bluuebunny/crossref_metadata_2025 huggingface dataset:
FUNCTIONAL LIMITATION IN LATER LIFE: THE IMPACT OF SIPS, SOCIALIZATION, AND SADNESS
Authors: Scott Rosanna , Wiener Chelsea , Paulson Daniel
Published: November 2019

Recent studies posit discrepant impacts of alcohol use on health outcomes. Potential reasons for contrasting results include: (1) selection bias involved in classifying individuals as “abstainers” or “drinkers,” (2) unexamined demographic variables associated with alcohol use, and (3) unaddressed mechanisms of action. Given new studies identifying socialization as a mediator between alcohol use and health outcomes, this study examines social interaction and depressive symptoms, respectively, as serial mediators in the relationship between moderate alcohol use and functional limitation, while employing methods to reduce selection bias. HRS data from 2012 and 2014 were utilized (n=1,902); heavy drinkers, adults younger than 65, and respondents with inconsistent alcohol use from 2008 to 2014 were excluded. Hypotheses were evaluated using a longitudinal serial mediation model with bias-corrected bootstrapping. Results indicated that, in the context of demographic variables, medical burden, and previous functional limitation, the beneficial relationship between moderate alcohol use and future functional limitation is only present when considering social interaction and depressive symptoms as mediators, both individually and serially (variance accounted for=39.4%). There was no direct effect of moderate alcohol use on functional limitation outside the context of these mediators. Data indicate that previously suggested relationships between moderate drinking and reduced functional limitation are better explained through increased social interaction and subsequent reduced depressive symptoms. Results identify social interaction as an accessible treatment target to prevent/reduce depressive symptoms and functional limitation in later-life, and support increased assessment of IADLs in adults experiencing depressive symptoms to facilitate early treatment/prevention of functional limitation.
USING CAREERS IN AGING WEEK (CIAW) TO PROMOTE INTERGENERATIONAL COMMUNITY ENGAGEMENT
Authors: Andreoletti Carrie
Published: November 2019

This presentation will discuss how we used CIAW 2017 to promote intergenerational community engagement by collaborating with our office of Continuing Education and AARP Connecticut to host “#DisruptAging – A Conversation Across Professions, Perspectives, and Generations.” Together we developed a half day program designed to build bridges among academic institutions, aging professionals, community collaborators, and consumers who are passionate about aging issues. We brought together a multi-generational audience of professors, students, professionals, and representatives of various community organizations to discuss ways to change the conversation around aging. This gave us an opportunity to highlight our gerontology programs and showcase our gerontology students, while students learned about aging-related careers, public policy initiatives, and organizations in Connecticut that support older adults and their families.
PROMOTING EFFECTIVE CAREER DEVELOPMENT IN GERONTOLOGY THROUGH APPLIED INTERGENERATIONAL PROGRAMS
Authors: Manoogian Margaret M
Published: November 2019

With the rise in global older adult populations, university programs need to produce an effective, gerontology-trained workforce (Silverstein & Fitzgerald, 2017). Career decision-making involves interactive learning (Super, 1990), as adults explore career options, engage in career learning, and understand curriculum integration within professional settings (Savickas, 2013). Gerontology faculty can utilize career planning models that integrate intergenerational engagement within the curriculum to aid student career decisions (Reardon, Lenz, Peterson, & Sampson, 2012). This paper provides an overview of a career planning model and highlights the ways intergenerational programs can be intentionally staged in research, service, and extracurricular domains to promote career planning and success in post-graduate employment. Data from our recent gerontology alumni survey including graduates since the program inception will be outlined to support the importance and success of developing strong applied intergenerational career programs in gerontology.
EMPOWERING VULNERABLE GROUPS IN LATER LIFE: FOCUS ON THE ROLE OF ACTIVITIES, SOCIAL NETWORK, AND ROUND-THE-CLOCK CARE
Authors: Smetcoren An-Sofie , Zijlstra G A Rixt
Published: November 2019

Europe has been challenged with an intense rise of aging populations facing for example multiple chronic health problems, functional limitations and social and psychological challenges. With increasing age people may become vulnerable, nevertheless, they can still report high levels of well-being despite their deficits. Older adults’ strengths and resources can balance negative experiences and increase positive well-being outcomes. These resources can be personal (e.g. have sufficient income) or stemming from the social environment of the older person (e.g. an involved social network). Hence, this symposium focusses on these strengths and resources and how they might (positively) affect the well-being of vulnerable groups ageing in place. The main objective of the symposium is to give insights into different aspects and strategies that can protect older adults against negative outcomes. Four different studies from Belgium will be presented: Sarah Dury starts with explaining the potential buffering predictor of leisure and civic activities, by uncovering the mechanisms underlying the relationship between multidimensional frailty and well-being. Lise Switsers examines if the absence of social and emotional loneliness can act as a buffer to maintain a good well-being for older adults at risk of frailty. An-Sofie Smetcoren examines how ‘living in solidarity’ in a co-housing project can contribute to ageing in place. Finally, Sylvia Hoens explores the experiences of the older care users and their informal caregivers with live-in migrant care workers and examines how this care can increase their well-being.
EXPLORING MECHANISMS OF AGING THROUGH LONGITUDINAL TRAJECTORIES: BIOLOGICAL, PHENOTYPIC, AND CLINICAL
Authors: Schrack Jennifer A , Ferrucci Luigi
Published: November 2019

Over the past several decades, researchers have searched for early and accurate predictors of healthy aging, establishing metrics to potentially quantify the aging process based on functional performance, disease diagnosis, or other clinical tests. Using these metrics, efforts have been made to disentangle the concepts of “normal” versus “accelerated” aging to identify individuals transitioning into states of disease and disability, allowing for more targeted and effective treatment(s). Yet, many of the variables included in these indices have been chosen based on their availability using cross-sectional associations with chronological age. Such variables may reflect birth cohort differences and selective attrition and fail to accurately represent the mechanisms most representative of the aging process. Using data longitudinal data from the Baltimore Longitudinal Study of Aging and beyond, this symposium will present a conceptual framework of phenotypic aging and its relationship with biological aging, and trajectories of aging phenotypes using state-of-the-art measures collected over the past 10 years. Specifically, we will discuss new insights into trajectories of molecular (inflammatory and metabolic markers), physiological (energetics, body composition, brain atrophy), and clinical measures (gait speed and executive function), and discuss methodological considerations for combining these phenotypes into a measure that can be linked with biological aging measured using a systems approach to improve and refine future understanding of mechanisms of “normal” versus “accelerated” aging. Further development and application of the methodology presented in this symposium will highlight the importance of using longitudinal data to improve understanding of physical and cognitive trajectories with aging.
FINANCIAL LITERACY, RETIREMENT, AND BECOMING FINANCIALLY CAPABLE IN A DEVELOPING COUNTRY
Authors: Davis Julian G McKoy , Eldemire-Shearer Denise
Published: November 2019

Worldwide, 3.5 billion (67%) of older adults do not understand basic financial concepts. In the Caribbean, families and professionals alike are struggling to assist and financially support a rapidly ageing population. The concept of children as “pension guarantee” is widely practised throughout the Caribbean, but factors such as modernization, urbanization, migration, and a shift in societal norms pertaining to familial responsibilities, have left many older persons financially fending for themselves. Less than half of all Jamaicans have adequate retirement funds. People with limited financial resources can and do save, but often use strategies that are not advantageous. The stark reality of low pension coverage among older Jamaicans and austere working conditions among public and some private sector workers indicate growing economic, financial, and societal challenges. Jamaica’s rapidly growing ageing population has resulted in both a workforce and a retirement financial crisis. This symposium provides an overview of the current policy and economic issues. We describe the design, implementation, and evaluation of an economic program to increase financial literacy and planning of adults nearing retirement age. To increase financial retirement literacy of Jamaicans with limited educational and financial resources, a peer-to-peer program was developed using a culturally adapted version of the FDIC Money Smart Program. A peer-to-peer approach has the potential to strengthen financial literacy and enhance retirement planning behaviours of underserved adults and avoid further burdening an already limited workforce. This project’s findings can inform policy, shape program development, and guide implementation of similar programs in low resource countries.
POLICY AND ECONOMIC INFLUENCES ON RETIREMENT, FINANCIAL LITERACY, AND ECONOMIC SECURITY IN JAMAICA
Authors: Davis Julian G McKoy
Published: November 2019

The changing pension landscape, as well as the accompanying privatization, marketization and individualization of the pension planning process, has resulted in inadequate and risky investment practices. Jamaica, like many other countries in the international community, has been engaged in pension reform. The main issues in the current dispensation of pension reform are in relation to pension adequacy to mitigate against longevity risk, low levels of pension coverage; with the aforementioned leading to the need to increase the number of persons contributing to the pension pool as well as possibly an increase in the value of pension contributions to account for inflation and investment risks. This paper describes the current legal and regulatory framework on pension reform in Jamaica within the context of population ageing and the National Financial Inclusion Strategy that targets persons who were previously underserved by the domestic financial system. Policy and programmatic recommendations are will be provided.
IMMIGRATION, RESILIENCE, AND ORAL-HEALTH-RELATED QUALITY OF LIFE AMONG CHINESE AMERICAN OLDER ADULTS IN HAWAII
Authors: Wu Bei , Pei Yaolin , Zhang Wei
Published: November 2019

Very few studies have compared oral health status between the US-born and foreign-born immigrant older adults. Using data collected among 430 Chinese older adults age 55+ residing in Hawai’i, we examined the association between immigrant status and oral health related quality of life (OHQoL) and the moderating role of resilience in linking the association. Controlling for some key covariates, our study results show that US-born Chinese immigrant older adults had better OHQoL than their foreign born counterparts. Factors such as higher level of education (graduate degree or higher), better self-reported health status and no significant tooth loss were related to better OHQoL. The association between immigrant status and OHQoL was moderated by resilience. Specially, resilience was positively and significantly associated with OHQoL among U.S.-born older adults but not among the foreign-born ones. Our findings indicate the importance of immigration and resilience in shaping oral health outcomes among older Chinese Americans.
THE IMPACT OF DEMENTIA STIGMA IN RECRUITING PARTICIPANTS INTO RESEARCH STUDIES
Authors: Rose Karen , Lopez Ruth Palan
Published: November 2019

Despite efforts to increase awareness and education about Alzheimer’s disease and other dementias, persons with dementia and their family caregivers experience stigma. Dementia related stigma is associated with negative repercussions for those with the disease and their family caregivers. In our prior work, we identified shame as a mechanism by which stigma is enacted and results in isolating and delaying access to supportive services for family caregivers. As such, stigma may influence decisions to participate in research studies. Healthcare providers, friends and family, and society, in general, play roles that further perpetuate stigma in dementia. Best practices from the literature, coupled with our experiences and findings in recruiting persons with dementia and their family caregivers in to research studies will be examined.
THE INFLUENCE OF RECESSION HARDSHIPS ON THE PSYCHOSOCIAL WELL-BEING OF SANDWICHED AND FILIAL CAREGIVERS
Authors: Hodgdon Barbara , Wong Jen D
Published: November 2019

The 2007-2009 U.S. Great Recession impacted the lives of many families, and it has been documented that multigenerational households in the U.S. increased by 10% during this period. Given the vulnerability of providing care to multiple generations, there is a need to examine the influence of recession hardships on sandwiched caregiving and psychosocial well-being in the context of more normative caregiving (e.g., filial caregiving). Informed by the life course perspective, this study assessed the impacts of types of family caregiving (sandwiched and filial caregivers) on psychosocial well-being (e.g., affect, environmental mastery, and social actualization) and the moderating role of recession hardships (e.g., job loss, foreclosure). Sandwiched and filial caregivers (N=127; Mage=53; SD=11.02) from the Refresher Cohort of the Midlife in the United States (MIDUS) Survey provide information on demographics, recession hardships, family caregiving, and well-being. Results from regression analyses showed that sandwiched caregivers exhibited lower levels of positive affect and environmental mastery than filial caregivers. Moderation analyses showed that filial caregivers with lower recession hardships exhibited lower positive affect and social actualization when compared to sandwiched caregivers with lower recession hardships. Filial caregivers with lower recession hardships exhibited lower positive affect and social actualization than sandwiched and filial caregivers with greater recession hardships. These results illustrate the complexity of family caregiving in that providing care to multiple generations does not necessarily translate to lower levels of well-being. Study findings have the potential to inform programs that may promote sandwiched caregivers’ well-being and support filial caregivers navigating financial disruptions.
SENIOR FRIENDLY PACKAGING AND PRODUCT TESTING: FEEDBACK FROM OLDER CONSUMERS
Authors: Hollis-Sawyer Lisa A , O’Neil Alison
Published: November 2019

By 2050, older adults ages 65 or older will account for 83.7 million people in the U.S. population (An Aging Nation: The Older Population in the United States, 2014). It is imperative that products and technologies are designed to accommodate age-related changes that older adults are likely to experience. Given this population surge of older adults, there is a growing interest in identifying consumer products that are usable for older adults or “senior friendly.” Senior-friendly product testing (e.g., Senior Select®) focuses on the usability of various health and consumer products targeted to people with diminishment of any of the following: hearing, vision, taste, touch, smell, mobility & dexterity and /or mental acuity. A usability evaluation study was conducted in three senior living communities located in the Atlanta area. Twenty-nine participants ranged in age from 66 years old to 102 years old. Participants were shown a snack bar product and then asked to use the product themselves to perform a series of prepared tasks. After interacting with the product, participants were asked to share any comments that they had concerning the product. Issues of color contrast between the main packaging and the pull tab, easy of gripping and tearing the wrapper, the labeling of the nutrition information, and the package labeling (should refer to “adult” snack) were reported. Many respondents suggested that senior-friendly package design relates to their health and well-being. Implications toward a wide range of products for older adults of varying ability levels will be discussed.
METABOLITES ASSOCIATED WITH HIGH VERSUS LOW WALKING ABILITY AMONG COMMUNITY-DWELLING OLDER MEN AND WOMEN
Authors: Marron Megan M , Wendell Stacy G , Tseng George C , Boudreau Robert M , Santanasto Adam J , Clish Clary , Zmuda Joseph M , Newman Anne B
Published: November 2019

Low walking ability is highly prevalent with advanced age and associated with a higher risk of major adverse health outcomes. Metabolomics may help better characterize differences among older adults with vastly different walking abilities and provide insight into altered metabolic processes underlying age-related declines in physical functioning. Here, we sought to identify metabolites associated with high versus low walking ability using a nested case-control study of 120 community-dwelling adults ages 79-95 (40% men, 10% black) from the Cardiovascular Health Study (CHS) All Stars study. Participants with high versus low walking ability were matched one-to-one on age, gender, race, and fasting time. Using liquid chromatography-mass spectrometry, 569 metabolites were identified in overnight-fasting plasma. High versus low walking ability was defined as the best versus worst tertile of gait speed (≥0.9 versus <0.7 meters/second) and Walking Ability Index scores (7-9 versus 0-1). Ninety-six metabolites were associated with walking ability extremes (p<0.05, false discovery rate<30%), where 24% were triacylglycerols. Triacylglycerols containing mostly polyunsaturated fatty acids (e.g., omega-3) were higher, whereas those containing mostly saturated/monounsaturated fatty acids were lower among those with high versus low walking ability. Arginine and proline metabolism was a top pathway identified. Body mass index partly explained the association between a subset of metabolites and walking ability extremes. These findings may partly reflect pathways implicating modifiable risk factors including excess dietary lipids and lack of physical activity, which contribute to obesity and cause further alterations in metabolic pathways, potentially leading to age-related declines in walking ability in this cohort.
CULTURAL MOTIVATION TO VOLUNTEER AMONG OLDER JEWISH ADULTS: AN EXPLORATORY STUDY
Authors: O’Dea Eireann , Wister and Andrew
Published: November 2019

The physical, mental, and social benefits for older adults who volunteer are well-documented. Absent from this area of research however, is an understanding of volunteer motivation and experiences among culturally diverse older adults. This study addresses this research gap by exploring the volunteer pathways, motivations, and experiences of Jewish older adults in Vancouver, BC, Canada. The Jewish community is notable for possessing high levels of social capital, indicated by close community ties and the large number of faith and culturally based organizations, including community centres, day schools, seniors’ centres, and family service agencies, which provide many opportunities for older adults to volunteer. Despite this, they remain an understudied population. Semi-structured qualitative interviews were conducted with twenty-one older adult volunteers (age 55+), and two paid volunteer staff in the Jewish community. Theoretical concepts including social capital, generativity, and the life course perspective on aging were used to guide interview questions. Data analysis revealed three themes related to cultural motivation to volunteer: 1.) A desire to support the current and future generations of the Jewish community, 2.) To satisfy the “Jewish ethic” of giving back, and 3.) Experiences of discrimination (anti-Semitism) over the life course. Participants frequently volunteered for organizations that supported the infrastructure of the Jewish community. Findings indicate how cultural experiences and values may influence the decision to volunteer and the types of volunteer roles taken on by older adults. Further, they suggest the ways in which cultural and religious generativity may be expressed through volunteerism, a previously unexplored concept.
INVESTIGATING WALNUT CONSUMPTION AND COGNITIVE HEALTH IN A REPRESENTATIVE SAMPLE OF OLDER U.S. ADULTS
Authors: Bishop Nicholas J , Zuniga Krystle E
Published: November 2019

Population aging increases the need to identify modifiable risk factors of cognitive decline such as nutritional intake. Several nutrients found in walnuts appear to play a neuro-protective role, yet few studies examine whole walnut consumption or draw from representative longitudinal samples. We draw observations from the nationally-representative Health and Retirement Study and Health Care and Nutrition Study to investigate the association between walnut consumption and cognitive trajectories among older US adults. The analytic sample consisted of 6,639 adults age 50 and over in 2013, representing a population of 77,726,682 community-dwelling older adults. Walnut consumption was a categorical measure representing no consumption, moderate consumption (< one serving per week), or high consumption (≥ one serving per week). Indicators of cognitive function representing working memory (immediate and delayed word recall) and global cognitive function (Telephone Interview of Cognitive Status, TICS) were measured at 3 time points (2012, 2014, and 2016). Latent growth models were used to estimate each linear trajectory while adjusting for covariates and complex survey design. Walnut consumption was positively associated with word recall and global mental status at baseline, but was not associated with change over the four year observational window. For example, those with high walnut consumption had baseline TICS scores .89 units greater (SE = .17, p < .001) than those consuming no walnuts. These results indicate that walnut consumption appears to have a positive association with cognitive health, but walnut consumption does not appear to be associated with short-term change in the cognitive outcomes measured.
MINDFULNESS AND COGNITIVE FUNCTION IN PATIENTS WITH COGNITIVE IMPAIRMENT
Authors: Tolea Magdalena I , Park Juyoung , Galvin James
Published: November 2019

Mental health benefits of mindfulness, the attribute of being aware and present in the moment, have long been acknowledged. Mindfulness has also been linked to improved cognitive performance and improvements in AD neuropathology (↓hippocampal atrophy, ↑brain connectivity) in MCI or early-stage AD patients. This study was designed to: investigate the relationship between mindfulness and cognitive function in a patient population with varying degrees of cognitive impairment; identify the specific mindfulness components that provide benefits; and explore differences by sex and disease severity. Patients (N=112; 43% female; 77.0±7.7yrs; 11% cognitively normal, 27% MCI, and 67% dementia) attending a university-based dementia clinic were administered the Applied Mindfulness Process Scale (AMPS) and underwent neuropsychological testing. Cognition was linearly regressed on AMPS with adjustment for age, gender, education, and disease stage, in the entire sample and stratified by sex and stage. In fully adjusted models, higher mindfulness was associated with lower AD8 scores (β=-0.05±0.02(p = 0.003)), better animal naming (AN)(β=0.11±0.04(p = 0.008)), and faster TMA times (β=-0.72±0.32(p=0.025)). All three mindfulness factors (F1=decentering; F2=positive emotional regulation; F3=negative emotional regulation) were significantly linked to AD8, while F3 was not predictive of AN, and F1 was not predictive of TMA. In addition, mindfulness significantly predicted subjective cognitive impairment (SCI)(βF2AD8=-0.18±0.07(p=0.011)) and TMA in men βTMA=-1.14±0.42(p=0.011); βF2TMA=-2.63±1.26(p=0.043); βF3TMA=-2.74±1.12(p=0.019) and dementia patients (βF1AD8=-0.19±0.08(p=0.021); βF2AD8=-0.14±0.07(p=0.044); βTMA=-0.09±0.51(p=0.039)); and AN in women ((βAN=0.12±0.06(p=0.047);βF2AN=0.34±0.16(p=0.036)) and MCI patients (βAN=0.13±0.06, p=0.033; βF3AN=0.36±0.16(p=0.035)). Our findings suggest that effectiveness of mindfulness-based interventions may be enhanced by a focus on emotional regulation and sex- and stage-specific cognitive targets.
SPOUSAL ASSOCIATIONS IN MONTHLY REPORTS OF DISABILITY IN THE PRECIPITATING EVENTS PROJECT
Authors: Monin Joan K , Laws Holly , Gahbauer Evelyne , Murphy Terrence E , Gill Thomas M
Published: November 2019

While many prior studies have evaluated the antecedents and consequences of changes in disability, few have considered the social context. As nearly 60% of older adults currently live with a spouse or intimate partner, it is important to examine spousal influences on disability. This study examined spousal associations in self-reported disability using data from the Precipitating Events Project, an ongoing longitudinal study of 754 initially nondisabled community living adults age 70 and over who have had monthly assessments of functional status since 1999. We hypothesized that one spouse’s level of disability would be associated with increases in the other spouse’s subsequent disability. We used the Actor Partner Interdependence Model (APIM), a statistical modeling framework that accounts for the interdependence in two-person data and tests the associations of both self (actor) and partner influences on outcomes. We used multilevel, longitudinal APIMs to examine lagged associations in spouses’ monthly reports of disability in 13 activities of daily living (e.g., walking a quarter mile, bathing) in the 37 married couples. As hypothesized, one partner’s prior disability level was significantly associated with the other partner’s (the actor’s) subsequent disability level (B = .674, SE = .012, p < .001) after controlling for the actor’s prior disability level. Also, when both couple members had higher levels of prior disability, they were particularly at risk of subsequent increases in disability (B = .016, SE = .003, p < .001). Incorporating partner disability level in modeling individuals’ outcomes provides greater precision in predicting future disability levels.
A SYSTEMATIC REVIEW ON CAREGIVING FOR ABUSIVE FAMILY MEMBERS
Authors: Zhang Qiyi
Published: November 2019

While elder abuse perpetrated by caregivers has raised significant attention in the past 30 years, the well being of and support for caregivers of abusive or previously abusive family members remains little known. This population is large in scope, but greatly neglected in the scientific investigation of elder abuse or domestic violence. This systematic review aims to summarize conceptual discussions and empirical findings from existing peer-reviewed articles to shed light on how to understand, identify, and provide support for this group. I performed a search using MEDLINE, PsycINFO, Cochrane, CINAHL, EMBASE, Ageline, and Social Work Abstract, and examined reference lists of identified articles in the stage of full-text screening. Targeted articles are written in English, peer-reviewed, published between 1989 to 2019, and contribute significant knowledge to the study aims. The search concluded with four conceptual articles and six empirical articles. This review reveals a change in approaches in understanding the living situation of maltreated caregivers: previously an indicator of poor caregiving relationship for predicting caregiving outcomes, now it is increasingly acknowledged as a vulnerable group in need of special attention and support. Empirical studies showed that a significant percentage of caregivers have a history of being abused, and they suffered from worse mental health and responded more poorly to certain coping mechanisms than caregivers without those experiences. Stress and self-esteem were found to be possible mediators. Competing conceptual frameworks on this issue include: 1) abuse versus interpersonal violence; 2) life course perspective; 3) communal model versus exchange model of caregiving.
EXPLORING RACIAL-ETHNICITY DIFFERENCES IN SERVICES USED BY GRANDPARENTS RAISING GRANDCHILDREN
Authors: Shovali Tamar E , Emerson Kerstin G
Published: November 2019

Nearly three million grandparents in the US serve as primary caregivers for their grandchildren. Little research on formal service use and grandfamilies exists for Black and Hispanic populations. To begin to address this gap we conducted exploratory analyses using nationally representative estimates of characteristics and service accessibility of noninstitutionalized children living with grandparents from the 2013 National Survey of Children in Nonparental Care. Our goal was to understand differences in service use as a function of grandfamily race/ethnicity. We specifically explored grandparents’ formal service count, financial services received, confidence in obtaining/using community services, and level of role preparation by race/ethnicity. We calculated descriptive statistics for these service variables for grandparents raising Hispanic, White, Black, and Other identified grandchildren (N = 892). On average, there was a minimal range for the number of formal services used (M range = 5.26 – 5.84, possible = 0 – 10 higher equals more services used), reported number of financial services (M range = 0.71 - 0.78, possible = 0 – 3 higher equals more financial services received), and confidence obtaining/using services (M range = 7.4—7.9, possible = 1 – 9 higher equal more confidence). Most prepared to take on the caregiving role were grandparents of White children (55%) followed by Black (21.6%), Other (12.3%), and Hispanic (11.1%) indicating that although grandparents in this sample report being confident and able to access formal services, grandparents of White children report being feeling more prepared to take on caregiving than grandparents of Black, Hispanic, and Other combined.
IMPLEMENTING A NEW MODEL IN PRIMARY CARE FOR OLDER CANADIANS LIVING WITH FRAILTY
Authors: Elliott Jacobi B , Gould Joanie Sims , Gregg Susie , Tong Catherine , Stolee Paul
Published: November 2019

Primary care may be the best place within the health system to coordinate care for older persons, but at present, it is poorly equipped to do so. Effective models for complex patients require appropriate targeting, patient/caregiver engagement, and care coordination. A large national project aims to co-design and implement a model in primary care that includes risk-stratification, patient engagement and care coordination techniques for older adults. This presentation focuses on the process of implementation in primary care. Grounded in the Consolidated Framework for Implementation Research, researchers worked with nine primary care sites in three Canadian provinces. Project implementation was completed in two phases. Pre-implementation: Interviews with providers (n=25) and older adults (n=8) were conducted to understand current practices and plan for implementation. Implementation: Researchers worked with sites to train staff and support implementation. Monitoring of the implementation process included Interviews with providers (n=20) and field notes. Data were analyzed using directed coding, following the framework. A number of learnings emerged: buy-in was required from the entire team, teams provided meaningful information to guide implementation, contributing to a sense of ownership, and it was important that intervention components were tailored to the needs at each site. Ongoing and frequent discussions with the team was necessary. Scheduling meetings and training sessions for providers was challenging due to the length of time away from direct patient care. A new primary care model for older adults living with frailty was implemented. Lessons from this project will be used to guide future implementation and spread.
MEDICARE IS THE LAST HOLDOUT: EXAMINING THE IMPACT OF MEDICARE POLICY ON OLDER ADULTS’ ACCESS TO MENTAL HEALTH CARE
Authors: Fullen Matthew C , Wiley Jonathan , Morgan Amy , Lawson Gerard , Sharma Jyotsana
Published: November 2019

Medicare is the primary insurance provider for approximately 59 million Americans, and the number of beneficiaries is expected to surpass 80 million by 2030. Currently, Medicare regulations allow psychiatrists, psychologists, clinical social workers, and psychiatric nurses to provide mental health services. These providers were last updated in 1989 with passage of the Omnibus Budget Reconciliation Act of 1989. Since that time, the mental health marketplace has changed dramatically, and Medicare beneficiaries are unable to access care from approximately 200,000 graduate-level mental health professionals with similar training to eligible Medicare providers. There is evidence that this Medicare mental health coverage gap (MMHCG) impacts both providers and beneficiaries. For example, some beneficiaries may begin treatment only to have services interrupted, or stopped altogether, once the provider is no longer able to be reimbursed by Medicare. We surveyed 6,550 members of the American Counseling Association, including 3,815 who identified themselves as practicing counselors. These individuals work in diverse contexts (e.g., community mental health agencies, private practice, and integrated care settings). Survey results indicated that a significant number of practicing counselors turn away or refer Medicare beneficiaries who seek mental health care due to the MMHCG. In-depth interviews were also completed with eight licensed mental health professionals who detailed the challenges they and their clients experienced. Participants perceived a discrepancy between Medicare’s intended aims to promote health and provider restrictions that were confusing and frustrating to navigate. Participants concluded that the MMHCG has a negative impact on older adult clients.
MEASUREMENT EQUIVALENCE OF THE POSITIVE AND NEGATIVE AFFECT SCHEDULE BETWEEN YOUNG-MIDDLE-AGED AND OLDER ADULTS
Authors: Lee Jeongwoo , Shon En-Jung
Published: November 2019

A Short form of the Positive and Negative Affect Schedule (PANAS-SF) has been widely used to measure of affect in diverse cultural groups. Limited studies have been evaluated the measurement equivalence test of PANAS-SF in diverse age groups. This study examined whether parameters in the measurement model (two-factor model: positive and negative affect) is equivalent across the two age generations (young-middle aged: <65 years [n=1,122]; older adults : ≥65 years [n=1,817]). The sample was obtained from the 2012 Health and Retirement Study and Multiple Group Analysis was performed. The five items of determined, enthusiastic, inspired, alert, and excited reflected positive affect; and the five items of afraid, upset, scared, nervous, and distressed reflected negative affect. The configural model reported acceptable fit (X2= 904.98 [df = 64, p < .001], X 2/df =14.14, CFI =.93, GFI=.94, RMSEA=.06 [90% CI=.06 - .07]). When all factor loadings were constrained, it indicated measurement non-invariance status between young-middle aged and older adults (ΔX 2 = 56.03, Δdf = 8, p< .001, CFI=.93, ΔCFI=.004). Given findings of non-invariance on the full constrained model, the invariance test of each factor loading was performed additionally. Majority of negative items (Afraid, upset, scared, and nervous) and several positive items (determined and excited) were nonequivalent between the two groups. Variances in the measure between two age groups raise a number of issues for future research on affect assessment, suggesting cautious using of PANAS-SF in older adults.
RESILIENCE AND POST-TRAUMATIC GROWTH: EXPLORING THE PERCEPTIONS OF GAINS AFTER ADVERSITY IN OLDER ADULTS
Authors: Bouchard Lauren M , Manning Lydia K
Published: November 2019

Resilience has been consistently shown across the literature as a protective factor in terms of aging successfully. Resilience is defined as a process of adjustment and adaptation, where painful life experiences can result in accumulative positive outcomes such as greater life meaning, hopefulness, and spiritual transcendence (Ramsey, 2012). These outcomes are also mentioned in the separate but related construct of “post-traumatic growth,” defined as positive outcomes (i.e. self-perception, improved interpersonal relationships, and a changed philosophy on life) which emerge after traumatic experiences (PTG; Tedschi & Calhoun, 1996). This study explored older adults perceptions on adaptation in regards to adverse life situations. Our findings indicate some participants were more likely to espouse resiliency and post-traumatic growth related explanations while others participants articulated difficulty in seeing the benefit related to the challenges they had faced. Similarly, participants faced a range of challenges from everyday stress to major life traumas, which also shaped perceptions of their own growth. Participants also indicated a range of orientations toward growth after adversity including denial, reluctance, acceptance, and optimism. Our results also suggest key differences in these constructs while they also remain similar and complementary in terms of our participants lives and stories. Our study also provides limitations and future directions in operationalizing PTG and resilience in the gerontological literature.
IS COMBINED TRAINING MORE EFFECTIVE THAN SINGLE-DOMAIN TRAINING: A RANDOMIZED CONTROLLED TRIAL WITH OLDER ADULTS
Authors: Ballesteros Soledad , Rieker Jennifer , Reales josé M , Mayas julia , Jiménez María Pilar , Prieto Antonio , Toril Pilar
Published: November 2019

Previous research suggests that both cognitive training and physical exercise help to maintain brain health and cognitive functions that decline with age. The main objectives of this four-arms RCT are (1) to investigate the synergetic effects of a group-based multidomain training program that combines cognitive video-game training with physical exercise, in comparison to those produced by cognitive training combined with physical control activity, physical training combined with cognitive control activity, or a combination of both control activities; (2) to investigate in a memory-based task switching task whether event Related Potential (ERP) latencies of the P2 component are shorter, and N2 and P3b components are enhanced after training; and (3) to find out whether possible enhancements persist after a 3-month period without training. One hundred and twenty participants will be randomly assigned to one of the four combinations of cognitive training and physical exercise. The cognitive component will be either video-game training (cognitive intervention, CI) or video games not specifically designed to train cognition (cognitive control, CC). The physical exercise component will either emphasize endurance, strength, and music-movement coordination (exercise intervention, EI) or stretching, toning and relaxation (exercise control, EC). This RCT will investigate the short and long-term effects of combined multi-domain training compared to cognitive training and physical training alone, on executive control and memory functions of healthy older adults, in comparison with the performance of an active control group. This trial is an ongoing project started in 2018. Trial registration: Clinicaltrials.gov ID: NCT03823183; https://register.clinicaltrials.gov/
COMPASSION-BASED ENVIRONMENTAL VOLUNTEERISM AMONG OLDER ADULTS: A CASE STUDY OF TZU CHI RECYLING PROGRAM
Authors: Hsiao Hsinyi , Hsu Chiu-Tien , Chen Lei , Wu Jinli , Chang Pao-Sheng , Lin Chin-Lon , Lin Miing-Nan , Lin Tin-Kwang
Published: November 2019

To promote environmental sustainability and mitigate climate change that causes numerous families to suffer from natural disasters, a group of older residents’ volunteer to recycle usable materials by setting up recycling stations in their communities and transform recycled bottles into eco-friendly blankets for disaster survivors globally. This study examined long-term effects of the peer-led Tzu Chi Recycling Program (TCRP) on older adults’ compassion, psychological and physiological well-being. Using a quasi-experimental design, 1-year longitudinal data were collected from older adults at recycling stations (intervention group n = 36) and community centers (control group n = 36) in rural areas in Southern Taiwan. Findings from two-way repeated analysis of variance show that TCRP significantly improved older adults’ self-compassion, compassion for others, depression, hostility, happiness, and hypertension. Older adults built resilience through environmental volunteering in the TCRP as an environmental sustainability model for health promotion and social good
EPIGENETIC CLOCKS OF COMPUTED TOMOGRAPHY MEASURES OF FATTY ORGANS
Authors: Lu Ake T , Horvath Steve
Published: November 2019

DNA methylation (DNAm) based biomarkers collectively known as “epigenetic clock” yielding accurate measure of age in any tissue across the entire life course have associated with a large host of age-related conditions. To study their implications in metabolic syndromes, we analyzed computed tomography (CT) derived measures of adiposity with 1) three widely-used clocks: Horvath, Hannum, and Levine (PhenoAge), and a newly developed clock DNAmGrimAge, and 2) seven DNAm based plasma proteins, the components comprising the DNAmGrimAge. Age-adjusted DNAmGrimAge and several age-adjusted DNAm plasma proteins including plasminogen activation inhibitor 1 (PAI-1) stand our followed by adrenomedullin and leptin. Fatty liver (r ≤ 0.41, P ≤ 2.9E-37) and excess visceral adipose tissue fat (r ≤0.42, P ≤ 1.5E-41) are the most significant CT-based measures of DNAmPAI-1 and DNAmGrimAge. Furthermore, age-adjusted DNAmGrimAge and age-adjusted DNAmPAI-1 continued showing the most significant relationship with lifestyle factors including healthy diet and educational attainment in expected directions.
DETECTION OF ELDER ABUSE BY FAMILY PHYSICIANS IN MONGOLIA: AN EXPLORATORY STUDY
Authors: Bagaajav Ariunsanaa
Published: November 2019

Elder abuse (EA) is a significant global social problem that jeopardizes the health and wellbeing of older adults around the world. Health providers can play a pivotal role in detection of EA and accessing resources and interventions. In Mongolia, where elder abuse is not widely recognized, family physicians (FPs) are particularly critical, providing frequent contact and home visits free of charge to community-dwelling older adults. However, little is known about FP knowledge and engagement with potential victims of EA. We interviewed 12 FPs from Ulaanbaatar participated via Skype about their knowledge of and responses to EA, using Grounded Theory data collection and analysis. All respondents reported encountering at least one case of EA in practice, and described the creative strategies they used to engage older patients, detect abuse, and prevent further harm. We present significant implications for guidelines for identification and prevention of EA in primary health care.
MEASURING NETWORK WELL-BEING AND HEALTH AMONG PEOPLE LIVING WITH DEMENTIA: A MIXED-METHODS STUDY
Authors: McConnell Eleanor S , Wei Sijia , Kang Bada , Woog Samantha , Wright-Freeman Kayla , Corazzini Kirsten N
Published: November 2019

The feasibility and utility of measuring social networks of people living with mild to moderate stage dementia to improve care quality was examined by comparing information obtained using Antonucci’s social network mapping approach and through information elicited through a series of open-ended questions regarding life story and well-being. Data were obtained from 24 interviews with 12 people belonging to one or more networks of people living with dementia receiving care in adult day programs. Concurrently we obtained measures of health and well-being using validated symptom checklists and the ICE-CAP suite of well-being measures. Parallel interviews were conducted with social network members who were in a care partner role, either paid or unpaid. Respondents were able to map social networks, and preferred open-ended questions to more standardized measures of quality of life and well-being. Findings from both sources were generally convergent, with open-ended questions providing richer information to guide care.
LONG-TERM EFFECTS OF MINDFULNESS ON URGE URINARY INCONTINENCE IN OLDER ADULT WOMEN: ANALYZING RCT RESULTS AT 6 MONTHS
Authors: Felsted Katarina Friberg
Published: November 2019

Urge urinary incontinence is a condition estimated to cost $82 billion by 2020. Innovative treatments are needed, particularly in the older adult population. A prior combined feasibility study and randomized controlled trial examined six feasibility determinants and five preliminary efficacy outcomes of treating urge urinary incontinence in older adult women (N=25; average age=74 years) utilizing an 8-week mindfulness-based stress reduction (MBSR) intervention compared with the health enhancement program (HEP), which is an active comparison modality specifically validated to be used alongside MBSR in scientific research. Feasibility and preliminary efficacy results were reported at GSA in 2018. This 2019 presentation relays the preliminary efficacy results at 6-month follow up. Outcomes include symptom severity, symptom bother, perceived stress, perceived self-efficacy, and rate and trajectory of change. Future research is needed in the form of a multi-site trial to provide a larger sample with greater diversity.
CAPTURING IMPACT ON STUDENTS PARTICIPATING IN AGING IN PLACE: A PROGRAM TO ENHANCE GERIATRIC EDUCATION
Authors: Smilowitz Stephen T , O’Toole Elizabeth , Morris Diana L , Fennimore Todd , Booth-Lord Cynthia , Smilovich-Fine Elizabeth , Rosenberg David M , Thomas Patricia A
Published: November 2019

Curricula to enhance healthcare students’ geriatric training has been lacking. Therefore, we developed AIP, an interprofessional (IP) community-based curriculum, in which IP student teams visit community-dwelling older adults. Using established instruments did not capture personal and professional changes experienced by students. Thus, an additional method using qualitative analyses of students’ six post-visit reflections over 15 weeks was employed to evaluate students ‘experiential learning. A grounded theory approach was used to describe students’ growth in geriatric proficiencies related to participation in the January-April 2017 AIP program . By program completion, 21 students had submitted 111 reflective essays. An interdisciplinary panel reviewed a sample of reflections and developed an initial coding system, which was then systematically applied to the whole via QSR-NVivo. Seventy-three distinct codes across 111 student essays generated 2515 occurrences. Prevalent themes, revealed by frequency analysis, and themes with remarkable trendlines yielded fifteen central themes. Students became attuned to their client’s life-world (n=185) as demonstrated by four central themes: 1) isolation, loneliness, and depression (n=44); 2) risks of fall (n=19); 3) loss of function/control (n=98); and, 4) importance of socializing in care (n=24). This attunement informed interactional intentionality (n=284), which shaped interactions with their client (n=207). From these authentic encounters, students described learning about 1) myself; 2) current and future practice; 3) team dynamics; and 4) my client as an older person. Systematic analysis of student reflections revealed student growth attributable to AIP. This evaluation approach should be further assessed in geriatric curricula.