bluuebunny/crossref_metadata_2025 huggingface dataset:
How Can Providers Better Address Recovery Needs for Geriatric TBI Survivors?
Authors: Vogel Mia , Jung Wonkyung , Thompson Hilaire
Published: December 2021

Older adults are at increased risk for poorer recovery from traumatic brain injury (TBI), incidence of pre-injury frailty, and comorbidity compared to younger adults. In this study, a longitudinal multiple case study approach was taken to describe gaps in health service delivery identified by older adults following mild-moderate TBI. Participants were interviewed at 1 week, and 1, 3, 6, and 12 months post injury (5 times). In total, 57 interviews were conducted with 13 participants and transcribed verbatim. Codes were identified inductively to develop a codebook for guiding thematic analysis in NVIVO. Two independent investigators double coded 16 transcripts (28%) and reached consensus; remaining transcripts were allocated to the two investigators for independent coding and verified and reconciled with the other coder until consensus was reached. Many participants were happy with the care they received. However, ongoing health issues and TBI symptoms sometimes remained unaddressed. Follow-up and care planning would have been helpful for most patients as well as ways to address common balance and dizziness issues. Among some, the unwillingness to go to a provider for follow-up or adhere to medication and physical therapy exercises were issues. In some cases, providers were unable to help or understand the reason for patients’ symptoms (e.g., smell/taste changes, ear issues, etc.). Sometimes, providers did not address the issues that were of most concern to patients, or they would prescribe treatments that were not acceptable to patients. Empathetic, tailored, and patient-centered approaches are needed to improve care delivery and outcomes.
Cognitive Decline and Retirement: Findings From the Canadian Longitudinal Study on Aging
Authors: Gosselin Catherine , Désilets-Jutras Meghan , Boller Benjamin
Published: December 2021

Since increasing life expectancy leads to a longer period of retirement, several studies have been investigating the possible impact of retirement on cognitive health. Several epidemiological studies with cross-sectional designs have reported a negative association between retirement and cognitive capacities. However, very few studies with longitudinal designs have confirmed the negative effect of retirement on cognitive functioning. The present study was conducted to investigate the impact of retirement on cognitive capacities among older Canadians. We used data from the Comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA) to compare performance retirees and workers (N = 1442), 45 to 85 years of age at baseline. Memory and executive functioning were assessed using standardized assessment tools at baseline and at three-year follow up. Retirees and workers were matched for age, gender and education using the nearest neighbor propensity score method with a caliper of 0.02. Mixed ANOVA and post hoc analyses were conducted separately for the English- and French-speaking samples. Results for the English-speaking sample showed a significant decline on both the Stroop and the Mental Alternation Task for retirees compared to workers from baseline to follow-up. These results support previous cross-sectional studies that have demonstrated a negative effect of retirement on executive functioning. The absence of significant results in the French-speaking sample will be discussed in terms of sample size and professional occupation.
Falling Between the Cracks: Experiences of Black Dementia Caregivers Navigating U.S. Health Systems
Authors: Alexander Karah , Oliver Sloan , Epps Fayron
Published: December 2021

In addition to numerous care responsibilities, family caregivers are expected to navigate health systems and engage in healthcare management tasks on behalf of their persons living with dementia (PLWD). These challenging tasks pose additional difficulties for Black dementia caregivers. Due to the centuries-old, disadvantaged social history of Black Americans, several unique stressors, vulnerabilities, and resources have emerged which inform and affect Black dementia caregivers’ experiences and well-being. Focus groups were held with Black caregivers (N = 19) from the United States (U.S.) to explore the unique experiences and perspectives of this population navigating the U.S. health system on behalf of their PLWD. Five overarching themes were developed during thematic analysis: Forced Advocacy, Poor Provider Interaction, Payor Source Dictates Care, Discrimination, and Broken Health System. Black dementia caregivers unanimously concurred that the health system that they experience in America is “broken.” Gaps in the health system can lead to people [as one caregiver passionately expressed] “falling between the cracks,” in terms of care, services, and resources needed. Caregivers agreed that class, sex, utilizing public health insurance, and being a “person of color” contribute to their difficulties navigating the health system. Caregivers perceived being dismissed by providers, forcing them to advocate for both themselves and their PLWD. Healthcare providers and researchers can utilize these findings to improve the experiences and healthcare outcomes of Black patients with dementia and their caregivers. Additionally, these findings can lead to the development of culturally tailored caregiver education programs.
The Modified Mini Mental State (3MS) Test - Development of an Online Training Program
Authors: Rose Tara , Teng Evelyn , Chen Chia Ying , Manzo Elyse , Erickson Katherine , Chui Helena
Published: December 2021

The Modified Mini Mental State (3MS), a screening test for cognitive abilities, can be administered in approximately 10 minutes and has a score range of 0-100. Early detection of cognitive impairment is important for clinical care. An individual’s score change over time can also help assess disease progression and treatment effects. The Web of Science, an online database, reports 1,864 publications using the 3MS, including 412 in the last 5 years. Articles came from 52 countries in 7 continents, with languages in English (98.7%), French (0.5%), Spanish (0.5%), German (0.2%), Czech (0.1%), and Korean (0.1%). The fields that publish with 3MS data included Geriatrics/Gerontology, Neurosciences/Neurology, Psychiatry, Psychology, and General/Internal Medicine. One reason for the popularity of the 3MS is its detailed manual for test administering and scoring; however, to date the manual is available only in print form. Here we present an online training program. It includes detailed directions on administering and scoring, video of a 3MS administration, and post-training tests on a trainee’s competency. This training material also covers clinical benefits of cognitive screening and a comparison of the 3MS with other measures. The 3MS helps clinicians with early detection of cognitive impairment, allowing time to address its underlying and potentially reversible causes, and aids in disease management. This online training program will help ensure accuracy and reduce between-tester variability of the obtained scores in both clinical care and research studies.
Understanding the Predictive Factors that Influence the Perceived Burden of Dementia Caregivers
Authors: Lucas Kaitlyn , Judge Katherine
Published: December 2021

Caregivers of individuals with dementia have increased levels of burden because of their caregiving duties which in turn results in negative effects on their physical, emotional, and mental wellbeing. Few studies have examined individual difference-based constructs such as positive and negative affect in relation to caregiver burden. Positive affect is characterized by pleasant emotions and expressions and higher levels of overall life satisfaction whereas negative affect is characterized by more pessimistic emotions and expressions and lower overall life satisfaction. Analyses were performed on dementia caregivers (n=102) using the online data collection tool MTurk Prime. The average caregiver provided 21 or more hours of care with 76.9% of caregivers living with their loved one with dementia. Significant correlations were found between caregiving burden and positive affect (r= -.31, p=.002) and negative affect (r= .56, p=<.001), with higher positive affect related to lower burden and higher negative affect related to greater burden. Results of multiple regression models showed that positive affect (β = -.24, p = .03) and negative affect (β = .35, p = .01) were significant predictors of burden even while controlling for other constructs including types of coping, compassion towards other, and assessment of family dynamics. Understanding the relationship between these constructs will allow for more individualized interventions to be created to help reduce the level of burden that dementia caregivers experience.
Working and Caring During the Coronavirus Pandemic: The Impact of Workplace Policy on Working Female Caregivers
Authors: McLaughlin Jessica , Taeckens-Seabaugh Ashley , Kennicutt Amy , Capellaro Taylor
Published: December 2021

The unprecedented nature of the coronavirus pandemic created significant socioenvironmental changes for working caregivers who found themselves juggling a new landscape of working and caring. Changes in workplace policy were often intended to accommodate those with caring responsibilities, however, there is little information available on how working female informal caregivers of older adults (defined as individuals age 50 or older) received, interpreted, and experienced those policy changes. Given this, it is necessary to gather a complete picture of workplace policy in the daily lives of working female caregivers during the pandemic. This qualitative study involved interviews held between February and April 2021 via video conferencing technology with 29 working female caregivers, ranging in age from 27 to 75 years old. Using a Role Conflict framework and descriptive, structural, and emotion coding strategies, analysis of written transcripts revealed that, while many caregivers were grateful that their workplaces had become more accommodative during the pandemic, apprehension and uncertainty about the future, both with caregiving and with work, also weighed heavily on many of them. The most positively endorsed workplace policy changes were flexibility in work schedules and the ability to work remotely during the pandemic. This research elucidates policy implications for working female caregivers outside of the pandemic context, as many of these policies enabled caregivers to provide care while working with greater ease.
A Qualitative Analysis of Dietary Practices and Motivators Among Older Adults Living With Parkinson Disease
Authors: Ferguson Christine , Lawrence Jeannine , Douglas Joy , Jung Seung , Halli-Tierney Anne , Bui Chuong , Oden Kyndal , Ellis Amy
Published: December 2021

Research supports the role of diet in the onset and progression of Parkinson disease (PD); however, there is no specific dietary pattern recommended for PD. This is partially due to a paucity of in-depth data on the dietary practices of this population. Therefore, the purpose of this study was to qualitatively explore the dietary practices and motivators of older adults with PD. Eleven dyadic semi-structured interviews with older adults and their care-partners were conducted via Zoom about their dietary practices and motivators. Interviews were audio-recorded and transcribed verbatim, and data were thematically analyzed using NVivo 12 software. The following themes were identified: 1) Intentionally making healthier choices on a regular basis; 2) Following a specific dietary pattern; for example, the Mediterranean diet, ketogenic diet, vegetarian diet, and/or intermittent fasting; 3) Limiting or avoiding certain foods, food components, and/or food groups, such as dairy, gluten, sugar, animal meat, and/or alcohol; 4) Purchasing or growing organic produce; and 5) Adjusting the timing of their protein intake to their medications. Their PD diagnosis and symptoms were reported as the primary motivators for following their respective diets. Overall, older adults with PD may be motivated by their diagnosis to modify their dietary intake; however, there are a variety of patterns or restrictions they may be adhering to. These results support the need for a consensus on the dietary recommendations for this patient population.
Discrimination and Sleep in Chinese American Older Adults
Authors: Dong Alexander , Bergren Stephanie , Le Qun , Lanza Lisa , Dychtwald Dana K
Published: December 2021

Since the start of COVID-19, reports of discrimination in the US against Asian Americans have increased approximately 150%. Prior research has demonstrated that victims of discrimination are more likely to experience physiological health concerns, possibly linked to sleep. The objective of this study was to determine if there was a relationship between disordered sleep and discrimination among Chinese older adults using data collected from the Population Study of ChINese Elderly (N=3124, 59% female). To assess, the experience of discrimination in nine settings (school, hiring, work, housing, medical, service, finance, public, and authority) and four indicators of sleep quality (duration, trouble falling asleep, insomnia, and self-reported sleep quality) were evaluated using logistic- and multinomial logistic regression. With an average age of 75 years, discrimination was experienced by 7.2% of participants. Experiencing any discrimination was associated with lower odds of longer sleep durations (>8 hours) compared to those sleeping 6-8 hours. Experiences of discrimination in housing (OR: 5.51 (95%CI:1.08-27.98)) and with authority figures (OR: 6.02 (95%CI:1.16-31.31)) were significantly associated with shorter sleep durations (<6 hours), compared to those sleeping 6-8 hours. Those who experienced discrimination in a school setting were less likely to have trouble falling asleep (OR: 0.28 (95%CI:0.09-0.88)), while discrimination in medical settings were more likely to experience insomnia (OR: 2.29 (95%CI:1.13-4.63)). All other relationships between discrimination and sleep measures were non-significant. Given mixed evidence and the increased relevancy of discrimination against Asian Americans, further research on how discrimination may impact health outcomes and sleep quality is warranted.
Drag Expression Among Older Gay Men: Exploratory Findings of a Pilot Study
Authors: Chapman Brian , Donorfio Laura , Tomasino Debra
Published: December 2021

This poster presentation highlights pilot findings of how older gay male drag queens define drag expression and its associated positive and negative attributes. While drag has become more mainstream, little is known about this sexual and gender minority (SGM) and what it means to be an older drag queen and how it interfaces with societal gender expectations. (Knutson, Koch, Sneed, Lee, & Chung, 2020; O’Brien, 2018). Research to date reports that while sexual minority youth experience bullying, anxiety, lower self-esteem, and suicidal ideation at higher rates than their heterosexual and gender conforming peers, research has not examined the role drag expression plays as a healthy coping mechanism and, in particular, what role it may play for older drag queens. (Levasseur, Kelvin, Rosskopf, 2013; Mueller, James, Abrutyn, & Levin, 2015). Several studies have found that familial support and connectedness offers valuable protective factors for sexual minority youth in their sexual identity development, but again, little is known about the benefits this may provide older drag queens (Brandon-Friedman & Kim, 2016; Eisenberg & Resnick, 2006). Utilizing Grounded Theory, in-depth interviews were conducted with gay males over the age of fifty (n=5) who identified as drag queens to understand how drag expression is integrated into one’s persona, how it may serve as a healthy coping mechanism, and how it interfaces with dragism, generativity, and family relationships over their lifespan (Donorfio, 2020). In addition to sharing the qualitative findings, demographic and data measures of personality, coping, resilience, and mood are also be reported.
Hope As A Motivator For Healthy Behaviors In Older Adults: Findings From A Cross-Sectional Survey
Authors: Khan Mushira , Hill Patrick , O'Brien Catherine , O'Connor Dugan
Published: December 2021

Hope can be understood as a motivational state that enables people to move toward their goals. Yet, how hope may act as a motivator for healthy behaviors in older adults is not well-understood. Further, the extant literature utilizes varied conceptualizations of hope, and a better understanding of the constructs that underlie the relationship between hope and health behaviors is needed. This study examined the relationship between hope and health behaviors, explored how this relationship may differ across different socio-demographic groups, and considered how hope relates to perceived future selves among older adults. Community-dwelling adults 55 years and older (n = 711; mean age 67.38 years; 280 men, 431 women) completed an online, cross-sectional survey. Survey measures included, along with the Adult Hope Scale (AHS) and the Herth Hope Index (HHI), a health behaviors checklist, self-reported health, and a future self scale. We found a moderately strong positive correlation between hope and healthy behaviors in older adults (AHS r = 0.46, p < .01; HHI r = 0.50, p < .01). Participants with higher levels of hope also reported more positive future selves and better health. The associations were similar across different racial/ethnic groups and the magnitude of this effect held even after controlling for gender, education, marital status, and income. Of the two hope scales, we recommend the AHS measure given its relative parsimony, greater use in the field, and the fact that the associations were fairly similar to the HHI with respect to health and health behavior.
Current and Future Directions in Minority Aging: Embracing Interdisciplinary Models
Authors: Farmer Heather , Thierry Amy , Whitfield Keith
Published: December 2021

Racial/ethnic disparities in health among older adults are well-documented. More research is needed to clarify the complex and multifactorial mechanisms underlying these associations. This symposium will feature research that employs innovative theoretical and methodological approaches to understand the biopsychosocial mechanisms that underlie racial/ethnic disparities in older adults’ health and determine sources of within-group heterogeneity in minority aging. Dr. Forrester will integrate stress biology and intersectionality to demonstrate the importance of stress and resilience (e.g., John Henryism) with biological aging within Black adults participating in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Dr. Brown Hughes will present innovative research using data from the African American United Memory and Aging Project (AA-UMAP) on the importance of Alzheimer’s disease-specific knowledge and perceptions among Black older adults. Dr. Gamaldo will employ a within-race approach to understand how knowledge and perceptions of Alzheimer’s disease and related dementias (ADRD) shape cognitive performance among Black older adults in the AA-UMAP study. Dr. Mitchell will use Health and Retirement Study data to explore the role of midlife stress exposure in accounting for racial disparities in trajectories of cognitive functioning. Drs. Thierry and Farmer will use HRS data to examine how psychosocial resilience (e.g., mastery) affects the relationship between perceived neighborhood conditions (e.g., disorder) and cognition among Black older adults. This work highlights the importance of applying an interdisciplinary lens to move the study of minority aging forward and ultimately, to reduce the unnecessary burden of morbidity and mortality among minoritized groups.
Lifespan Developmental Analysis of Health Problems and Problem Drinking Across White and Underrepresented Adults
Authors: Boyd Willard , Li Yimei , Ahmed Mohammed , Mohammed Dania , Kwan Thomas , Lee Matthew
Published: December 2021

Research has illustrated potential health benefits from moderate drinking, but also health risks from excessive drinking. Few studies have contrasted drinking effects on health across different periods of the lifespan, and how such contrasts may vary across sociodemographic subpopulations. In this study, we investigated underrepresented racial and ethnic group status as a moderator of drinking effects on health across the lifespan. Analyses used data from two waves of a large U.S.-representative sample. We estimated a series of 3*3 between-persons ANOVAs testing effects of Wave-1 drinking group (abstainer, moderate drinkers, and excessive drinkers), age (young adulthood, midlife, and older adulthood), and drinking-group-by-age interactions in White versus underrepresented status. The outcome variable was Wave-2 hypertension (controlling for Wave-1 hypertension). In the older-adult White group, results reflected the familiar “j-shaped” curve of alcohol effects on health. Specifically, abstainers experienced higher hypertension than moderate drinkers (with marginal significance: p=.054), and excessive drinkers experienced higher hypertension than moderate drinkers (p= .002). In contrast, among underrepresented older adults, hypertension levels did not vary significantly by drinking group. Graphical results clarified that the lack of drinking effects among underrepresented older adults reflected that they had similarly elevated hypertension across all three drinking groups, whereas the White older adults only had comparably elevated hypertension in the excessive-drinker group. These findings suggest that the positive health effects of moderate drinking apply primarily to White older adults. Our poster will discuss potential explanations for the apparent lack of health benefits of safe-drinking practices among underrepresented older adults.
Psychological Impact of COVID-19 Pandemic on Frontline Responders and Students in Training
Authors: Revell Andrew , Gauvin Mitchell
Published: December 2021

Medical personnel have been in the frontlines of the pandemic leading to increased levels of stress and an impact on mental health. Risks may include, but are not limited to, pronounced burnout (Shechter et al., 2020), vicarious trauma, and post-traumatic stress disorder. The goal of this investigation was to gain insight on the psychological effects that the pandemic had on both frontline responders (EMTs and emergency room staff) and students in clinical training. Emerging adults and adult participants (N=150; ages 18-46; 70.4% ages 18-24) were recruited through the introductory psychology subject pool, community healthcare, and social media. Linear regression and means testing were employed to assess differences between current frontline workers and future workers on the Depression, Anxiety, and Stress Scale (DASS-21; Lovibond, 1995) on irritability, sleep, covid-19 positive presence, concentration, and other mental health factors. Hierarchical linear regression, controlling for age, indicated higher anxiety subscale scores (b=2.49, p=.008) and higher stress subscale scores (b=2.25, p=.035) were present on the DASS-21 for women. Dichotomous means testing indicated higher anxiety, stress, and depression levels for those who also reported a significant change in sleep habits (p <.001) and for those who reported being more irritable on their days off (p <.001) during the pandemic. Students in training (37.7%) indicated interest in considering a different career path (r = .302, p = .02). Future studies should examine these dynamic relationships among mental health factors among healthcare professionals and the implications for training the next generation.
Psychosocial Predictors of Psychological Well-Being During the COVID-19 Pandemic
Authors: Ryou Yeon Ji , Lee Gina , Arieli Rotem , Martin Peter , Choi Shinae , Cho Jinmyoung , Heinz Melinda
Published: December 2021

People worldwide have been largely affected by the COVID-19 outbreak. In addition to worries about physical health, it also causes concerns about psychological and mental health. This research aims to explore predictors affecting psychological well-being during the pandemic using the 2018 Health and Retirement Study (HRS) RAND longitudinal data (N = 42,233) and the 2020 HRS COVID-19 module (N = 3,266). Demographics (i.e., gender, age, and education), psychosocial (i.e., personality traits), and health (i.e., comorbidity) variables were included in multivariate logistic and ordinary least square regression analyses predicting feeling “overwhelmed,” “stressed,” and “lonely” during the pandemic. Our results indicated that neuroticism was positively associated with all outcomes. Women were more likely to feel overwhelmed, stressed, and lonely compared to men. Age negatively predicted the overwhelmed and stressed feelings. Furthermore, the effect of depressive symptoms in 2012, 2014, 2016, and 2018 on psychological well-being was assessed by conducting a latent growth curve model. Findings indicate that initial level and increasing change of depressive symptoms over four-time points (waves 11-14) were positively related to psychological feelings. A higher level of depressive symptoms at the initial level of 2012 and increasing reports of depression symptoms predicted higher rates of being stressed, feeling overwhelmed, and lonely during the COVID-19 pandemic. The results have implications for future research and interventions that should target the emotional antecedents and consequences of pandemics.
Social Determinants of Alzheimer’s Disease and Related Dementias: Racial and Regional Variations
Authors: Martin Roy , Shan Liang , Geldmacher David , Pilonieta Giovanna , Kennedy Richard , Oates Gabriela , Pisu Maria
Published: December 2021

To examine whether racial and regional social determinants of health disparities exist for older adults with Alzheimer’s disease and related dementias (ADRD). We identified 115,879 African American (AA) and White older adults with ADRD (10% from the Deep South) from administrative claims data for a 5% random sample of Medicare beneficiaries (2013-2015). We examined racial and regional differences across sociodemographic characteristics, county-level linked poverty indicators, medical resource availability categories, insurances quality indicators. Social context differences were found between regions including Deep South older adults with ADRD having higher economic impoverishment and lower access rates to specialty medical care services. Older Deep South AA had higher Medicare/Medicaid eligibility rates and less medical access. Significant socioeconomic disparities exist between Deep South and other US regions across several social determinant factors in older adults with ADRD. Social context differences were especially prominent for older Deep South AA with ADRD.
Can We Do Better for Older Adult Research Participants? Clinical Trial Improvements Prompted by a Global Pandemic
Authors: Stark Susy
Published: December 2021

Retaining older adults in clinical trials has often been a challenge for researchers. Clinical trial procedures, aimed at improving fidelity, often offer barriers to frail older adults who have challenges traveling to medical centers and enduring long clinical assessment visits. During the COVID-19 pandemic, we modified the procedures of two randomized controlled trials. COMPASS: A novel transition program to reduce disability after stroke is a clinical trial examining the efficacy of a transition home program that provides home modifications and self-management strategies compared to stroke education. HARP: Removing home hazards for older adults living in affordable housing is a pragmatic trial examining the effectiveness of a home hazard removal program for residents of low-income housing. Modifications to the trials were designed to reduce human contact but in some cases reduced the burden on trial participants. Modified procedures addressed retention, assessment of endpoints and intervention methods.
Simulation approach to interprofessional education
Authors: Greenwald Margaret , Mendez Jennifer
Published: December 2021

A team practice simulation approach to interprofessional education is presented. Participants (79 trainees over 4 years) were assigned to one of six teams representing clinical services for a client with complex clinical needs (medical care, outpatient therapy, dental, nutrition, speech and hearing, leadership). Each student within the team was assigned a specific role (e.g., primary care, policy maker, family member). A critical component of this activity is that each participant adopted the role and perspective of an individual in a different clinical area than their own. In preparation for a live discussion by all participants, each team met to study their assigned clinical roles and to prepare a one-page slide addressing specific questions given only to their team. At the live session, the overall goal was to develop a coherent clinical plan for the client. This is an effective approach for IPE in care of clients across the lifespan.
Using Canvas for an Interprofessional Virtual Team Visit
Authors: Reed Ashley , Mendez Jennifer
Published: December 2021

The is session will demonstrate how to use the Canvas learning management system (LMS) to organize and facilitate interprofessional education experiences (IPE) amongst students and faculty. Emphasis will be placed on the use modules as a way to organize content and facilitate requirements associated with IPE. In addition, the session will include demonstration on how to assign disciplines to sections to aide in faculty abilities to review of student submissions.
Diabetes Diagnosis, Social Support, and Health Behavior Changes in Older Adults
Authors: Qin Weidi
Published: December 2021

The growing disease burden of diabetes in older adults highlights the importance of health-promoting behaviors in this population. A new diagnosis of diabetes can be a teachable moment that motivates older adults to engage in health behavior changes. Guided by the convoy model of social relations, social support from family and friends may influence health behaviors, and moderate the effects of a diabetes diagnosis on health behaviors. The current study investigates health behavior changes in drinking, smoking, and physical activity before and after a diabetes diagnosis, and whether social support moderates the relationships. A sample of 13,143 older adults without diabetes at baseline were selected from the Health and Retirement Study, and followed up for six waves. Social support from family and friends were measured separately. Mixed-effects regression models were performed. Sampling weights were adjusted to generate population estimates. After a diabetes diagnosis, older adults reduced alcohol consumption and were more likely to quit smoking. More social support from family was associated with decreased alcohol consumption, and more social support from friends was associated with increased physical activity. Significant interaction between social support from family and diabetes diagnosis was found. Specifically, among older adults with a diabetes diagnosis, more social support from family was associated with less drinking and smoking cessation. The study findings suggest that health practitioners can consider the timing of diabetes diagnosis to facilitate health behavior changes. Furthermore, diabetes educators can help older adults mobilize support from family and friends to better engage in health-promoting behaviors.
Many Faces of Sleep: Diverse Sleep Characteristics and Their Joint Associations With Stress on Health in Adulthood
Authors: Chai Hye Won , Lee Soomi , Sin Nancy
Published: December 2021

Two separate bodies of literature point to the significant roles of sleep and stress and their associations with health outcomes in adulthood. To further extend the field’s knowledge on sleep, stress, and health, it is essential to consider the multi-dimensional aspects of sleep and diverse stress contexts and identify ways in which the three factors are interrelated to each other. Different sleep characteristics may have varying implications for stress processes that, in turn, shape health outcomes. Therefore, this symposium integrates diverse characteristics of sleep (duration, quality, and pileup) in conjunction with various stress processes and experiences (bereavement, stressor exposure and appraisals, rumination), and examines their associations with cognitive, emotional, and physiological health outcomes. The first paper by Vigoureux and colleagues investigates the interaction between daily sleep and stressor frequency and severity on daily rumination. The second paper by Slavish and colleagues examines the bidirectional associations between daily stress and sleep duration and efficiency. The third paper by Mu and colleagues explores the mediated associations of sleep quality and sufficiency with work impairment through perceived cognitive abilities and rumination. The fourth paper by Lee uses the stress concept of pileup and tests how pileup of insufficient sleep is associated with day-to-day trajectories of affective and physical well-being. The final paper by Chai and colleagues examines whether sleep quality moderates the association between family bereavement and heart rate variability. The discussant, Dr. Nancy Sin, will integrate key points and discuss considerations for mechanisms and long-term implications of sleep, stress, and health.
Living Arrangements and Psychosocial Well-Being Among Older Adults: Evidence From the Health and Retirement Study
Authors: Basu Rashmita , Luo Huabin , Steiner Adrienne , Stevens Alan
Published: December 2021

Despite growing attention to the association between living arrangements and health outcomes, less is known about how emotional well-being and life satisfaction vary by living arrangements. Using data from the 2014 and 2016 Leave Behind Questionnaires from the Health and Retirement Survey (N=13,275), we estimated generalized linear regression models comparing emotional well-being (a ratio of positive to negative emotion) and life satisfaction (the satisfaction with life scale, SWLS) by living alone versus living with others, controlling for socioeconomic and other health-related characteristics. Overall, individuals who lived alone had lower emotional well-being (β=-0.11; p<0.01), and SWLS score (β=-0.42; p<0.001), compared to those living with others. The direction of these relationships stratified by the cognitive status was the same. Policies and programs designed to support the growing population of older adults living alone should focus on improvement in these positive outcomes to enhance the quality of life.
Designing Conversational Agents to Support Self-Regulated Learning for Older Adults
Authors: Chin Jessie , Desai Smit
Published: December 2021

The rapid growth of the off-the-shelf smart speakers (such as Amazon Alexa and Google Home), also called Conversational Agents (CAs), creates potential to deliver everyday life support to users at home (such as checking weather, listening to news, scheduling events). Literature demonstrated the technology acceptance of CAs among older adults (including novice users) given the low barriers to use CAs. The natural conversations among CAs and users enable the opportunities to build deeper understandings about a topic through theory-driven guided dialogues. Our study has designed the metacognition strategies in the guided dialogues of CAs to support informal self-regulated learning of health information among older adults. The study has shown the feasibility and acceptance of CAs to help older adults learn new health information on their own through these guided dialogues. Additional analyses on the feasibilities to implement different metacognitive strategies in guided dialogues in the off-the-shelf CAs were also conducted.
Designing Behavioral Feedback Visualizations to Support Health Behavior Change
Authors: Nie Qiong , Morrow Daniel , Harris Maurita , Rogers Wendy
Published: December 2021

Health technology has the potential to support behavior change by measuring performance and providing users with visualizations of this performance as feedback. Such visual feedback has had limited success in changing health behaviors, but it is not clear why. We conducted a systematic review of the visual feedback literature to develop an organizational framework representing the visual feedback-action process. We identified the components that have been investigated in the context of visual feedback. These components are classified into four categories: visualization types (e.g., bar graph) and variables (e.g., color); feedback characteristics (e.g., social comparison); psychological processes (e.g., motivation) and action (e.g., exercise). The insights will inform the design of feedback visualizations in a smartphone application to support medication adherence for older adults. More broadly, this integrative perspective will yield principles of feedback visualization techniques and components that influence the behavior change process and develop a roadmap to facilitate the design.
Muscle Bioenergetics and Cognitive Executive Function: The SOMMA Study Baseline
Authors: Krtichevsky Stephen , Cummings Steve , Newman Anne , Coen Paul , Molina Anthony , Hepple Russell , Cawthon Peggy
Published: December 2021

Better executive function has been associated with faster walking speed, but the basis for this association is unclear. Systemic factors appear to contribute mitochondrial function across multiple tissues including muscle and brain. We hypothesized that muscle-based measures of bioenergetics capacity would be associated with cognitive function at SOMMA’s baseline. MRI-based ATPMAX and muscle fiber respirometry-based max OXPHOS were correlated with scores on the MoCA (mean: 24.0; SD: 3.2); Trails B (mean: 138 seconds; SD: 73) and the Digit Symbol Coding Tests (mean: 50.8; SD: 14.9). The spearman correlations between ATPmax and the three measures were: 0.10 (p=0.29); -0.20 (p=0.03) and 0.16 (p=0.09), respectively. The association between max OXPHOS were: 0.18 (p=0.02); -0.20 (p<0.01) and 0.11 (p=0.13), respectively. Some associations appeared stronger in men than women. Gender interactions and whether energetics mediate some of the association between cognitive function and gait speed will be explored in the full baseline sample.
Caregiving Is Driving My Time: Caregiver and Care Recipient Driving Behaviors and Hours of Care
Authors: Koumoutzis Athena , Vivoda Jonathon , Cao Jiawei
Published: December 2021

Informal caregivers often provide transportation assistance as older adult care recipients (CRs) begin regulating their driving (e.g., avoid certain driving situations, decrease/cease driving). This study examined how caregiver and CR driving frequency and CR’s driving avoidance behaviors impact caregiving intensity. Using data from Round 7 of the National Health and Aging Trends Study and the linked National Survey of Caregiving (n=1048 dyads), results indicated that caregiving intensity was highest among caregivers who drove everyday (5.38 hours) and for CRs who had not driven in the last month/did not drive (4.65 hours). Negative binomial regression techniques were used to assess and compare driving-related predictors. Compared to CRs who reported no avoidance of nighttime driving, caregivers of CRs who do not drive at all can expect to provide about 36% more hours of caregiving per day. Caregiving intensity was not significantly related to CR’s driving alone, on the highway, or in bad weather avoidance behaviors. CRs who drove every day, most days, and rarely required between 33% and 40% fewer expected hours per day of caregiving compared to CRs who had not driven in the past month. The expected number of hours spent providing care per day was 36% higher among caregivers who drove the care recipient every day, 28% higher among most-day drivers, and 30% higher among those who never drove as opposed to caregivers who drove some days per week. Results suggest that caregiving intensity is related more to caregiver and CR driving frequency than CR driving avoidance behaviors.
The Emergence and Benefits of Social Relationships in Two Community-Based Dementia Choirs
Authors: Smith Andre , Sheets Debra , Kennedy Mary , Erb Tara , Kampen Ruth , Hozempa Chandra Berkan , MacDonald Stuart
Published: December 2021

Community choir participation for persons with dementia (PwD) confers benefits to health and well-being, including the benefit of socializing which can reduce feelings of loneliness and social isolation. Using the concept of social capital, this study examines the degree to which two intergenerational Voices in Motion choirs facilitate the development of social relationships between PwD, caregivers, and high school students. Data collection involved interviews with 17 dyads of PwD and caregivers, completion of a social relationship questionnaire, and focus groups with a total of 29 high school students. The results show a gradual increase in the level of interactions between all participants, with students in particular interacting more frequently with PwD. Over time, trust and reciprocity emerged within the choirs as more people shared information about themselves. Students’ understanding of dementia changed over time as they learned to appreciate PwD as unique human beings with rich life stories and experiences.
Has the COVID-19 Pandemic Increased Advance Care Planning Discussions Held by Older Adults?
Authors: Gutman Gloria , deVries Brian , Beringer Robert , Gill Paneet , Daudt Helena
Published: December 2021

In an online survey exploring older Canadians’ experiences during the COVID-19 pandemic, 3989 respondents aged 55-99 indicated whether they had discussed their future care preferences and with whom, prior to and since the outbreak. Pre-pandemic, 62% had held such discussions; since the pandemic 43% did so, 11% for the first time. Rates were significantly higher among white respondents than among persons of color, women than men, and those 65+ than younger respondents. Respondents were most likely to have talked, respectively, with their spouse (58% before; 40% since), family (35%; 22%), and friends (12%; 10%)—with higher rates for white, women and older respondents. Surprisingly, only 4% before and 2% since the pandemic had discussed their care preferences with a doctor. Initiation of some new discussions was encouraging but there were fewer than expected, perhaps due to denial, superstition, or disbelief of pandemic severity. Advance care planning remains an under-utilized resource.
COVID-19 and Death Anxiety: The Impact on Students’ Appraisals to Completing Advance Directives
Authors: Vogel Carlyn , Dobbs Debra , Templeman Maureen , Marino Victoria , Haley William
Published: December 2021

This study examined possible effects of COVID-19 on students’ appraisals, coping, and responses to completing advance directives (ADs). We used the transactional model of stress and coping to explore 93 undergraduate students’ responses to an AD assignment completed in an undergraduate course during COVID-19. Students watched a recorded lecture, read content related to ADs, and examined a sample copy of a 5 Wishes document. Students completed an assignment reflecting on reactions to completing ADs. Content analysis of 65 responses indicated almost 10% of students mentioned COVID-19 or the pandemic as a reason to complete ADs. Approximately 18% mentioned their youth and 40% mentioned sudden or serious illness as reasons to complete ADs. Nearly 30% mentioned death anxiety as a reason for being unprepared to complete ADs. Instructors should consider ways to inform and help students process their emotions given contextual factors (e.g. the pandemic) when teaching about ADs.
Return Home Interviews for Missing Older Adults With Dementia: A Scoping Review
Authors: Neubauer Noelannah , Letts Elyse , Daum Christine , Miguel-Cruz Antonio , McLennan Lauren , Liu Lili
Published: December 2021

Introduction: Persons living with dementia are at risk of becoming lost. When a person is returned home safely after a missing incident, an interview with the person or care partner may identify ways to prevent repeat incidents. It is not known if these interviews are being conducted for this population. Objectives: The purpose of this review was to understand return home interviews and whether they are being used with persons who have dementia. Methods: Scholarly and grey literature were searched in 20 databases. Articles were included from any language, year, study design if they included terms resembling “return home interview”, “missing,” “lost,” or “runaway”. Results: Eleven articles in scholarly, and 94 in grey literature sources were included, most from the United Kingdom. The majority of academic (55%) and grey (61%) articles were related to missing children, and none were specifically about persons living with dementia. Interviews were typically conducted within 72 hours after a missing person was returned, and by police or charitable organizations. The main reasons were to understand the causes of the incident and confirm the missing person’s safety, identify support needs, and to provide support to reduce repeat missing incidents. Conclusion: Existing reasons for interviews can also apply to persons with dementia. This review informs future research on return home interviews. It also informs community organizations, and police services interested in adopting this practice with persons living with dementia. Evaluations would confirm if these interviews can reduce repeat incidents and help keep people with dementia safe.
Addressing the California Master Plan on Aging Through Innovative Gerontology Specializations
Authors: Abbott-Enz Pamela
Published: December 2021

The 2021 Master Plan for Aging outlines five bold goals to pursue over the next ten years, including addressing the issues of housing, health, and quality of life, finance, and caregiving, the plan also addresses public safety and emergency services, community programs and public spaces, access, inclusion, and equity. In order to prepare the workforce to meet these goals, California Community Colleges have the unique opportunity to collaborate and develop Aging Specialists in fields not traditionally age-focused. This presentation explores the possible scope and path toward curriculum development of five innovative collaborations that will prepare Gerontology specialists for the workforce that will be created through the execution of the California Master Plan.
Disruption to Transformation: Engaged Research
Authors: Geary Carol , Abbott Katherine , McGaffigan Erin
Published: December 2021

With changes in funders’ requirements, engagement of persons with “lived experience” in the planning, conduct, and dissemination of research is increasingly common. Although patient and stakeholder engagement is expected, the body of literature describing necessary structures and processes is severely limited. Therefore, the purpose of this symposium is to aid in the movement of engaged research from disruption to translation. To do so, we will describe gaps in researcher knowledge and skills associated with patient and stakeholder engagement; structures and processes in current use with older adults, and outcomes associated with engagement. We will begin by sharing findings within advisory board models of engagement. Dr. Lessem will describe the Sage Resource Project researcher needs assessment. Researchers (N=103) shared both their engagement interests and their perceived knowledge and capability gaps. Dr. Berman will describe training developed within the same project to overcome researchers’ perceived gaps. Then, Dr. Roes will describe a qualitative evaluation of persons with dementia perspectives on rewards and benefits of advisory board involvement. Our final two presenters will describe engagement using a variety of engagement approaches. Dr. Douglas will share experiences with adapting Montessori philosophies and processes to engage CNAs in development of innovative programming for dementia care within a long term care environment. Finally, Dr. Geary will share her team’s findings from interviews completed using appreciative inquiry with sites with over five-years’ experience engaging patients in research. Each site has developed unique infrastructures and processes to most effectively achieve desired outcomes.