or to get a vaccine, specific test or to get a health exam (35%). The majority (62%) said they were likely (11% very likely, 51% somewhat likely) to use an alternative site for health care in the future, including 43% who had not used in alternative site in the past two years. Poll findings suggest that these sites will continue to play a significant role in the delivery of health care in the future.
MEDIATION OF THE NUTRITIONAL STATUS BETWEEN THE NUMBER OF TEETH AND DEPRESSION AMONG OLDER ADULTS IN WESTERN CHINA
Authors: Tian Xin , Hu Yuexia , Xie Yuqing , Xia Xin , Wang Yanyan
Published: January 2025

Depression is a common mental disorder. Studies have shown that depression is associated with the number of teeth, but underlying mechanisms deserve further research. Our study aimed to explore the mediating effect of nutritional status between the number of teeth and depression. We analyzed cross-sectional baseline data from the 2018 West China Health and Aging Trend study (WCHAT), including 6632 multi-ethnic adults aged 50-95. The survey tool for depressive symptoms is 15-item Geriatric Depression Scale (DGS-15), and nutritional status was evaluated through Mini Nutritional Assessment-Short Form (MNA-SF). We conducted a multiple linear regression to estimate relationships between the number of teeth, nutritional status, and depression. Mediation models and pathway analysis were constructed to figure out the mediating role of nutritional status. Of 6632 participants, the depressive symptoms proportion was 17.3%. Multiple linear regression proved a total association between the number of teeth and depression (β = -0.148; 95% confidence interval: -0.218 to -0.078), the associations remained significant after adjusting MNA-SF scores. Mediation analysis verified nutritional status partially mediates the associations between the number of teeth and depression (indirect effect estimate = -0.059, 95% CI: -0.076 to -0.044; direct effect estimate = -0.088, 95% CI: -0.155 to -0.017). Structural equation model framework pathway analysis confirmed the association between the number of teeth, nutritional status, and depression. Our data suggested that nutritional status partially mediated the relationship between the number of teeth and depression, early identification of nutritional status and emphasis on oral hygiene are necessary to mitigate the risk of depression.
THE ASSOCIATION BETWEEN ORAL HEALTH/HYGIENE AND COGNITIVE IMPAIRMENT AMONG MULTIETHNIC OLDER ADULTS IN WEST CHINA
Authors: Xie Yuqing , Xia Xin , Li Yun , Wang Yanyan , Tian Xin , Hu Yuexia
Published: January 2025

The prevalence of cognitive impairment increases with age. Meanwhile, older adults with cognitive impairment typically have deteriorating oral health and poor oral hygiene. However, the distribution of oral health and cognitive impairment varies among different ethnic groups. The aim of this cross-sectional, multi-center study was to investigate the association between oral health and hygiene and cognitive impairment in a sample of multi-ethnic older adults aged 50 years and older from four provinces in western China (N=6529, mean age 62.4 ±8.3 years). Oral health and hygiene were assessed by specialized oral tests and a self-made questionnaire. Cognitive status was assessed using the Chinese version of the Short Portable Mental Status Questionnaire (SPMSQ). Three multiple regression models were used to examine the association between oral health and hygiene and cognitive impairment, adjusting for relevant variables. Statistical analysis showed that the prevalence of cognitive impairment was 15.4%, with the Yi group having the highest prevalence (28.9%), followed by Tibetans and others. Poorer self-rated oral health, fewer residual teeth, less frequency of using toothbrush and toothpaste, and rare dental visits increased the risk of cognitive impairment. The SPMSQ scores and correlations between oral health and hygiene and cognitive impairment were heterogeneous across the multi-ethnic groups. These findings highlight that declining oral health and inadequate oral hygiene may increase the risk of cognitive impairment. The potential value of this study is to illustrate that implementing and promoting oral health and hygiene is essential to prevent cognitive impairment in multi-ethnic older populations.
STAYING GOLDEN: PERSPECTIVES FROM THE AGE 85+ ON THE REALITIES OF AGEISM
Authors: Patskanick Taylor , Ashebir Sophia , D’Ambrosio Lisa , Coughlin Joseph
Published: January 2025

The conceptualization, prevalence, and consequences of ageism are increasingly well-documented in research, but our understanding of how older people may personally experience this phenomenon during specific age periods in their older adulthood is less understood (e.g., Chasteen et al., 2021). The 85+ age cohort may experience unique forms of ageism and age-based discrimination relative to other older age groups and can comment on how they experience these biases relative to other ages in their own lifespan. This paper shares findings from a qualitative, cross-sectional study with the MIT AgeLab 85+ Lifestyle Leaders panel, a longitudinal panel of U.S. octogenarians and nonagenarians. Utilizing four virtual focus groups (N=17) conducted in January 2024, findings were analyzed in MAXQDA2024 using a team-based, inductive, thematic analysis approach. Results characterize Lifestyle Leaders’ experiences with felt forms of ageism (e.g., covert vs overt, positive vs negative, etc). The Lifestyle Leaders articulated experiences with ageism in specific domains such as product design, healthcare, and in the community-based built environment. Benevolent or compassionate ageism may be particularly amplified at age 85+. Lifestyle Leaders noted an inextricable intersectionality between their chronological age and social identities like physical ability, digital nativity, and gender. A plurality described having a longitudinal lens on the shifting institutional context for age-based discrimination over their life courses (e.g., ADEA). These findings and their implications for gerontological professionals and future research on ageism, including planned follow up to this study examining this topic via participatory action research methods, will be discussed.
VICTIMIZATION EXPERIENCES AND COGNITIVE HEALTH: VARIATION BY SEXUAL MINORITY STATUS
Authors: Barbee Harry
Published: January 2025

Studies have revealed how experiences of victimization generate stress and harm cognitive health outcomes. For minority populations, such as sexual minorities, victimization experiences may occur more frequently, thus posing a greater risk to their cognitive health outcomes in later life stages. This project explores this possibility by analyzing how different types of victimization experiences, including being treated with less respect, receiving poorer services, and being threatened or harassed influence cognitive health outcomes among older adults in the United States. To achieve this goal, I examined data from the Health and Retirement Study, a nationally representative survey of middle-age and older adults in the United States. Specifically, I employed adjusted logistic regression models and adjusted Poisson regression models to test the extent to which experiencing different forms of victimization influenced subjective cognitive health, via self-rated memory, as well as a variety of objective markers of cognitive health. All models controlled for key sociodemographic variables. Preliminary results indicate that respondents who experienced different types of victimization also reported significantly worse cognitive health outcomes. Additionally, sexual minorities who reported victimization experiences had worse cognitive health outcomes than the heterosexual respondents who also reported victimization experiences. Together, these results demonstrate how perceived experiences of victimization can harm cognitive health, and also reveals potential explanations for why older sexual minorities face greater risk of cognitive impairment than their heterosexual counterparts.
VULNERABILITY, LIFE SATISFACTION, AND SOCIAL SUPPORT AMONG OLDER ADULTS: RESULTS FROM THE CLSA
Authors: Levasseur Melanie , Naud Daniel , Cihlar Volker , Micheel Frank , Mergenthaler Andreas , Trottier Lise
Published: January 2025

When experiencing, at a specific moment, multidimensional difficulties (physiological, psychological, socioeconomic or social) increasing the probability of being harmed or having coping challenges that negatively impact their lives, individuals in situations of vulnerability are at risk of reduced life satisfaction. Although not demonstrated yet, social support may mitigate this impact in older adults. This study aimed to examine the associations between situations of vulnerability, life satisfaction and social support, as well as the moderating effect of social support on the association between situations of vulnerability and life satisfaction among older women and men. Secondary analyses of the cross-sectional data on 21,491 respondents aged ≥65 from the Canadian Longitudinal Study on Aging were conducted, stratified by sex. Confirmatory factor analysis was used for identifying a latent vulnerability variable using physiological, psychological, socioeconomic and social indicators. Linear regression estimated the association between vulnerability and life satisfaction, and the moderating effect of social support. Respondents were aged between 65 and 89 (mean=73.4; standard deviation=5.8). For both sexes, reporting more depressive symptoms, chronic conditions and insufficient income best explained vulnerability, followed by dependence in basic activities of daily living, less social participation and living with fewer people. Vulnerability was associated with lower life satisfaction (p<0.001) for both sexes, and social support acted as a buffer against vulnerability (p<0.001) for women. Results confirm the multidimensionality of vulnerability. The buffering effect of social support in women reinforces recommendations concerning policies and interventions designed to increase opportunities of social connections, and further research is warranted for men.
SOCIAL PARTICIPATION OF TRANSGENDER BABY BOOMERS IN QUÉBEC: RESULTS FROM A CASE STUDY OF ACTIVISTS
Authors: Valpuesta Dolores Majón
Published: January 2025

The systematic discrimination linked to the intersection of gender identity and advanced age in transgender older adults results in further social participation restrictions and higher risk of disability (65% of transgender adults report poor mental health). Despite the importance of participation for health, little is known about the social participation of transgender older adults, especially among the new generation, the baby boomers. This study thus aimed to explore the social participation for transgender older adults. Based on the Iridescent Life Course theory, a case study was carried out with 2 transgender baby boomer community-dwelling from Quebec (Canada). Two French-speaking transgender women, 60 and 67 years old, with more than 5 years of activism. According to the experience of these activists, participation was positive and, with the gender transition in old age, a form of liberation, overcoming fears and denunciation, having a favourable impact on the community (e.g., sharing life experience for empowering other generations). Despite their positive experience, gender transition also involved a networks restriction, and, in some situations, they considered their rights were not respect. Presenting themselves with pride allows them to overcome the stigmatization of others as a barrier to participate. Boomers are perceived as a prejudiced generation and, consequently, activists were more comfortable interacting with younger generations (more naturalization, less judgmental). When trying to be included in heteronormative and cisgender contexts that did not consider the specificity of their life trajectories as they age, transgender older adults perceived the invisibility of their realities conditioned their social participation.
VOLUNTEERING OF FORMER DEMENTIA CAREGIVERS: A PILOT INTERVENTION STUDY IN THE CHINESE AMERICAN COMMUNITY
Authors: Liu Jinyu , Lou Yifan , Cheung Ethan Siu Leung
Published: January 2025

To promote social engagement of elders of color and mental health of caregivers, we developed a three-month peer mentoring program (PMP) to train and supervise older Chinese Americans who used to be family caregivers of people with dementia (former caregivers) to provide weekly one-on-one mentoring to current caregivers in the same ethnic community. This pilot study aims to test the feasibility and preliminary effect of the PMP. A pilot randomized control trial was conducted among 38 current caregivers and 8 former caregivers in New York City. The current caregivers were randomly assigned to the PMP and control groups. Quantitative and qualitative data were collected at baseline, 3-month, and 9-month from former and current caregivers. T-test and difference-in-difference analyses were used to analyze quantitative data. A thematic analysis was conducted to understand former caregivers’ volunteering experience. The feasibility of the intervention was high, as indicated by an acceptable retention rate, fidelity, and positive feedback from former caregivers. Compared with the control group, the current caregivers in the PMP group had greater reductions in scores for loneliness, caregiver burden and depressive symptoms. Though former caregivers did not report significant changed depressive symptoms and loneliness after participating in the PMP due to their minimal symptoms at baseline, they highlighted that the intervention enhanced their sense of purpose, fulfillment, growth, and self-efficacy in narrative responses. The results indicated the feasibility and efficacy of empowering existing human resources of former caregivers in the same ethnic community to improve the mental health of Chinese caregivers.
MARITAL STATUS DIFFERENCES IN SOCIAL ISOLATION IN LATER LIFE
Authors: Li Lydia , McLaughlin Sara
Published: January 2025

Social isolation, characterized by infrequent social contact, is associated with morbidity, mortality, and healthcare costs. Using 9 waves of data from the National Health and Aging Trends Study (NHATS) that has conducted annual interviews with a probability sample of Medicare beneficiaries since 2011, this study examines how social isolation differs by marital status and whether the association between marital status and social isolation varies by gender. The sample includes 7,077 respondents aged 65+. We examine 4 categories of marital status (coupled, widowed, divorced, and never married.) Social isolation is assessed by an established index that uses four domains (living arrangements, close networks, religious service attendance, and participation in other activities) to determine social isolation (yes and no). Covariates include age, gender, race, education, community/facility residence, and time. Multilevel logistic regression is conducted. Results show that the risk of social isolation, from low to high, is coupled, widowed, divorced, and never married. The difference between all pairs, except divorced and unmarried, is statistically significant. The interaction effects of marital status and gender on social isolation are statistically significant [F (3, 54) = 3.43, p=.02]. Specifically, the probability of social isolation for coupled, widowed, divorced, and never married is.19,.35,.49, and.52 in men and.09,.25,.29, and.32 in women. The findings imply that divorced and never-married men should be prioritized for social isolation reduction interventions.
INTERGENERATIONAL REMINISCENCE ENGAGEMENT TO IMPROVE THE WELL-BEING OF OLDER ADULTS WITH COGNITIVE IMPAIRMENT
Authors: Xu Ling , Fields Noelle , Daniel Kathryn , Cipher Daisha , Troutman Brooke
Published: January 2025

Reminiscence and/or digital storytelling (DST) have been recognized as potentially effective intervention strategies for enhancing the well-being of older adults. When combined with an intergenerational engagement, they may also offer significant social and mental health benefits for this population. This study reported the efficacy of an intergenerational reminiscence engagement between trained young adult volunteers and community dwelling older adults living with cognitive impairment. A randomized control trial was used to assess the effects of the intervention. Participants of young and older adults were randomly paired and assigned to Reminiscence (n = 54) or sham (Social Wellness, n = 49) group. Data were collected at baseline, mid- intervention, at the end of the intervention. Linear mixed models (LMM) were performed to compare the Social Wellness group with the Reminiscence group on levels of loneliness, quality of life, affect, and resilience among the older adult participants. Results from LMM revealed no significant effects for group or time on loneliness, negative affect, and resilience. However, the groups significantly differed on their changes over time in quality of life (t(101) = -3.06, p =.003). Qualitative interviews with selected dyads showed that weekly intergenerational engagements with young adults decreased the feeling of loneliness among older adults. Results suggest that weekly intergenerational engagements with young adults benefit older adults with quality of life and loneliness. Implications for research and programs on reminiscence and DST in improving the well-being of older adults are discussed.
MENTAL AND PHYSICAL HEALTH CONDITIONS LIMITING ACTIVITIES IN A NATIONAL SAMPLE OF OLDER LGBT ADULTS
Authors: Meyer Ilan , Bouton Lauren , Lauderdale Diane
Published: January 2025

AIMS: Research suggests that the proportion of LGBT older adults experiencing disabilities and limitations in activities may be high compared with cisgender straight older adults, but we know little about these limitations. We aimed to understand the type and reasons for limitations in LGBT older adults. METHODS: Using a national probability sample of 210 LGBT adults 45 years and older we conducted in-person or zoom interviews and asked respondents if they were “limited in activities because of physical, mental, or emotional problems?” We followed with an open-ended question about the reason for endorsing having limitations. RESULTS: 36% of respondents reported 1 or more limitations. We categorized these limitations as related to mental health (17%), mobility (72%), pulmonary conditions (7%), sensory/cognition (8%), or cardiovascular including diabetes and obesity (8%). Overall limitations were more prevalent among respondents 65 years or older vs. 45-64 years old (47% vs. 30%), women vs. men (48% vs. 28%), White vs. POC (38% vs. 31%), bisexual and other sexual identities vs. LG (50% vs. 31%), and people with incomes below $49K vs. $50k or higher (48% vs. 32%). Reporting a chronic disease diagnosis (e.g., asthma, hypertension) vs. none was not associated with prevalence of limitations (37% vs. 36%) but self-rated poor/fair health was (58% vs. 31%). In age-adjusted analyses, being a woman, identifying as other than LG, lower income, and reporting poor/fair health were all associated with having limitations (RRR = 2.7, 3.3, 2.1, and 3.5, respectively). We will discuss predictors of observed high prevalence of limitations.
MESSAGE FRAMING AND INTENTION TO USE WEARABLE ROBOTS AMONG OLDER ADULTS: A PARALLEL AND MODERATED MEDIATION ANALYSIS
Authors: Cheng Clio Yuen Man , Lou Vivian Weiqun
Published: January 2025

Little is known about the intention to use wearable robots among older adults, an emerging assistive technology to compensate for age-related functional decline. Informed by the prospect theory and senior technology acceptance model, we examined the effect of persuasive health messages in enhancing technology acceptance of wearable robots among older adults. A 2 (message framing: gain versus loss) x 2 (temporal framing: distal versus proximal) randomized experiment was conducted with 176 older adults aged 50 to 74 in Hong Kong. Non-parametric bootstrapping analyses were used to test the mediation model of attitudinal beliefs, performance, and perceived health benefits as parallel mediators of the relationship between message framing and behavioral intention to use wearable robots. Additionally, a moderated mediation model where the indirect effects of temporal framing are explored on perceived benefits in the mediation model. The results showed that gain-framed messages enhanced behavioral intention, through increased perceived health benefits (IE = -.242, 95% CI: LL = -.435 to UL = -.085, p <.01). Findings also provided evidence on the moderating role of temporal framing. Specifically, we observed that, for participants who were exposed to distally/gain-framed conditions, the IE is statistically significant (IE = -.301, 95% CI: LL = -.601 to UL = -.050, p =.032). For participants who were exposed to proximally/gain-framed conditions, the IE is higher and statistically significant (IE = -.432, 95% CI: LL = -.786 to UL = -.157, p =.007). This study suggests using proximally/gained-framed messages to increase wearable robots’ acceptance is promising.
INTERNET UTILIZATION AMONG OLDER ADULTS WITH VISUAL IMPAIRMENT
Authors: Mumby Rachel , Clarke Philippa , Zhou Yunshu , Rein David , Ehrlich Joshua
Published: January 2025

Internet is increasingly used by older adults for communication, socialization, household tasks, and health information/care. Although the internet is most often accessed by visual means, little is known about whether vision impairment is associated with internet use in older adults. To address this question, we used nationally representative data from round 12 (collected in 2022) of the National Health and Aging Trends Study (NHATS), which included measures of visual function (distance visual acuity, near visual acuity, contrast sensitivity) and a series of questions about computer and internet use among US adults aged 65 and older. Data were analyzed using survey weighted multivariable logistic models adjusted for socioeconomic, demographic, and health-related covariates. There were 5,220 participants included (weighted: 45.6% male, 79.9% non-Hispanic White). Among those with any type of vision impairment, there were significantly lower odds of internet use (OR=0.59, 95% CI 0.47-0.73), email and texting (OR=0.52, 95% CI 0.40-0.68), online household activities (e.g., banking, grocery shopping; OR=0.69, 95% CI 0.57-0.84), online social networking (OR=0.64), 95% CI 0.52-0.80), and online health activities (e.g., prescription refills, telehealth; OR=0.64, 95% CI 0.50-0.82) compared to those without any vision impairment. Most of these associations were driven by near vision impairment. Although internet use has increased among older adults overall, there is a gap in utilization between older adults based on vision impairment status. Findings suggest a need for interventions to make the internet more accessible to older adults with impaired vision.
FEASIBILITY AND ACCEPTABILITY OF IMPLEMENTING AN AI-ENABLED SERVICE ROBOT IN LONG-TERM CARE
Authors: Hung Lillian , Ren Haopu (Lily) , Wong Karen Lok Yi , Davies Katharine , Kinugawa Arisa
Published: January 2025

In long-term care (LTC), staff members are responsible for the complex needs of people with disabilities. This task can be enhanced by integrating service robots equipped with Artificial Intelligence (AI). These robots offer personalized service for residents and empower the staff with efficient support. Despite growing interest, the implementation of service robots in LTC remains under-investigated. This study examines the feasibility and acceptability of implementing a service robot, named Aether, in a Canadian LTC home, guided by the underpinnings of Collaborative Action Research. We included interdisciplinary staff in pre- and post-intervention focus groups and conducted conversational interviews with residents, staff members, and managers. Consolidated Framework for Implementation Research (CFIR) informed our implementation, data collection and analysis. We identified key facilitators (staff engagement and training) and barriers (environmental dynamics and resource limitations). Our results underscore the imperative of structural support at micro-, meso- and macro-levels for staff in LTC to implement technology effectively. This study contributes valuable insights into the future development and deployment of AI-enabled service robots in LTC.